The Lindsay Clancy murder trial

Summary

Podcast Summary: Today, Explained

Episode: The Lindsay Clancy Murder Trial

Date: August 6, 2026

Hosts: Noel King, Sean Rameswaram
Guests: Christina Rex (WBZ Boston), Dr. Julia Nardi Riddle (UNC Reproductive Psychiatrist)

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Overview

This episode examines the harrowing Lindsay Clancy case, in which a Massachusetts mother killed her three children. The episode explores Clancy’s history of mental health struggles, the legal battle over her culpability, and the broader conversation around postpartum mental illness. Reporting comes from Christina Rex, who’s covered the trial, and Dr. Julia Nardi Riddle, an expert in women's mental health, unpacks the medical aspects of postpartum psychosis and discusses how such tragedies could potentially be prevented.

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Key Discussion Points & Insights

Lindsay Clancy: Background and Build-Up to the Crime

• Ordinary Beginnings: Lindsay Clancy, described as “very dedicated” and “a wonderful mom” (02:24), experienced mental health struggles after the birth of her youngest child in 2022.
• Emerging Symptoms:
  • Anxiety and deepening depression from September 2022 (02:24)
  • Attempts to get help, including seeing psychiatrists and being prescribed Zoloft (02:24)
  • Severe insomnia led her to sleep in the basement, seeking new specialists when initial medications failed.
  • Several ER visits for suicidal ideations and intrusive thoughts, including worrying she might harm her children (02:24–04:18)
• Crisis Point:
  • On New Year’s Eve 2022, she was recommended for inpatient care at McLean Hospital for five days (04:18)

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The Day of the Crime (January 24, 2023)

• Sequence of Events
  • Patrick Clancy, Lindsay’s husband, was working from home in the basement while Lindsay cared for the children (04:28)
  • The day appeared normal; Lindsay played outside with the kids and seemed in better spirits (04:28)
  • Lindsay arranged for Patrick to pick up medication for a child and takeout food, keeping up a normal exchange over text and phone (04:54–05:29)
    • “She’s pretty quiet. It sounded like she was busy... I remember hanging up, thinking, she’s probably in the middle of giving baths or something like that.” – Christina Rex, relaying Patrick’s testimony (05:29)
  • Patrick returned to a silent house, discovered Lindsay had attempted suicide by jumping from a window, and was led by her to the basement, where he discovered the children (06:17–07:47)
    • “I just saw blood everywhere. And the window is open.” – Christina Rex (06:17)
    • The children had been strangled with exercise bands. Two oldest declared dead the same night, the infant survived for a few days (06:41–07:47)
• Lindsay’s Situation Post-Tragedy
  • Paralyzed from the waist down due to her fall; living in a secure psychiatric facility (07:58)
    • “She knows what happened with those kids, and she wanted to die.” (08:18)

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The Legal Arguments

• Plea: Lindsay pleads not guilty by reason of insanity (mental disease or defect in Massachusetts law) (08:25)
• Prosecution’s Argument:
  • Claims she acted deliberately, overwhelmed by motherhood, decided to kill the children and herself
    • “One by one, she strangled the life out of each one of them. She did so with no hesitation, with deliberate premeditation and extreme atrocity and cruelty.” – Prosecution argument, paraphrased (08:58)
• Defense’s Argument:
  • Maintains Lindsay was a loving mother who suffered a catastrophic mental health crisis (09:30–09:56)
    • “This is a woman that did not get the medication, did not get the medical treatment that she so deserved. This is a woman that was suffering from psychosis at the time that she went down to that basement.” – Defense argument (09:36)
  • Asserts Lindsay reported hearing a commanding male voice—possible “command hallucination” (09:56)

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Broader Conversation Around Maternal Mental Health

• Lack of Legal Consideration: Massachusetts law lacks specific provisions for postpartum psychosis; only the general insanity defense exists (10:09–10:24)
• Public Reactions:
  • Local/National attention has spotlighted the deficiencies in mental health care and the challenge of addressing postpartum disorders (11:00)
  • Two major societal camps:
    • Sympathetic: See the case as evidence of a broken mental health system that failed Lindsay and her family
      • “She definitely was way overmedicated... The medical system seemed to have failed her.”—Dr. Riddle, community view (11:19)
    • Retributive: Reject postpartum psychosis as an excuse; insist on full criminal accountability
      • “Lock her up in prison and throw away the key. I don’t understand the lengths that some people are going to defend this woman.” (11:39)
    • Some blame directed at Patrick Clancy for allegedly not doing enough (12:16–12:37)

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Reflections on Societal Impact

• Reporter’s Hope:
  • “The possibility of some kind of greater outcome from this case is really the only thing that keeps me going in my work... the conversation is not did she do it? It’s why did she do it? And if it really was because of these severe postpartum mental health issues, what can be done to prevent this from ever happening to another family again?” – Christina Rex (13:20)

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Expert Insight: Dr. Julia Nardi Riddle on Postpartum Psychosis

What is Postpartum Psychosis?

