Earlier this year, a beautiful young wife and mother of two small children walked out to the horse barn on her Indiana farm, retrieved a rifle, and took her own life.
She was a member of my extended family.
I didn't know her well, but I had heard about her for years from other family members. By every account, she was a shining star.
From the outside, her life seemed almost perfect. She had a loving husband, a towheaded toddler son, and a six-month-old baby daughter. Her career was on fire.
Family and friends adored her.
A life-threatening struggle
When she died, it was a complete shock to everyone. Except it wasn't. Those closest to her knew she had been deeply struggling since the birth of her daughter.
Her aunt, a longtime hospital executive, told me that she had been diagnosed with postpartum psychosis.
There were people in the family who understood that she needed medical treatment. Her aunt discussed options with her and desperately wanted her to get help.
But she was also a deeply devout Christian. According to family members, her minister advised her that prayer, rather than medication, was the answer to what she was experiencing.
She chose to follow her faith and pray. Her condition worsened. Her husband and those closest to her rallied around her and prayed for healing. The healing never came.
After her death, the church reportedly offered her grieving husband one small consolation: At least she hadn't harmed her children. Instead, an adoring husband lost his wife, and two small children will grow up without their mother.
The extended family was heartbroken. Some people had known what was happening and had tried to help. There was even a diagnosis. And still, she died.
I couldn't stop thinking about it. It was the first time I had really thought about postpartum psychosis. Then I started reading about Lindsay Clancy.
Another mother. A very different tragedy.
Lindsay Clancy was also a young wife and mother. She was a labor and delivery nurse. She lived with her husband, Patrick, and their three small children in Duxbury, Massachusetts.
Unlike my family member, Clancy was actively receiving extensive psychiatric care. She sought ongoing medical treatment.
She had appointments with mental health professionals, and she took psychiatric medications. She spent five days at McLean Hospital in January 2023. Something was clearly wrong, but nobody treating her diagnosed postpartum psychosis.
On January 24, 2023, Clancy strangled her three children in the basement of their home. Cora was five, Dawson was three, and Callan was eight months old.
Clancy then jumped from a second-story window in an apparent attempt to take her own life. She survived but was left paralyzed from the waist down.
More than three years later, a Massachusetts jury was asked to decide a question that doctors themselves could not agree upon.
They were asked whether Lindsay Clancy was experiencing postpartum psychosis when she killed her children.
She was getting help
This is the part of the Clancy story I find particularly difficult to shake. She wasn't hiding everything from everyone.
Clancy first saw a psychiatrist, Dr. Jennifer Tufts, in September 2022. She reported feeling anxious and overwhelmed caring for three children. Tufts diagnosed generalized anxiety disorder and an adjustment disorder with depressed mood and recommended therapy and an antidepressant.
Over the following months, Clancy's psychiatric medications changed repeatedly as her symptoms continued and she complained about side effects.
Tufts testified that she considered whether Clancy might have bipolar disorder but concluded that she did not meet the diagnostic criteria. Another provider considered the possibility of bipolar disorder and prescribed an antipsychotic that could also be used for insomnia.
By January 2023, things had become very serious. Clancy admitted herself to McLean Hospital, where she remained for five days. Hospital psychiatrist Dr. Alia Goodheart testified that Clancy had experienced suicidal thoughts but denied having them at that moment. She also denied wanting to hurt anyone else.
Clancy was discharged January 5 and continued seeing Tufts. On January 23, one day before the killings, Clancy appeared depressed and unmotivated and described bouts of intense anxiety.
But Tufts testified that Clancy gave her no indication that she was hearing voices. She didn't tell her she was planning to kill her children, and Tufts testified that she saw no reason that day to have Clancy hospitalized.
Twenty-four hours later, three children were dead.
So what exactly is postpartum psychosis?
This is where I had to educate myself. Postpartum psychosis is not simply a particularly bad case of postpartum depression.
It is a rare and serious psychiatric condition that can begin suddenly after childbirth. Symptoms can include severe confusion, dramatic mood changes, paranoia, delusions, hallucinations, unusual behavior, and a profound loss of contact with reality.
It occurs in only a small percentage of women after childbirth, but rare does not mean harmless. Postpartum psychosis is considered a psychiatric emergency because the illness can place both the mother and her baby in danger.
