At Crossroads Counseling Services, we think about the Lindsay Clancy case often, not because it’s sensational, but because the tragedy is one of the clearest illustrations of what happens when postpartum mental illness is severe, underrecognized, and undertreated. Clancy, a labor and delivery nurse who knew clinically what postpartum illness looked like, found herself in a psychiatric crisis that her own training hadn’t fully prepared her to see in herself. That gap, between knowing something abstractly and being able to recognize it while inside it, is one of the most important things families and providers need to understand about perinatal mood disorders.
This post isn’t about the legal proceedings or the details of the case. It’s about what the situation revealed: that postpartum illness exists on a spectrum far wider than most people realize, that the most severe presentations are still systematically underidentified, and that the stakes of missing them are as serious as it gets.
What Most People Know About Postpartum Depression, and What They Don’t
The public conversation about postpartum depression has improved significantly over the past decade. There’s more openness, more awareness that the “baby blues” aren’t the only thing that can happen after delivery, and more language available for naming what might be going on.
But most of what the average person knows stops at postpartum depression: persistent low mood, fatigue, inability to bond with the baby, and a quiet despair that doesn’t lift the way normal sadness does. That’s real and it matters. It’s also only part of the picture.
The American Psychological Association distinguishes several distinct conditions in the perinatal period. Postpartum anxiety, which often presents as intrusive thoughts, hypervigilance, racing thoughts, and physical symptoms like heart palpitations, is actually more common than postpartum depression and is far less frequently discussed. Postpartum OCD involves intrusive, unwanted thoughts about harm coming to the baby, which parents almost universally keep secret because they mistake the thoughts for intent. And at the far end of the spectrum is postpartum psychosis: a psychiatric emergency involving hallucinations, delusions, rapid mood cycling, and severe disorientation that typically emerges within the first two weeks postpartum.
Lindsay Clancy’s experience was described by her psychiatric and legal team as postpartum psychosis, not depression. That distinction matters because they require very different responses, and psychosis in the postpartum period is still badly misunderstood by the general public, and sometimes by medical providers as well.
Why Postpartum Illness Gets Missed
Part of what makes perinatal mood disorders hard to catch is that several of the symptoms overlap with things that are considered normal after childbirth. Sleep deprivation is expected. Anxiety about a new baby is expected. Physical exhaustion, emotional intensity, preoccupation with the infant’s wellbeing. All expected. The clinical question isn’t whether any of those things are present, but whether they’re operating at a level that’s impairing functioning, causing significant distress, or escalating in a direction that raises concern.
There’s also the matter of disclosure. Research from Postpartum Support International consistently finds that a significant portion of people experiencing postpartum mental health symptoms don’t disclose them to a provider, out of fear of being seen as a bad parent, fear of having the baby taken, or simply not recognizing that what they’re experiencing goes beyond normal adjustment. The intrusive thoughts characteristic of postpartum OCD and anxiety are particularly unlikely to be reported, because parents experiencing them typically interpret the thoughts as dangerous rather than as a symptom.
Healthcare visits in the postpartum period don’t always help. The standard six-week postpartum appointment has been widely criticized as inadequate, since it is a single visit that often focuses primarily on physical recovery. ACOG’s updated guidelines now recommend ongoing postpartum care beginning within three weeks of delivery and continuing as needed, with explicit attention to mental health screening. But implementation is uneven, and a brief Edinburgh Postnatal Depression Scale administered in a busy OB office is a starting point, not a comprehensive evaluation.
The Full Spectrum: From Adjustment to Crisis
It helps to understand perinatal mood disorders not as a single condition but as a range with very different presentations and risk levels.
The baby blues affect up to 80 percent of people who give birth, presenting as tearfulness, emotional volatility, and mood swings that typically peak around day three to five and resolve within two weeks. No intervention required beyond support and monitoring to make sure resolution happens.
Postpartum depression affects approximately one in five new mothers and a meaningful proportion of new fathers as well. CDC data from the Pregnancy Risk Assessment Monitoring System shows consistent rates of one in eight mothers reporting symptoms of postpartum depression. Duration can extend months to years without treatment. It responds well to therapy, medication, or both, and early intervention shortens recovery significantly.