• Rarity and Symptoms:
  • “Postpartum psychosis is a very rare disorder, estimated at about one to two in a thousand [births].” (19:24)
  • Distinct from “baby blues” (transient, common), and postpartum depression (affecting ~15% of women)
  • Usually has rapid onset, in first weeks postpartum; mostly an “affective disorder” related to severe mood disturbance with psychotic features (19:24–21:09)
    • “It’s not a classic psychotic illness like schizophrenia... It’s more of a delirious mania or a severe depression with psychotic symptoms.” (19:24)
• Course and Treatment:
  • Early recognition and hospitalization can make recovery possible in about 40 days (21:06–21:09)
  • At least half of cases are misdiagnosed, often prolonging suffering (21:09)
  • Emphasis on the necessity of sleep and targeted medication

Causes and Risk Factors

• Hormonal Changes: Rapid drop in estrogen and progesterone post-delivery may precipitate symptoms in vulnerable women (22:16)
• Inflammatory Factors: Pregnancy/postpartum are highly inflammatory states; women with conditions like preeclampsia may be at increased risk
• Sleep Deprivation: Severe sleep loss can trigger episodes (24:02) - “If you introduce severe sleep disruptions to someone with this vulnerability... that seems to be one of the real, real, real risk factors.” (24:02)

Danger and Outcomes

• Violence is Rare, Risk is Real:
  • “The vast majority of women incur no violence. This is rare, treatable, and most women do not act violently... particularly suicide, but we worry about both [suicide and infanticide].” (24:19)
• Barriers to Recognition and Seeking Help:
  • Women are often unaware they’re psychotic; families/friends play a key role in early intervention (25:17)
    • “If it comes into your mind [to seek help], it’s time.” (25:17)
    • “It takes a village to raise a child, but it takes a village to take care of a mom, too.” (25:54)

Implications for Research and Care

• Need for Training and Resources:
  • “We currently don’t teach these things in psychiatry training, in psychology training, in social work training... so asking a system... to be able to understand it fully and recognize it every time and not misattribute it to something else, right? That’s a big ask.” (27:05)
  • Urgency for increased research, diagnosis, and support infrastructure for postpartum mental health

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Notable Quotes & Memorable Moments

• On Lindsay Clancy’s Devotion as a Parent:
  • “She did everything. She started reading them books at three months and she made up songs for them. I remember she used to make green eggs and ham for Cora, a former nanny.” – Christina Rex (00:21)
• On the Tragedy’s Aftermath:
  • “She knows what happened with those kids, and she wanted to die.” – Community member (08:18)
• On Societal Impact:
  • “If you want to know why, Cora is my why, Dawson is my why, and Callan is my why.” – Community member on lack of sympathy (12:05)
• On Advocacy for Research:
  • “I’m crossing my fingers and toes, like, please, please, please let it [the case] be because we need this. We absolutely need more research.” – Dr. Julia Nardi Riddle (27:05)
• On Help Seeking:
  • “If it comes into your mind, it’s time... One of the best predictive factors for all of kind of maternal mental illness is support.” – Dr. Julia Nardi Riddle (25:17)

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Timestamps for Important Segments

• Clancy’s Mental Health Spiral and Timeline: 02:24–04:18
• Day of the Crime – Timeline and Discovery: 04:28–07:47
• Legal Arguments & Plea: 08:25–10:09
• Public Response and Blame: 11:00–12:37
• Reflections on Case Meaning: 13:20
• Expert Explanation of Postpartum Psychosis:
  • What is it? Differences from depression: 19:24–21:09
  • Causes and symptoms: 22:16–24:02
  • Violence and risk: 24:19
  • Advice on seeking help: 25:17–25:54
• Research and Systemic Change: 27:05

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Final Takeaways

The Lindsay Clancy case is a devastating tragedy that has forced Massachusetts and the nation to confront uncomfortable questions about mental health, the limits of the legal system, and the inadequate support available to mothers with postpartum disorders. The episode is equally clear that postpartum psychosis, while rare, is real and requires urgent, specialized response.