The good news is that the condition is treatable. Hospitalization is often required until the situation can be stabilized. Depending on the patient, treatment can include medications such as antipsychotics and mood stabilizers.
Electroconvulsive therapy may be considered in some severe cases. Early recognition matters. And that is one reason the story of my family member hurts so much.
According to her aunt, the diagnosis had been made. She knew she was ill, and people who loved her knew she was ill. But knowing the name of an illness isn't the same thing as treating it.
Intrusive thoughts aren't the same thing as psychosis
I didn't understand this distinction until I began digging into the subject. Intrusive thoughts and psychosis are not the same thing, and that distinction matters enormously in the Lindsay Clancy case.
An intrusive thought is an unwanted thought, mental image, or impulse that enters a person's mind even though she doesn't want it there. Sometimes those thoughts can be horrifying.
A new mother might suddenly imagine dropping her baby down the stairs. She might picture a knife hurting her child. She might have a terrible thought about drowning, smothering, or otherwise injuring the baby she loves.
The thought itself can terrify her precisely because she does not want to do it. That is very different from wanting to harm a child, and it can also be very different from psychosis.
A mother experiencing an unwanted intrusive thought may understand perfectly well that the thought came from her own mind. She may recognize that it is irrational or horrifying and desperately want it to stop.
In psychosis, reality itself can become distorted. A woman may hear a voice that she experiences as coming from somewhere outside herself. She may develop a delusional belief that seems completely real to her.
She may believe her baby is possessed, that someone is trying to harm her family, that God has commanded her to do something, or that some terrible act is necessary to save her child.
To everyone around her, the belief may seem obviously impossible. To her, it may be reality.
That distinction became crucial in Clancy's treatment. Her medical records and the testimony at trial described intrusive thoughts, anxiety, and fears involving her children.
But the clinicians treating her before the killings testified that she did not report hallucinations to them and that they did not observe clear signs of psychosis.
The experts couldn't agree on Clancy's condition
Then came a very different account after the children were dead. Clancy reportedly told evaluators that she had heard a male voice telling her to kill her children.
Was that an intrusive thought? Was it a command hallucination caused by postpartum psychosis? Was it something else? That question eventually became part of the battle between the experts at her trial.
And suddenly a distinction that sounds almost academic becomes incredibly important. A frightening thought is not automatically an intention. An intrusive thought is not automatically a hallucination. And a woman reporting disturbing thoughts about her baby should not automatically be treated as though she intends to hurt her child.
That could have another terrible consequence.
If mothers become afraid that admitting an unwanted thought will automatically result in someone taking their baby away, they may stop telling doctors what they are experiencing.
At the same time, families and clinicians cannot assume every disturbing postpartum symptom is simply anxiety. The challenge is figuring out what the woman is experiencing, whether she recognizes those thoughts as unwanted and irrational, whether her grasp on reality is changing, and whether she or anyone around her may be in danger.
That distinction is for trained medical professionals to evaluate. But families should at least know the distinction exists. I didn't.
But was Lindsay Clancy psychotic?
That question eventually consumed her murder trial. Her defense experts said yes.
Forensic psychologist Paul Zeizel testified that Clancy had bipolar disorder and postpartum psychosis. According to his testimony, Clancy reported hearing a male voice ordering her to kill her children.
Forensic psychiatrist Dr. Phillip Resnick also concluded that Clancy suffered from bipolar disorder that developed into postpartum psychosis. He testified that she experienced a command hallucination and believed an outside force had taken control of her body.
Their conclusion went directly to the legal question before the jury: Was Clancy capable of appreciating the wrongfulness of what she was doing or controlling her behavior? Defense experts said she was not.
The prosecution's experts disagreed. Forensic psychologist Kirk Heilbrun testified that Clancy was mentally ill but was not experiencing postpartum psychosis when she killed her children. He questioned inconsistencies in her later account of hearing a voice ordering the killings and concluded that she understood the illegality of her actions.
And there was another complication. The clinicians who actually treated Clancy before the killings hadn't observed the psychosis that defense experts diagnosed afterward.
That doesn't tell us which experts were right. It tells us something perhaps more disturbing: Highly qualified mental health professionals could examine the same woman and reach profoundly different conclusions about what was happening inside her mind.
