Beyond the Breaking News: What Postpartum Psychosis Actually Is
If you have been anywhere near the news lately, you have likely seen headlines about the Lindsay Clancy trial. A mother. Three children. A tragedy that has shaken the country and reopened painful conversations about postpartum mental illness.
I want to be honest with you: this is heavy content, and I am writing about it carefully. My hope is not to sensationalize this case or speculate about what happened in that home. My hope is to use this moment, one that has so many people talking, searching, and worrying, to offer real psychoeducation about postpartum psychosis, to validate what so many pregnant and postpartum people are quietly feeling right now, and to gently push back against some of the fear-based messaging circulating online.
PMADs Are Bigger Than Postpartum Depression
When most of us hear "postpartum," we think of postpartum depression. But Perinatal Mood and Anxiety Disorders, or PMADs, describe an entire spectrum of conditions that can emerge any time during pregnancy through the first year after birth. This spectrum includes perinatal depression, anxiety, panic disorder, OCD, PTSD, bipolar disorder, and psychosis, since these conditions can happen both during pregnancy and postpartum, not only after birth.
Each of these conditions looks different. Each deserves its own understanding, its own language, and its own care. Collapsing all perinatal mental health struggles into a single label does a disservice to the many parents whose experiences do not fit neatly into that box, and it can leave the most serious of these conditions, postpartum psychosis, dangerously misunderstood.
It also helps to understand how PMADs differ from the baby blues. The baby blues are extremely common, affecting the majority of new parents, and typically involve tearfulness, mood swings, and mild overwhelm in the first one to two weeks after birth. They tend to resolve on their own without treatment. PMADs are different. They last longer than two weeks, tend to intensify rather than ease, and interfere more significantly with a parent's ability to function, bond, or feel like themselves. If symptoms persist beyond two weeks or feel like they are getting worse, it is time to reach out for support rather than wait it out. If you want to go deeper on this distinction, I unpack it further in Is This Baby Blues or Something Deeper? Understanding PMADs.
Postpartum Psychosis Symptoms and Warning Signs
Postpartum psychosis is a serious psychiatric emergency, and it is a completely different condition from postpartum depression. It typically emerges suddenly, often within the first two weeks after birth, and unlike postpartum depression or anxiety, which tend to build gradually, postpartum psychosis tends to come on fast and can shift dramatically within hours.
One important thing many people do not realize is that postpartum psychosis often waxes and wanes. A parent may seem lucid, articulate, and even calm one moment, then become confused, paranoid, or disconnected from reality the next. This fluctuation can make the condition especially dangerous, because a person may appear "fine" to a loved one, a provider, or even themselves in between episodes, which can delay the recognition and treatment that is so urgently needed. If something feels off, even intermittently, it is worth taking seriously.
Warning signs to take seriously include:
Confusion or disorientation, losing track of time, place, or what is happening
Delusions, or fixed false beliefs that do not respond to reassurance or evidence
Hallucinations, seeing or hearing things that are not there
Rapid mood swings, sometimes cycling between elation, agitation, and despair
Paranoia or suspicion toward loved ones, including a partner or care providers
Severe insomnia, an inability to sleep even when exhausted or when the baby is sleeping
Disorganized thinking or behavior that feels out of character
Thoughts of harming the baby or oneself that feel urgent, commanding, or paired with a loss of touch with reality
If you notice these signs in yourself or someone you love, this is not something to wait out. Postpartum psychosis is a medical emergency, and immediate evaluation, often through an emergency room or a psychiatric crisis service, can be lifesaving.
It is also worth understanding who may be more vulnerable to postpartum psychosis. A personal or family history of bipolar disorder is one of the strongest known risk factors, along with a prior episode of postpartum psychosis, sleep deprivation, and stopping psychiatric medication abruptly during pregnancy or postpartum. I want to be clear about something important here: a risk factor is not a determining factor. Risk factors simply tell us who may benefit from closer monitoring and earlier support, particularly in those first days and weeks after birth.
Here is what I want you to hold onto above all else: postpartum psychosis is treatable. With the right combination of medication, often including mood stabilizers and/or antipsychotics, along with therapy and a strong support system, full recovery is possible. In my own clinical work, I have treated and witnessed that recovery firsthand. This is not a hopeless diagnosis. It is a medical emergency that responds to care.
Intrusive Thoughts Are Not the Same as Hallucinations
This is one of the most important and most misunderstood distinctions in perinatal mental health, and I think it is at the heart of a lot of the fear circulating right now.