The trial’s outcome may be precedent-setting, but the hosts and guests alike hope it prompts broader, lasting reform and compassion in both medicine and law.

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If you or someone you know is struggling with postpartum mental health:
National Maternal Mental Health Hotline (24/7): 1-833-TLC-MAMA (1-833-852-6262)

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Transcript

[Noel King]

Before she killed her three young children, Lindsay Clancy was by all accounts an ordinary person. She met her husband Patrick in her 20s. They got married and moved to the suburbs. Lindsay was a labor and delivery nurse at Mass General. Was she a good mother? Yes, says everyone. Her now ex husband who has refused to condemn her.

[Guest or Interviewee 1]

What kind of a mother was she?

[Christina Rex]

She's very dedicated. She did everything. She started reading them books at three months and she made up songs for them. I remember she used to make green eggs and ham for Cora, a former nanny.

[Dr. Julia Nardi Riddle]

I observed a wonderful mom who loved her kids.

[Noel King]

Do I love Lindsay?

[Christina Rex]

Yeah.

[Guest or Interviewee 1]

I did love Lindsay. Yes.

[Noel King]

Lindsay Clancy admits that she killed her kids, but she says she was experiencing postpartum psychosis. Now her future is in a jury's hands. That's coming up on today explained from Fox.

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[Christina Rex]

this is Today Explained.

[Noel King]

I'm Noel King. You should know before we get into it that today's show includes details of a very gruesome crime. If that is not for you, how about this? I'll see you back here tomorrow. Christina Rex has been covering this story literally from the day the crime occurred. She's a reporter with wbz. That's the CBS affiliate in Boston. I asked Christina what she'd learned at the trial about when it became clear that something was wrong with Lindsay Clancy.

[Christina Rex (continued)]

Yeah. So it really seems like the spiral, as it's been referred to in court, starts in September of 2022. So at this point, the youngest Callan is around four months old. And the family has just had what was described as a very pleasant summer, you know, going to Cape Cod, going to the beach. Lindsay is supposed to be heading back to work in October, but starts to experience that same anxiety. And then it seems to become something deeper. She reports having feelings of depression she actually ends up seeking out a psychiatrist at that point and getting a Zoloft prescription. And she doesn't like the way it's making her feel. She also starts experiencing some insomnia, so much so that she separates and goes and sleeps down in the family basement to try and get better sleep. At this point, she starts seeking out new care. So she switches from a psychiatrist to a perinatal psychiatrist instead, and then a different psychiatrist after that. Over the course of November and December, there are multiple emergency room visits as Lindsay starts reporting the some suicidal ideation. And she goes to the ER at one point, because she hasn't slept in 48 hours, she starts reporting to her husband Patrick, not only those suicidal ideations, but one time she reported to him a fear that she was going to harm their children and also a fear that the children were like, going to become very ill. And she reported having intrusive thoughts. So she ends up trying to do an outpatient program for mothers. But when she gets there, she reports that she's told that she's actually not a good fit for the program. So she leaves that after a day. Then it kind of all comes to a head on New year's Eve into 2023, which is when Patrick takes Lindsay to the emergency room at Mass General. And at this point, she's recommended to do an inpatient stay at McLean Hospital, which is like the primary inpatient mental health facility in Massachusetts. So she goes there for five days.

[Noel King]

January 24, 2023, was the. The day that these murders happened. Can you walk us through what happened on that day, what you've learned in court?

[Christina Rex (continued)]

Yeah, so it was a weekday. So her husband Patrick was working in the basement, working from home at the time. Lindsay is not working. She's the primary caretaker for the kids. And he reported that Lindsay was playing with the kids outside in the snow, kind of a normal day. A day he actually described as one of her best days yet, because he thought she really seemed to be getting better at this time. This is two and a half to three weeks after she got out of that inpatient psychiatric facility. At one point during the day, Lindsay

[Christina Rex]

texts Patrick something along the lines of, do you want to get takeout? I haven't planned anything.