Eleven jurors believed she wasn't criminally responsible
After weeks of testimony and more than 70 witnesses, Lindsay Clancy's jury couldn't reach a unanimous verdict. Eleven jurors reportedly favored finding her not guilty by reason of lack of criminal responsibility. One did not. Judge William Sullivan declared a mistrial on September 4, 2026.
That means, as I write this, the legal story isn't over. On October 1, Judge Sullivan rejected a defense request for a judgment of acquittal. Prosecutors have not yet announced whether they will retry Clancy or pursue another resolution.
At this stage, I’m convinced the most important question raised by this case isn't whether Lindsay Clancy belongs in prison. That’s not a question for anyone but the courts.
The question that interests me is what happened before January 24, 2023.
One diagnosis. One missed diagnosis. Two catastrophes.
I keep coming back to the two women. They weren't the same.
Their illnesses may not have presented in the same way. Their circumstances were different. Their treatments were different. And the terrible outcomes were very different. I don't want to pretend otherwise.
But there is something about placing their stories beside each other that I can't ignore.
In Indiana, according to her aunt, a young mother was diagnosed with postpartum psychosis. Medical treatment was available, but faith ultimately took precedence over that treatment. She died.
In Massachusetts, another young mother knew something was terribly wrong and entered the mental health care system. She saw providers, took medications, admitted herself to a psychiatric hospital, and continued outpatient treatment after leaving the hospital. But she was not diagnosed with postpartum psychosis before three children were dead.
The first woman was diagnosed, but the medical intervention that should accompany a psychiatric emergency didn't happen. The second received substantial medical intervention, but the diagnosis that eventually became the centerpiece of her murder defense wasn't made until after catastrophe struck.
One tragedy raises the question of what happens when postpartum psychosis is recognized but not adequately treated. The other raises the question of what happens when it isn't recognized at all.
Prayer and medicine don't have to be enemies
There is another part of my family member's story that I have struggled with. Her faith mattered deeply to her. I don't want to ridicule that.
I don't think faith was foolish, and I don't think prayer was foolish. For millions of people, prayer provides enormous comfort during illness, grief, or fear.
But postpartum psychosis isn't a failure of faith. It isn't something a woman can simply think herself out of, and medical treatment doesn't have to mean abandoning God. Faith and medicine don't have to compete for the same chair.
When a condition can involve hallucinations, delusions, profound confusion, and the loss of contact with reality, asking the sick person herself to choose between the two may be asking her to make one of the most consequential decisions of her life precisely when her ability to make decisions may be compromised.
The woman may not know how sick she is
Perhaps that is the part of postpartum psychosis that frightens me most. A person experiencing psychosis may have little or no insight into her own illness.
Think about what that means. She may not recognize that what she is experiencing isn't real. The delusion can feel real. The voice can sound real. The fear can be real.
And because psychiatric symptoms don't necessarily announce themselves in neat, unmistakable packages, someone can sometimes appear much more like herself than her illness would suggest.
That puts an enormous responsibility on the people surrounding a new mother. Not to diagnose her or to panic every time a sleep-deprived mother cries, but to understand that certain symptoms require something more than reassurance, more than rest, more than good intentions and, yes, more than prayer alone.
They require medical help immediately.
I wish I had known about it sooner
Before this year, I knew about postpartum depression and had heard about the baby blues. Postpartum psychosis wasn't something I had spent much time thinking about. Now I can't stop thinking about it.
I think about a young woman on an Indiana farm with two beautiful children and a family that desperately wanted her to get better. I think about Cora, Dawson, and Callan Clancy. I think about Lindsay Clancy, sitting in a courtroom more than three years later while doctors debate whether she knew what she was doing that January night.
And I think about all the families bringing babies home today who have probably never heard the words postpartum psychosis. Most of them never will. It is rare. But rare doesn't mean unimportant when the consequences can be catastrophic.
I learned from these two terrible stories that recognizing postpartum psychosis matters. Treating it matters. Understanding what a woman is actually telling us matters.
And when something has gone terribly wrong in the mind of a new mother, neither love, intelligence, a successful career, a devoted husband, a supportive family, nor deeply held faith makes her immune.
Sometimes loving someone means praying for her. And sometimes loving her means recognizing that prayer isn't the only help she needs.