Intrusive thoughts are common. Research suggests the majority of new parents experience them at some point. They are unwanted, distressing, often violent or disturbing thoughts that pop into a parent's mind, "What if I dropped the baby down the stairs," "What if something happened while I was driving." The defining feature of an intrusive thought is that the parent is horrified by it. They know it is not something they want to happen. They may avoid stairs, knives, or bathtubs out of fear of the thought itself, not because they intend to act. This kind of thought is a hallmark of postpartum anxiety and postpartum OCD, and it is treatable and does not mean someone is dangerous.
Hallucinations and delusions, on the other hand, involve a break from reality. A parent experiencing psychosis may believe something is true that is not, for example, that their baby is possessed, that they need to save their child from some imagined threat, or that voices are instructing them to act. Unlike intrusive thoughts, these experiences are not recognized by the person as irrational in the moment. That loss of insight is what makes postpartum psychosis so dangerous, and it is also what separates it entirely from the anxious, unwanted thoughts that so many loving, safe parents quietly carry and never act on.
Understanding this difference matters. When we lump intrusive thoughts and psychosis together, we terrify parents who are already struggling, and we discourage the very disclosure that keeps everyone safe.
Navigating the Noise Right Now
High-profile cases like this one tend to pull public conversation in a lot of different directions at once, some compassionate, some judgmental, some oversimplified. It is easy to lose the nuance in the noise. What is actually true is that severe mental illness and profound tragedy can coexist, and that holding compassion for a suffering parent does not require erasing the loss of the children involved.
A few things I would gently offer as you navigate the headlines and the comment sections:
Be cautious of anyone, including yourself, diagnosing from a distance. Postpartum psychosis is a clinical diagnosis made by trained professionals, not a label to assign based on news coverage.
Notice if the messaging you are consuming is increasing your fear about your own intrusive thoughts. If so, it may be time to step away from the headlines and toward a professional who can help you sort through what you are actually experiencing.
Remember that awareness and stigma reduction can exist alongside accountability. This is not a binary.
If this moment has stirred something in you and you want to channel it into something productive, there are meaningful ways to advocate beyond social media commentary. You might share accurate resources like the National Maternal Mental Health Hotline with parents in your life, support organizations like Postpartum Support International, encourage your own OB or pediatric providers to screen for PMADs at every visit, or simply check in on a new parent you know instead of assuming they are fine. Awareness does not have to be loud to be meaningful.
Take a Parent's Cry for Help Seriously
If a pregnant or postpartum parent tells you they are not okay, believe them. If they tell you they feel disconnected from reality, are hearing or seeing things, or are terrified of their own mind, that is not the moment for reassurance alone. That is the moment for action: a trip to the emergency room or a call to a crisis line.
So many of these cases involve a parent who tried to reach out and was not heard, was told they were just tired, or minimized their own symptoms out of shame or fear of being seen as an unfit parent. Many of us have been taught to push through, to not complain, to be grateful and strong no matter what. That conditioning can be dangerous in the perinatal period, when timely intervention genuinely saves lives.
You do not need to have the perfect words. You do not need to know exactly what is happening. You simply need to take the cry for help seriously and get that parent connected to care immediately.
Affirmations for Perinatal Mental Health
Affirmation: My mental health struggles do not define my worth as a parent.
Affirmation: Asking for help is an act of love for my family and myself.
Affirmation: I can be a good parent and still need support.
Affirmation: My intrusive thoughts are not a reflection of who I am.
Dialectical Statements to Hold
Dialectical statement: I can love my baby fiercely and still be struggling in this season.
Dialectical statement: I can hold compassion for a parent in crisis and grieve for the children who were lost.
Dialectical statement: I can be strong and still need someone to take my cry for help seriously.
A Few Truths to Hold Onto
Perinatal mental illness is not something a parent chooses and it is not a reflection of how much they love their child. Postpartum psychosis is a serious diagnosis, and it is also a treatable one. With early recognition, the right medication, therapy, and support, recovery is very much possible.
If you are pregnant or postpartum and any of this resonates with you, whether it is intrusive thoughts that feel scary, or something that feels more disorienting than that, please do not sit with it alone. Reaching out is not a weakness. It is one of the most protective things you can do for yourself and your baby. I unpack this further here https://www.ashleyrodriguezphd.com/blog/the-healing-parent-why-your-wellness-is-your-childs-superpower
If you or someone you love is in crisis, please contact the National Maternal Mental Health Hotline. Call or text 1-833-TLC-MAMA (1-833-852-6262) for free, confidential, 24/7 support in English and Spanish. If there is an immediate danger to your safety or your baby's, please call 911 or go to your nearest emergency room.
