A Massachusetts courtroom has become the unlikely focal point of a national conversation about postpartum psychosis, as Lindsay Clancy stands trial for the murders of her three young children. The defendant has pleaded not guilty to three counts of first-degree murder, with her defence team arguing she was experiencing a severe and rare mental illness when the tragedy unfolded in 2023.
While the jury’s determination of Clancy’s mental state may ultimately decide her fate, women who have lived through postpartum psychosis say the spotlight on this case could finally drag the condition out of the shadows. They are calling for better support systems, more research funding and improved medical training to identify the illness before catastrophe strikes.
Despite its severity, postpartum psychosis remains poorly understood, with significant gaps in research, diagnosis and treatment. Experts insist that far more could be done to help affected women.
Understanding the Illness
Postpartum psychosis is a mood disorder with psychotic features, explains Dr Soudabeh Givrad, a clinical associate professor of psychiatry and behavioural sciences at Stanford Medicine. Those affected may experience hallucinations, delusions, confusion, deep depression, insomnia and a turbulent mixture of low and manic moods. The condition carries an alarming risk of suicide and infanticide.
Symptoms typically emerge within two weeks of giving birth, though the NHS notes they can sometimes appear later. The fluctuating nature of the illness can make it notoriously difficult to identify during the brief windows patients share with healthcare providers.
It is, thankfully, rare — affecting roughly one to two women per 1,000 births — but it is classified as a psychiatric emergency. “Each case I have been part of treating has shown just how incredibly devastating postpartum psychosis can be,” says Crystal Schiller, a clinical psychologist and director of the University of North Carolina at Chapel Hill Centre for Women’s Mood Disorders. “Women deserve better access to care, and they deserve experts who really understand what’s going on.”
Causes and Risk Factors
The precise cause of postpartum psychosis remains elusive, though experts believe it arises from a collision of biological vulnerability and external triggers. The dramatic hormonal shifts, sleep deprivation and immune system changes that accompany pregnancy can all play a role.
A family history of postpartum psychosis or bipolar disorder is a known risk factor. A 2026 paper in Biological Psychiatry suggests postpartum psychosis should be considered a distinct illness within the bipolar spectrum, and there is genuine overlap in treatments. Yet, crucially, around 40% of cases have no identifiable risk factors at all.
Treatment and Recovery
Postpartum psychosis demands urgent intervention. Early signs like sleep deprivation, irritability and racing thoughts can rapidly escalate into full-blown hallucinations and beliefs detached from reality. Treatment may involve antipsychotics, antidepressants, mood stabilisers such as lithium, or electroconvulsive therapy.
“The majority of cases can be very treatable,” Givrad says. “We have lots of women who have postpartum psychosis and then go on to live normal lives.” However, research into the condition has been chronically underfunded — a casualty, Schiller argues, of historic neglect in women’s health and a tendency to channel limited resources toward more common conditions like postnatal depression.
Recovery times vary. Severe symptoms may linger for two to 12 weeks, though many patients go on to recover fully. A 2021 study of 106 women found that more than two-thirds experienced no major psychiatric episodes outside the postpartum period. Cognitive behavioural therapy can also play a vital role in longer-term recovery.
Prevention and the Push for Better Care
For women known to be at higher risk, preconception counselling can be transformative. Some clinicians begin patients on antipsychotics or mood stabilisers late in the third trimester or at delivery, carefully balancing medication against any plans for breastfeeding. But stigma and systemic barriers continue to deter women from seeking help.
“Many women are afraid they’ll be referred to law enforcement or their children will be taken away if they disclose anything,” Schiller says. That fear is compounded by a stark absence of screening tools. Unlike depression, there is no standardised checklist for postpartum psychosis — meaning detection often falls to alert paediatricians during early baby checks, or to observant family members.
The structural gap is glaring. In the US, the standard six-week postnatal check-up falls well after the period of highest risk. The UK fares somewhat better, offering specialist mother-and-baby psychiatric units that allow women to be treated alongside their infants. The US has only a handful of comparable programmes — UNC runs a five-bed unit that draws patients from across the country.
Experts are also campaigning for postpartum psychosis to receive its own distinct classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Inclusion would unlock funding, sharpen diagnostic criteria and ensure women receive the cover they need from insurers.
Why it Matters
The Lindsay Clancy trial has done what years of medical advocacy alone could not: it has placed postpartum psychosis squarely in the public eye. For the thousands of women who experience this terrifying illness each year, awareness is not a luxury — it is a lifeline. Without systemic change, from better screening and more specialist units to formal recognition in psychiatric manuals, families will continue to fall through the cracks. The tragedy in Massachusetts is a brutal reminder that postpartum psychosis is a medical emergency, not a moral failing, and that the women suffering from it deserve nothing less than the highest standard of compassionate, expert care.
