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As with countless courtroom proceedings that have been sensationalized, the agonizing testimony during the opening days of the murder trial of Lindsay Clancy, the former labor and delivery nurse accused of killing her three young children in Massachusetts, has produced a wave of public commentary debating the forces that might have driven a mother to kill her children.
The ruling theories go something like this: Clancy, as her defense team argues, should not be held criminally responsible because she had been overmedicated, with some of the medications worsening her later diagnosis of bipolar disorder. Prosecutors say the responsibility for the crime is entirely Clancy’s as she “deliberately and meticulously” killed her children. Online, criticism has even been directed at Clancy’s husband, Patrick, for supposedly leaving his wife to suffer in the throes of depression, while he got brunch with friends.
In the absence of a clear source to blame for this family’s catastrophe, it is the list of medications that had been prescribed to Clancy in the months leading up to the tragedy that has received outsized attention, often inspiring fierce judgment online. “Great opportunity to hold the antidepressant industry accountable for serious harm,” Alex Clark, the MAHA wellness influencer, wrote on social media, as courtroom filings revealed doctors had prescribed a range of medications— including antidepressants, sleep aids, and antipsychotics—to treat symptoms of severe postpartum depression after Clancy gave birth to her third child in 2022.
“Four months. Thirteen different medications,” the Boston Globe wrote in an Instagram post that featured a list of the medications with the full names of the doctors who prescribed them. As others, including Katie Miller and Jack Posobiec, expressed alarm over Clancy’s treatment plan, over on TikTok, clips concluding “textbook psych harm” were also going viral. Consider some of the responses to the Globe post:
“That literally will induce severe psychosis.”
“Pure malpractice. Those doctors should go to jail.”
“So sad. Way too many pills.”
Untreated mental health conditions are the leading cause of preventable pregnancy-related deaths in the United States.
The Globe later added an addendum to its post acknowledging that there was still much to learn about the prescribed medications. But in the hours between, I thought about the postpartum parents who may have seen the post, and wondered, as some true crime podcasts have: “Did Lindsay Clancy’s own medication make her worse?”
Experts caution against the intense public scrutiny of Clancy’s treatment, particularly posts that lack the critical context needed to understand providers’ decisions—such as what might have prompted dosage adjustments or how certain meds were added or removed—for they could unleash misinformation around postpartum conditions and the life-saving, effective measures used to treat them.
“My worry is that if [the Clancy case] makes folks more reticent to take medications to treat their mental illness, there’s potential harm there too,” Dr. Sunny Patel, a psychiatrist at Georgetown’s Thrive Center for Children, said, referring to the fact that untreated mental health conditions are the leading cause of preventable pregnancy-related deaths in the United States.
“My worry is that if [the Clancy case] makes folks more reticent to take medications to treat their mental illness, there’s potential harm there too.”
“It is difficult to understand the use of psychiatric medications out of context,” said Reid Mergler, a clinical psychiatrist and medical director of the Penn Center for Women’s Behavioral Wellness. “Although we are unable to comment in this specific case, in general, in the case of medication adjustments, it is common for patients to start medications and quickly want to try other options. This is especially true if a patient is suffering.”
When asked about the Globe‘s post, Mergler said the medications listed are often prescribed for different reasons, including insomnia, depression, and anxiety.
The Clancy trial arrives at a particularly fraught moment for antidepressants, which have long been a target of the nation’s most powerful public health official. In fact, in the two and a half years he has been health secretary, Robert F. Kennedy Jr. has made it something of a personal mission to wean Americans off of SSRI’s, such as Zoloft and Prozac, claiming that the country is over-medicated and over-dependent on them. (Before his HHS post, Kennedy used to claim, without evidence, that psychiatric medicines lead to homicidal behavior like mass shootings.)
People with authority who seek to use Clancy’s trial to push an anti-medication agenda can potentially persuade suffering people who might need and benefit from help to avoid it.
Postpartum depression is not uncommon, affecting roughly 10 percent of new birthing people. But postpartum psychosis, the clinical condition Clancy’s lawyers say she had been suffering when she killed her three children in January 2023, is far rarer, affecting less than one percent of 1,000 people.
“People start perceiving reality in a way that’s not accurate,” Allison Horan, a psychotherapist and psychopharmacologist in San Francisco, said. Common symptoms of psychosis include “false fixed beliefs or delusions, hallucinations, and paranoia.”
“Sleep sometimes gets extraordinarily disrupted, more so than is naturally the case in a postpartum period,” Horan continued. “People can at times develop suicidal thoughts or homicidal thoughts. It’s a psychiatric emergency.”
But postpartum conditions, Horan stressed, have high rates of recovery.
“They’re some of the most treatable conditions I treat as a psychiatrist, and people get better all the time,” she said, adding that it was important for people who suspect that something like depression or psychosis might be affecting themselves or a loved one to know that help, including prescription medication and close monitoring, is critical to seek.
None of which is to suggest that something may not have gone wrong with Clancy’s treatment; each expert I spoke to emphasized that they couldn’t comment on the specifics of her medications because they were not privy to the essential context within which they were prescribed. More broadly, communication gaps, whether it’s between prescribing doctors or outpatient services, persist throughout the medical system. And medical schools, Reid said, don’t spend much time educating students about postpartum psychosis despite the devastating consequences that can unfold if the condition is not treated properly.
It’s hardly surprising that social media commentators do not exercise the restraint of medical experts, but authority figures who seek to use Clancy’s trial to push an anti-medication agenda potentially can persuade suffering people who might need and benefit from help to avoid it. That’s especially the case for those who have just given birth, many of whom report feeling pressure to present an Instagram-worthy image of glowing new parenthood.
For the medical community, context-less scrutiny over Clancy’s medications, as well as decisions like the Globe’s to publish the names of Clancy’s doctors, could jeopardize legally protected processes that are in place to assess what may have gone wrong medically.
“Generally, anytime you look at a bad outcome, only one thing is rarely to blame,” Patel said. He noted that the job of medicine is to examine all the factors that were at play and determine the facts of what happened. Using a kind of “fishbone diagram,” clinicians then map the events along a timeline “to figure out what happened at each one of them. We really get granular to [determine] what the potential failure points were, and then what interventions we could implement that would prevent this bad outcome from happening.”
The more extreme the event, the greater the desire to identify potential failures and improve on existing systems, which may be what is happening as the Clancy family’s ordeal unwinds in court. “The way a system improves,” Patel said, “is you need to be able to talk about bad things that happen.”