Postpartum psychosis is unusual among psychiatric emergencies in that the illness argues against its own recognition. Its opening symptom is energy — euphoria, sleeplessness, plans, the feeling of being unusually and finally good at everything — and the perinatal system that surrounds a new mother is calibrated almost entirely to the opposite signal. Erica Schwiegershausen, a senior writer at The Cut who was hospitalized with the condition after her daughter was born in 2020, makes that case by holding the Lindsay Clancy case next to her own care rather than at arm’s length from it.
Her episode began the way Clancy’s did. After bringing her daughter home in October 2020 she was euphoric, sleeping little, dressing the baby in endless outfits, drafting a plan for a parenting website at five in the morning and emailing her boss about a job title she had not been given. Her own description is the most useful line in the piece: “I felt as if all my best qualities had been turned up.” Her husband and closest friends read it immediately; the clinicians did not. She convinced more than one doctor she was merely sleep-deprived. Her OB missed it. A therapist she spent an hour with — while explaining that her husband kept saying she was manic — scheduled her for the following week.
The system sees depression
Postpartum psychosis affects roughly one or two women in a thousand births. It is most common in women with bipolar disorder but can occur with no prior psychiatric history, and it is not recognized as a distinct diagnosis in the DSM, which helps explain how often it is missed. What the piece shows is that the miss is structural rather than merely careless. Screening for new mothers is organized around depression: the questionnaires, the warning-signs class, the Edinburgh scale. Mania is not on the form. When Schwiegershausen gave birth to her second daughter in 2023, she knew what she needed and asked to see a psychiatrist; the hospital was reluctant to prescribe lithium, the drug that had stabilized her before, because she wasn’t “running around naked.” The new-parent class covered safe sleep and postpartum depression. Nobody mentioned that a mother having far too much energy could also be a warning sign.
Her account of being treated is also a candid account of coercion. Taken to the ER by her husband, she was held against her will — “they wouldn’t tell me when I would be able to see my baby” — sedated with Ativan, started on antipsychotics, and openly hostile to the psychiatrist assigned to her. She says the hospital stay was more traumatic than the illness. Then she adds the sentence that complicates the standard objection: “if I had been in charge of my own care while in the throes of postpartum psychosis, I would not have gotten better.” What finally worked was a partial-hospitalization program for perinatal mood disorders at Women & Infants in Rhode Island, one of the few places where mothers are not separated from their babies — and months of therapy and medication cycling after that.
What the trial showed
Against that, the piece assembles what is publicly known about Clancy, who killed her three children in January 2023 and whose trial ended in a mistrial this month after a week of deadlock. Clancy has sued the doctors who oversaw her treatment, alleging they failed to diagnose and treat symptoms despite repeated efforts to get help. According to the suit, she described herself at intake in December 2022 as “numb and crazy depressed” and scored 23 on the Edinburgh scale — severe depression — but the evaluating doctor concluded she had neither postpartum depression nor bipolar disorder, told her to stop taking Seroquel, and sent her home. In the months before the killings she was prescribed more than a dozen medications, many of which she said made things worse. A nurse practitioner testified that she raised a possible bipolar diagnosis and that Clancy’s husband rejected it. The psychiatrist she saw by telehealth the day before the killings testified that she saw no indication of danger. Two suicide-hotline calls were assessed as non-emergencies because she had no plan. Prosecutors argued that she lied about her symptoms and manipulated her care; the forensic psychologist who examined her afterward diagnosed bipolar disorder with postpartum psychosis and described a woman with no appreciation of the wrongfulness of her act, while another expert testified that she was in a dreamlike state, “like she was a puppet.” She has been held on suicide watch at Tewksbury Hospital for three years; a suicide attempt left her paralyzed from a spinal-cord injury. Her son would have turned seven this month.
The two stories are not the same story, and the piece is careful not to pretend otherwise — Clancy’s culpability is unresolved, and the allegations against her clinicians are allegations. What they share is a diagnostic environment. Postpartum psychosis is legible to forensic examiners after the fact and apparently illegible to the ordinary perinatal system beforehand, which is a way of saying that the failure is prospective: the apparatus exists, it is simply pointed at the wrong symptom, and the women it misses are the ones whose mania reads as coping.
Read the full story at The Cut.