Lindsay Clancy Trial Postpartum Psychosis Postpartum Depression

According to testimony in the case, Clancy had taken medication for mental health problems after Callan’s birth and had sought help from several mental health professionals. Prosecutors, meanwhile, have pointed to descriptions of the incident as evidence of “deliberate premeditation, extreme atrocity or cruelty, and the state of mind of the defendant,” according to a CNN report. The trial has therefore placed a complex medical condition alongside difficult questions about responsibility and severe mental illness.

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Postpartum psychosis is among the rarest and most serious psychiatric disorders associated with childbirth. The report also mentions that mental health problems are among the most common complications associated with pregnancy and parenting, affecting as many as one in five women in the US during pregnancy and the year after birth.

Understanding postpartum psychosis is important not only because of its potential severity but also because early recognition and treatment can make a significant difference. Experts explain how the condition differs from postpartum depression and other post-birth mental health problems, who may be at risk, and what families should watch for.

Dr Jagadish Hiremath, a Public Health Intellectual, tells indianexpress.com, “Postpartum psychosis is a rare but severe psychiatric condition in which a woman loses contact with reality, typically developing symptoms such as hallucinations, delusions, paranoia, severe confusion or marked changes in mood and behaviour. It is estimated to occur in around 1 to 3 women per 1,000 births.”

Neha Cadabam, Senior Psychologist and Executive Director, Cadabam’s Hospitals, adds, “The exact cause is not fully understood, but postpartum psychosis appears to involve a complex interaction of biological vulnerability, rapid hormonal changes, sleep disruption and underlying psychiatric risk. Women with a personal or family history of bipolar disorder or psychosis, or a previous episode of postpartum psychosis, are particularly vulnerable. However, it is important not to assume that the absence of a psychiatric history means someone is not at risk. It can occur unexpectedly after childbirth.”

This is very different from baby blues, Dr Hiremath notes, which are common, mild mood changes that usually peak within the first few days after delivery and resolve within about two weeks. “Postpartum depression and anxiety can cause persistent sadness, excessive worry, guilt, fatigue and difficulty functioning, but the person generally remains in touch with reality. In postpartum psychosis, that connection with reality can be significantly impaired,” he stresses.

The early warning signs can sometimes look like extreme exhaustion or an unusually intense emotional reaction to childbirth, Cadabam says, so families need to pay attention to sudden and significant changes in behaviour. “A woman may go for prolonged periods with little or no sleep, become unusually agitated or energised, speak rapidly, behave in a disorganised manner, or appear markedly confused. She may hear or see things that are not there, develop fixed beliefs that others cannot share, become intensely suspicious, or believe that the baby or family members are in danger. There may also be abrupt shifts between manic, depressive and confused states. Importantly, she may genuinely believe these experiences are real and may not recognise that she is unwell.”

From a medical perspective, Dr Hiremath says that severe or rapidly worsening insomnia “is an important warning sign, particularly when it occurs alongside confusion, unusual behaviour or changes in perception.” He suggests that families should not dismiss these changes as simply being part of new motherhood. Postpartum psychosis commonly has a sudden onset, often within the first few weeks after delivery, and the situation can deteriorate quickly. A new mother who suddenly seems disconnected from reality needs an urgent psychiatric assessment rather than routine postpartum reassurance.

“Postpartum psychosis is considered a psychiatric emergency because impaired judgement and loss of contact with reality can place both the mother and baby at immediate risk,” says Dr Hiremath, adding that treatment generally requires urgent psychiatric intervention and often hospitalisation, with medication used to control psychotic and mood symptoms. “The exact treatment plan depends on the clinical presentation and may involve antipsychotic medication and, where appropriate, mood-stabilising treatment. Early intervention is critical because psychosis can escalate rapidly, but recovery is possible with appropriate treatment.d or unreported cases.”