[Christina Rex (continued)]

And he says, sure. And she picks a restaurant, asks him what he wants. He tells her she calls the restaurant, orders dinner. At the same time, she tells him she needs him to run out to CVS because she needed some kids. Mural acts for their daughter. So shortly after 5 o' clock that night, he leaves the house to run to CVS and then pick up the takeout. He calls Lindsey and she doesn't answer. And then she calls him back. At some point while he's in cvs, he has a question about the medication. She answers him normally. He really doesn't suspect anything is wrong, but he says maybe. She seemed kind of distracted.

[Christina Rex]

She's pretty quiet. It sounded like she was busy. I remember hanging up, thinking, she's probably in the middle of giving baths or something like that.

[Dr. Julia Nardi Riddle]

So it sounded to you like she was in the middle of something?

[Christina Rex]

Yeah.

[Christina Rex (continued)]

Probably about a half hour after that, he arrives home and what happens? We know this through his own testimony as well as listening to the 911 call. He gets home, he goes in the house. Nobody's responding to him.

[Christina Rex]

The house is really quiet.

[Dr. Julia Nardi Riddle]

Is that unusual?

[Guest or Interviewee 1]

Yeah.

[Dr. Julia Nardi Riddle]

And when you, you realized it was really quiet, what did you do?

[Christina Rex]

I called out.

[Dr. Julia Nardi Riddle]

And who did you call out to?

[Christina Rex]

Everyone.

[Dr. Julia Nardi Riddle]

Did anyone answer?

[Christina Rex]

No.

[Christina Rex (continued)]

So he goes upstairs to the master bedroom to look for Lindsay and notices the door is locked, which is unusual. He finds a key and he unlocks the door.

[Christina Rex]

I just saw blood everywhere. And the window is open.

[Christina Rex (continued)]

So without even going to the window, he immediately runs outside to the backyard and he finds Lindsey on the ground. After an apparent suicide attempt, he's on the phone with 911. In that 911 call, which was not allowed to be recorded, but I heard in court, you can hear him saying, lindsay, stay with me. Look at me, look at me. He asks her at some point, I

[Christina Rex]

said, where are the kids?

[Christina Rex (continued)]

You can't hear her response. You can just kind of hear her moaning in the background. But he said, she said they're in the basement. About four minutes in. First respond, and he says to them, can you take care of her? I gotta go check on my kids. And you hear his footsteps enter the house, go down to the basement. And he says, guys, like looking for the kids. And then just horrific screams in agony as he discovers all three of his children in the basement. They had been strangled with exercise bands. Dawson, the middle son, was in the office, separated from his sister and brother, who were together in the living room. As you can imagine, all hell breaks loose at this point. All first responders are called in who can come to that house. And life saving efforts are made on all of the children. All of the children. And Lindsay and eventually Patrick, because of his emotional reaction, are brought to hospitals. Cora and Dawson, the older children, are declared dead at the hospital pretty early on. And then Callan, the baby does stay alive for a few days because they did get his heart started again, but he died a few days later because his brain never recovered.

[Noel King]

All right, so obviously a very devastating day. It has been three and a half years since then. What is Lindsay Clancy's situation today?

[Christina Rex (continued)]

She severely injured her spine in that fall from the second story window. So she's paralyzed from the waist down, wheelchair bound, and she is technically in custody, but she lives full time at an inpatient psychiatric facility, like a secure facility. And according to her attorney, her understandably mental health is just shattered.

[Guest or Interviewee 1]

She's living her own hell. She knows what happened with those kids, and she wanted to die.

[Noel King]

And she is pleading not guilty.

[Christina Rex (continued)]

Yeah, she's pleading not guilty by, in what Massachusetts is called mental disease or defect, what's commonly known as not guilty by reason of insanity. She's not saying, I didn't do this. In fact, she is saying, I did do this in an episode of postpartum psychosis. I wasn't in my right mind when it happened.

[Noel King]

Given that the plea is I did it, but there was a reason behind it, what are the arguments being made by the prosecution and the defense here? What's really standing out?

[Christina Rex (continued)]

So the prosecution is arguing that Lindsey Clancy was in her right state of mind when she killed her kids.

[Noel King]

One by one, she strangled the life out of each one of them. She did so with no hesitation, with deliberate premeditation and extreme atrocity and cruelty.

[Christina Rex (continued)]

And they are claiming that she became so overwhelmed with motherhood and that she was such a controlling person in general role, that when she felt like she was losing that control and feeling so overwhelmed with having three kids, that she made the decision that she wanted to take her own life.

