Postpartum psychosis gains attention as Lindsay Clancy trial highlights need for DSM inclusion
The trial of Lindsay Clancy, who pleaded not guilty to killing her three children, has sparked renewed focus on postpartum psychosis and calls for its formal recognition in psychiatric diagnostic manuals.
The ongoing trial of Lindsay Clancy, who admitted to killing her three children but maintains a not-guilty plea, has brought postpartum psychosis into the public eye. Prosecutors argue the killings were premeditated, while the defence contends that Clancy was experiencing a severe psychiatric emergency known as postpartum psychosis at the time.
Clinical and forensic psychologist Paul Zeizel testified that Clarity was unable to conform her behavior to the law and lacked appreciation for the wrongfulness of her act. Experts explained that postpartum psychosis can involve mania, depression, hallucinations and delusions, and in rare cases may lead to harm toward self or others.
Forensic psychiatry professor Susan Hatters-Friedman described the condition as a delirium-like state with irritability, mood swings and insomnia, noting that “psychosis … means the person is out of touch with reality, often including hallucinations and fixed false beliefs.”
Reproductive psychiatry specialist Jennifer Payne said a woman can appear fine one moment and become seriously ill shortly thereafter. The cause of postpartum psychosis remains unclear, though hormonal changes, stress after birth and prior mental-health issues are suspected contributors.
A key issue highlighted by experts is the illness’s absence from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Psychiatrist Veerle Bergink, director of the Mount Sinai Women’s Mental Health Center, argued that without formal classification the disorder is omitted from medical curricula, research funding and insurance coding, effectively erasing it from clinical practice.
"You can only investigate and talk about the disease if you give the disease a name, and if it has criteria," Bergink said.
Treatment options such as lithium, electroconvulsive therapy and antipsychotic medications were discussed, with lithium commonly used to prevent relapse. Studies indicate that women with postpartum psychosis harm or kill a child in only 1% to 4% of cases.
The trial has prompted calls for a systematic approach to maternal mental health, including proactive support and education for parents about potential postpartum complications.