"It's Just the Baby Blues": How the DSM Failed Lindsay Clancy Before a Jury Ever Could
Following far too soon after the loss of my darling Hayden Panettiere, we are caught in the blaze of yet another headline case of maternal distress. "What? Maternal Distress? Can you not read Caroline? Lindsay Clancy killed her children. She's a monster. How could a mother do that to her own flesh and blood?" I can read perfectly well, so well that, having had the details of the Andrea Yates' crime maternal filicide (5 children 2001) firmly etched into the annals of my memory twenty five years ago, I took it upon myself to avail of the available public transcripts to determine, for myself, whether or not Lindsay Clancy is indeed a monster and guilty of the maternal filicide of her three children aged 5, 3 and 8 months.
The main charge is three counts of murder in the first degree. Clancy pleaded not guilty by reason of lack of criminal responsibility, the Massachusetts term for not guilty by reason of insanity. The Commonwealth, as the prosecution is called in Massachusetts, must prove beyond a reasonable doubt that Clancy was sane at the time of the killings.
In the four months preceding the horrific events of 24 January 2023 when Clancy strangled her three children, she had been on a cocktail of not less than 13 prescription medications (not all at the same time) and saw or spoke to a doctor, nurse or therapist up to 30 separate times (the exact number of clinical contacts is still not agreed). And, during the month of December 2022, she made almost daily portal messages to the same psychiatric nurse practitioner at South Shore Health's Perinatal Behavioural Health programme in Weymouth, Massachusetts. Nineteen days prior to said horrific events, Clancy was discharged from McLean psychiatric hospital in Belmont, Massachusetts where she had stayed as an inpatient for five days.
Lindsay's glut of treating clinicians all gave evidence for the prosecution, who relied on the fact that not a single one of them had recorded a finding of "psychosis". And why is that one may ask? Well, an answer might be found in the Diagnostic and Statistical Manual of Mental Disorders ("DSM"). The DSM does not recognise "postpartum psychosis" as a distinct diagnosis. Thus, doctors must first diagnose an underlying condition, such as bipolar disorder or major depression, and can then add a "peripartum onset" specifier, if symptoms began during pregnancy or within four weeks after birth. Yes, no formal "postpartum psychosis" diagnosis is currently available.
Two of the four symptoms of psychosis are disorganised thinking and disorganised behaviour. And I don't mean to make light of the situation, but speaking from experience, at four weeks post birth most new mothers are still trying to work out whether it is night or day, wearing the same robe they left the hospital in, and eating cold baked beans straight from the tin.
Fortunately, many clinicians who actually work in the field and interact with new mothers first hand vehemently disagree with the DSM's definition (or lack thereof) of postpartum psychosis. They hold the unblinkered view that postpartum psychosis is a distinct illness that can start months after birth.
In the Clancy trial, the prosecution of course cited the DSM. They said that Lindsay had either depression or bipolar II, but not postpartum psychosis. By my count, her symptoms began when her baby was 4 months old. So technically she was three months too late for the DSM's peripartum label.
Dr. Resnick, for the defence, departed from the DSM and took the clinical view that postpartum psychosis can start months after birth. He diagnosed Clancy as suffering postpartum psychosis despite her symptoms having started outside the DSM's 4 week window. He said that she was "clearly psychotic" the day of the crimes, when the youngest child was 8 months old.
The prosecution had the bulk of the heavy lifting in the trial to prove their case. Twenty one days of evidence, of which the first thirteen were for the prosecution, the next five for the defence, followed by four days of prosecution rebuttal. Then each side gave its closing argument, with the defence going first. Despite thirty eight hours of deliberation over seven days, the jury of twelve could not agree, which was seriously unfortunate as a unanimous jury is required in Massachusetts to convict or acquit in serious criminal cases. A single juror was steadfast in their view (presumably but not confirmed) that Clancy was sane at the time that the crimes were committed. Thus, a mistrial has been declared.
Clancy is being held at Tewksbury State Hospital in Tewksbury, Massachusetts, under a Section 18 psychiatric commitment, and has been there since May 2023. So you can draw your own conclusions from that. And there she will wait until there is a new trial, de novo; or, a plea deal will be offered; or, the Commonwealth will choose to decline to proceed.
Whatever happens, it is time for the DSM to accept the formal recommendations from the international expert consensus published in Biological Psychiatry in October 2025 that postpartum psychosis is a distinctive, readily recognisable syndrome and should have its own place among the bipolar disorders in the DSM. Maybe this will draw long overdue attention to the serious nature of maternal health and excise forever from our vocabulary that oh so demeaning and dangerous term "it's just a case of the baby blues".
This article first appeared on LinkedIn.