[Noel King]

And because no one could take care of her kids the way she wanted them to, she had to take them with her.

[Christina Rex (continued)]

The defense has claimed that she was a wonderful mother until she snapped that day.

[Guest or Interviewee 1]

This is a woman that did not get the medication, did not get the medical treatment that she so deserved. This is a woman that was suffering from psychosis at the time that she went down to that basement.

[Christina Rex (continued)]

And Lindsey had previously reported after the incident happened, that she had heard a man's voice kind of commanding her to do so. So the idea of a command hallucination is going to be a big part of the defense's case.

[Noel King]

This conversation around postpartum mental illness has been charged in this country for quite some time, obviously, because often it involves very gruesome crimes. Does Massachusetts state law involve any kind of consideration for postpartum psychosis or mental illness?

[Christina Rex (continued)]

No. In fact, Lindsay Clancy's defense attorney has said that that is one of the challenges of the case is that it's kind of a novel concept for him to introduce in this state. And the only legal threshold that exists here is a plea of not guilty by reason of insanity. But that could be any type of mental disease or defect.

[Noel King]

I know that you've been covering this story right from the beginning. This is obviously a local case that has come to receive an enormous amount of national attention because of the details, I'm sure. What has the conversation been like around the trial and around Lindsey Clancy?

[Christina Rex (continued)]

Yeah, I think there's two major camps of thought and then some minor ones. So the two major camps of thought are a community of people locally who acknowledge a broken mental health system and a system that doesn't take postpartum issues seriously enough.

[Dr. Julia Nardi Riddle]

She definitely was, like, way overmedicated on, like, just weird cocktails and medication. I think that she definitely did the due diligence to seek help. The medical system seemed to have failed her.

[Noel King]

Listen, I'm not saying she's innocent. I'm not defending what she did. I'm just saying I don't think she should go to prison for the rest of her life.

[Christina Rex (continued)]

I think she was in severe mental health crisis psychosis. On the other side, there's a group of people who don't believe Lindsay Clancy actually had postpartum psychosis or say even if she did, that's not a reason to get away with killing your three children. You know, lock her up in prison and throw away the key. I don't understand the lengths that some people are going to defend this woman. She did this to her three children.

[Noel King]

So, no, I will not have sympathy for her. And if you want to know why, Cora is my why, Dawson is my why, and Callan is my why.

[Christina Rex (continued)]

There is also some, I would say, small but very vocal social media chatter, really putting a lot of blame on Patrick Clancy. So when is Patrick Clancy's trial?

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He didn't know what medication was taken, when she'd seen the doctor, what dosage that medication was, because he didn't care.

[Christina Rex (continued)]

He was supposed to help her, and he didn't.

[Dr. Julia Nardi Riddle]

He didn't.

[Christina Rex (continued)]

It's been pretty tough to watch that as someone from Massachusetts, as someone who has followed this case from the very beginning, because Patrick Clancy, even though they're divorced now, but he has supported Lindsay since this happened.

[Noel King]

Let me ask you lastly to reflect on something. Based on your years of covering this story, do you think it is possible that something good comes out of this trial, that maybe there is more attention to, you know, a situation, postpartum mental illness that, that didn't previously exist or that we see empathy or sympathy different when mothers are charged with horrible crimes. Like, is there any, is there any light here, do you think?

[Christina Rex (continued)]

I think it's hard to find the light in a case that's this dark. But at the same time, the possibility of some kind of greater outcome from this case is really the only thing that keeps me going in my work. You know, I cover a lot of very depressing stories. I cover a lot of criminal trials. And in this conversation, in this trial especially, where the conversation is not did she do it? It's why did she do it? And if it really was because of these severe postpartum mental health issues, what can be done to prevent this from ever happening to another family ever again? I mean, the public, reporters, anybody in that courtroom has seen this family's trauma just like ripped open again for the whole world to see over the course of this trial. And at times it feels so unfair to watch it happening that way. And I can only hope that conversations that are happening about maternal mental health are some tiny positive outcome from this negative experience.

[Noel King]

Christina Rex, she's with wbz, which is the CBS affiliate in Boston. Coming up, a reproductive psychiatrist who has treated women with postpartum psychosis is going to tell us what it is and why we know so little about it.

[Guest or Interviewee 1]

Foreign.