Postpartum anxiety is equally common, possibly more so, and includes a subset of people with intrusive, unwanted thoughts about harm. These thoughts are ego-dystonic, meaning they feel horrifying to the person having them and are entirely inconsistent with intent. A parent who reports being consumed by fear that they might drop the baby, or who compulsively checks on a sleeping infant to the point of sleep deprivation, is experiencing a symptom, not a warning sign about their character.
Postpartum psychosis is rare, affecting approximately one to two per thousand deliveries, but it is a psychiatric emergency. It typically emerges in the first two weeks postpartum and can progress rapidly. Symptoms include hallucinations, delusions, rapid mood shifts, confusion, severe insomnia, and disorganized thinking. People experiencing it are not fully oriented to reality. This is not a variation of depression with some unusual features. It requires immediate psychiatric evaluation and often hospitalization.
For Partners and Families: What to Watch For
One of the most important lessons from the Clancy case is that severe postpartum illness may not be accurately self-reported. Someone experiencing postpartum psychosis may not have clear access to the fact that something is wrong, or may be frightened enough by the symptoms to conceal them. Partners, parents, and close family members are often the people best positioned to recognize that something is happening.
Warning signs that warrant immediate contact with a mental health provider or emergency services include: belief in things that aren’t real (delusions), hearing or seeing things others can’t perceive, rapid mood swings that seem entirely out of character, severe confusion about where they are or what has happened, expressing beliefs that the baby or the family would be better off without them, or statements that suggest a distorted perception of the people around them.
Less acute symptoms that still deserve prompt attention: intrusive thoughts about harm that the person seems unable to stop or dismiss, escalating anxiety that isn’t responding to reassurance, sleep that remains severely disrupted beyond the newborn period without a clear reason, or withdrawal and emotional flatness that intensifies rather than easing over time.
Asking directly, “Are you having thoughts that scare you?” does not plant ideas. It opens a door that many people are waiting for someone to open for them.
What Effective Treatment Looks Like
The good news is that all perinatal mood disorders, including postpartum psychosis in most cases, are treatable. Recovery is the norm, not the exception, with appropriate care.
For postpartum depression and anxiety, therapy has strong evidence, particularly CBT and interpersonal therapy. Medication is safe for many breastfeeding individuals and highly effective when indicated. The combination of both tends to produce the fastest outcomes.
For postpartum psychosis, treatment typically involves stabilization, often in an inpatient or intensive outpatient setting, with medication that addresses the psychosis directly. Follow-up is critical, as postpartum psychosis carries elevated risk for recurrence in subsequent pregnancies.
For the full range of presentations, finding a provider who specializes in perinatal mental health matters. Not every therapist has specific training in this area, and the intersection of hormonal, relational, and psychological factors in the postpartum period is complex enough that specialized experience makes a real difference.
When to Reach Out
If something doesn’t feel right after delivery, whether in yourself or in someone you’re supporting, that feeling is worth taking seriously. Postpartum mental health conditions are not a reflection of how much a person loves their child, how capable they are as a parent, or what kind of person they are. They are medical events that happen to real people, including people who are knowledgeable, prepared, and deeply devoted.
Our team at Crossroads Counseling Services works with individuals in the perinatal period across our Yorkville, Plainfield, and Morris locations. If you’re in the postpartum period and struggling, or if you’re supporting someone who is, please reach out. You don’t have to wait until things escalate. Reaching out early is what changes the trajectory.
If you or someone you know is experiencing a psychiatric emergency, contact the 988 Suicide and Crisis Lifeline by calling or texting 988, or go to the nearest emergency room.
Works Cited
“Optimizing Postpartum Care.” American College of Obstetricians and Gynecologists, ACOG Committee Opinion, May 2018, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care.
“Postpartum Depression.” American Psychological Association, www.apa.org/topics/women-girls/postpartum-depression.
“Pregnancy Risk Assessment Monitoring System.” Centers for Disease Control and Prevention, www.cdc.gov/prams/data-portal/index.html.
“Research Library.” Postpartum Support International, www.postpartum.net/learn-more/research/.
“Postpartum Psychosis.” Marcé Society, www.marcesociety.com/for-families/information-sheets/.