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[Dr. Julia Nardi Riddle]

My name is Julia Nardi Riddle. I am a physician, a reproductive psychiatrist here at the University of North Carolina in the center for Women's Mood Disorders. I both am a practicing clinician in clinical care as well as a clinical researcher and educator.

[Noel King]

What do you sort of focus on

[Dr. Julia Nardi Riddle]

as a reproductive psychiatrist? I focus on everything related to the female reproductive system and mental illness, mental wellness. So that includes menstrual cycle related disorders, disorders related to pregnancy and the postpartum and perimenopause.

[Noel King]

The Lindsay Clancy case is drawing a lot of attention to something called postpartum psychosis. This is not a term that I was very familiar with. I definitely had heard of postpartum depression But I understand postpartum psychosis is something quite different. What is it exactly?

[Dr. Julia Nardi Riddle]

So it is very, very different than historically when we talk about the baby blues, which is not a disorder. The baby blues is sort of a transition of all the changes that happens in the first few weeks. And the majority of women experience that for a few days. Then, as you mentioned, postpartum depression, which our current rates put it at about 15%. So kind of 1 to 2 in 10 women. Whereas postpartum psychosis is a very rare disorder, the incidence of postpartum psychos seems to be right now estimated at about one to two in a thousand. So it's very, very rare. In the vast majority of cases, it is considered an affective disorder. Affective means like a mood disorder. And in the majority of those cases, 50 to 80%, it seems to be related to bipolar disorder, but not always. There's a subset that is only in the postpartum. So what it is, postpartum psychosis. It's kind of a misnomer because it's not a classic psychotic illness like schizophrenia. It's more of a delirious mania or a severe depression with psychotic symptoms. It's less common that it's just the psychotic symptoms, like delusions without concurrent mood symptoms either elevated. Right. So like a mania, you know, low in a bad depression or in this mixed state, which is actually very hard to describe. Unique to postpartum depression is that it has a pretty rapid onset. So we see it occur very, very early in the postpartum, often in the first few weeks. But the truth of the experience of is because it's so hard to diagnose and currently often gets missed, it can have this very long tail where women really don't recover because they don't get the appropriate recognition and treatment.

[Noel King]

For how long do women typically suffer from this?

[Dr. Julia Nardi Riddle]

You know, some of the data has shown that if we can identify it early. Right. Either it's someone that had it in the past, or they are lucky enough to be in care or have someone in their life that says, you are not yourself, let's get you to the hospital. And it is identified correctly, generally with appropriate treatment. So we're talking early on. What you want to try to do is get that person sleeping. So we're talking about like a benzodiazepine, maybe an antipsychotic, and then lithium. Some data has shown within 40 days we can really get that person back in, but usually they have to be hospitalized. Now, the research also shows that in at least 50% of cases, it's misdiagnosed, which often means the wrong medicine is given. So women can suffer with this for months and months, or it can mutate into something else. So it's not that the natural course of it, it'll just go away. We don't know enough about what happens if you hopefully get someone sleeping, but then do they have this long tail of a depression afterwards? We don't have perfect data on that because we don't know who we're not seeing always.

[Noel King]

Do we know what causes postpartum psychosis? Whether it is one thing, many things, environmental, internal.

[Dr. Julia Nardi Riddle]

The postpartum is like no other time in a human's life. So many things change. First and foremost, as a society, we don't fully understand how the brain works. And the postpartum involves a few different things. Right? So in pregnancy, hormones go to, you know, levels not seen in any other time in our lives. So estrogen, progesterone. So the leading theory right now is as those drop off, which they drop off rapidly as a woman delivers a baby. It seems to be that there's a subset of women who are very susceptible to that change. It's not a deficit, but it seems to be that either due to the neuroprotective agents within estrogen due to substrates of progesterone, that parts of their brain do not respond to that rapid change the way somebody else that doesn't experience that experiences it. Okay, so that's one. Pregnancy and the postpartum are a very, very inflammatory period. Okay, first, you're tolerating something that is partially yours. So half of that genetic material is foreign to the body. And as pregnancy goes about, it can be a very, very inflammatory state. And if a woman has something like preeclampsia, gestational diabetes, there can only be more of an inflammatory state. So that's another leading theory. Is that, is there an inflammatory pipeline here? Is there an inflammatory mediator that's causing this? Then if you introduce severe sleep disruptions to someone with this vulnerability rate, that seems to be one of the real, real, real risk factors with someone with these vulnerabilities. And what is the postpartum, the early postpartum, but an exercise in the highest level of sleep disruption. Right. That most people will ever experience.

[Noel King]

The Lindsay Clancy case is drawing so much attention because this is a horrific story. Obviously, these are horrific details. Also, this is a very rare thing here, you know. Do you have a sense of how often postpartum psychosis can lead to infanticide?

[Dr. Julia Nardi Riddle]

Yeah. So I want to Be very clear on something. The vast majority of women incur no violence. This is rare, treatable, and most women do not act violently. Not unheard of, which is why we consider it a psychiatric emergency, right? Not unheard of, particularly suicide. So we worry about even more about suicide, but we worry about both because the nature of the illness can involve so much paranoia or these delusional thoughts. It's not as if you ask a woman who's dealing with these and they just tell you, right? They're suspicious of the whole world. It's not that. They just say, oh, finally someone's asked. Let me share with you all my thoughts. And I think about our patients, right? Our patients right now are terrified that, will I become psychotic? Will I hurt somebody? So it is treatable.

[Noel King]

Let me ask you on behalf of listeners. It will be a small number, but you never know who's listening. When do you know that it is time to seek help? What are things that you would identify as, this is a red flag. You gotta talk to someone and soon.

[Dr. Julia Nardi Riddle]

My opinion on this is if it comes into your mind, it's time, huh? You might be okay. But if it comes into your mind that you think you want to talk to somebody doesn't mean you have to start a medication, doesn't mean you have to do anything more. But get the help, right? One of the best predictive factors for all of kind of maternal mental illness is support. And if extending your support team to include counseling, to include a physician, to include a postpartum doula or peripartum doula, if that increases your support network, then the minute you think about it, do it. Because it might be your brain's way of telling you either like something is going on or something's coming. The other part of this that I want to mention is in postpartum psychosis, there's not always an awareness that you're in it, right? Because again, the very nature of these illnesses makes it hard to know you're in it. And so it's often the spouses, it's often the family that says, this is not quite right. But you can imagine if it's the first child and there's a spouse who themselves are anxious, they're like, well, I think it's normal. We do so much to normalize. Oh, of course you're exhausted. Of course you're not sleeping. It's so hard. Of course you're not eating. You must be exhausted, right? If your partner or your daughter or your sister or your friend is not quite themselves, right? They're telling you they don't want you to come over, but they are the most social person. You know, they're not calling you, they're not responding. That might be time to say to them, hey, I. I think we should reach out for help. It takes a village to raise a child, but it takes a village to take care of a mom, too. These are treatable illnesses, right? Postpartum depression, postpartum anxiety, postpartum ocd, which we haven't even mentioned, and postpartum psychosis.

[Noel King]

Does the Lindsey Clancy trial and the conversation around this open the door in your experience to more research, to more efforts to study this, to try to treat this? Does this go anywhere?

[Dr. Julia Nardi Riddle]

You know, this is an audio interview, but if you. Look, I'm crossing my fingers and toes, like, please, please, please let it be because we need this. We absolutely need more research. It affects the mother, it affects the baby, it affects the family, it affects the community, it affects the economy. We know these things. It affects the whole system. The other thing that I'd say is that, you know, we currently don't teach these things, right? We don't teach these things in psychiatry. Training, in psychology, training in social work training, right? Everyone that's in the mental health care system is not receiving training on the unique things within reproductive health, right? Within women's mental health. So asking a system, right, in which a mother is often seen once in the postpartum and the practitioners are not getting training in this to be able to understand it fully and recognize it every time and not misattribute it to something else, right? That's a big ask. And so we need more care for mothers. We need more training for the workforce, right? All of those things are true.

[Noel King]

That was Dr. Julia Riddle at the University of North Carolina. If you are a new parent and you're going through it, or you know someone who's a new parent and going through it, you should know that there is a hotline that you can call 24 7, the National Maternal Mental Health Mental Health Hotline. It's an 833-TLC-MAMA. 833-852-626247. We're gonna be off tomorrow. We call that a summer Friday here on Today Explained. We have a nice little rerun for you in the feed about micro dramas. You may recall they said the movies were dead, so they made micro dramas. Then Christopher Nolan made a maxi drama. Everyone went back to the theater. Maybe they spoke too soon. Enjoy that one. Avishai Artsy produced today's show. Amina Elsadi edited Gabriel Dunnov Checked the facts and Patrick Boyd Mixed and mastered I'm Noel King. It's Today Explained.

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