What I Want You to Know About Postpartum Psychosis

If you've been following the news lately, you've probably heard about the Lindsay Clancy trial. It ended in a mistrial this month, after the jury couldn't agree on a verdict. The case has put a spotlight on something I think about every single day in my work: postpartum psychosis.

As a perinatal mental health counselor, I've sat with a lot of new moms in a lot of hard moments. And when a case like this makes headlines, it becomes even more clear how much misinformation is out there, which is why I thought this post was needed to keep educating and breaking down the stigma.

So let's talk about it, gently and honestly. 

I want to say up front: I'm not weighing in on this specific case, what happened in that courtroom, or what was in anyone's mind that day. That's not mine to judge, and frankly, no blog post could do it justice. What I can do is help you understand the illness itself, because there's so much fear and misinformation swirling around it right now, and fear helps no one, least of all the moms who are suffering in silence.

What Postpartum Psychosis Actually Is

Postpartum psychosis is a rare but serious psychiatric emergency. It affects roughly 1 to 2 out of every 1,000 births.  It's not just "really bad baby blues." It's not "postpartum depression, but worse." It is its own distinct condition, and it involves a break from reality. That can look like:

• Delusions (fixed, false beliefs, like believing the baby is in danger, possessed, or not really hers)

• Hallucinations (seeing or hearing things that aren't there)

• Severe confusion or disorientation

• Rapid mood swings, from euphoria to despair

• Paranoia

• Not sleeping for days, even when exhausted

• Behavior that feels completely out of character

This is a medical emergency, like a stroke or a severe allergic reaction. It requires immediate psychiatric treatment, usually hospitalization, because a person experiencing psychosis is, by definition, not able to reliably tell what's real from what isn't.

What It Is Not

Here's where I want to slow down, because this is the part that gets muddled in headlines, comment sections, and maybe even with your friends and family. 

It's not the baby blues. The baby blues are incredibly common (up to 80% of new moms experience them); they're mild, and they resolve on their own within a couple of weeks.

It's not the same as postpartum depression. PPD involves sadness, hopelessness, exhaustion, and difficulty bonding, but it does not involve a loss of touch with reality. Someone with PPD knows a scary thought is scary. Someone with psychosis may not.

It's not the same as postpartum OCD, which involves unwanted, intrusive, distressing thoughts about harm coming to the baby. These thoughts are ego-dystonic, meaning the person is horrified by them and actively avoids anything related to them. This is one of the most misunderstood distinctions in perinatal mental health, and it matters: a mom with postpartum OCD is not a danger to her baby. She is suffering, and she needs support, not shame.

And it is not a character flaw, a parenting failure, or something a person can "snap out of." It is a biological and treatable medical condition.

Why This Matters So Much to Me

Every time a case like this becomes national news, I worry about two things. First, that moms who are quietly struggling will be too afraid or ashamed to say anything, because they're terrified of being seen as dangerous, or fear that they will lose custody of their baby if they say they are struggling.

Second, that nuance gets lost, and whatever the mental health diagnosis being spoken of becomes a scary label thrown around loosely, when what it actually needs is compassion, awareness, and access to care. 

If there is one thing I hope you take from this: postpartum psychosis is treatable, and with fast intervention, the outlook for full recovery is genuinely good. This is not a life sentence. It is an emergency that, when caught, can be met with real, effective help.

CBS Sunday Morning ran a piece on this on September 6th — a woman sharing her own experience with postpartum psychosis, how she got help, went through treatment, and went on to have another baby. It's a powerful reminder that recovery is possible, and I'd encourage you to watch it. 

If You're Worried About Yourself or Someone You Love

Trust your gut. If something feels seriously "off", if a new mom seems disconnected from reality, is saying things that don't make sense, isn't sleeping at all, or is expressing beliefs that feel delusional, please don't wait it out. Call her OB, call a psychiatric provider, or go to the nearest emergency room. This is not the time for a wait-and-see approach. And if you're a mom reading this and something in your own mind feels off, frightening, or not like you, please reach out to your provider, to a trusted person, to me. You are not the first person to feel this way, and you will not be judged for asking for help. You deserve support. Your family deserves support. And no one should have to navigate this alone.

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If you are experiencing a mental health crisis, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. 

Postpartum Support International also has a free helpline: 1-800-944-4773.

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https://www.cbsnews.com/sunday-morning/full-episodes/  (16mins in) 

Caitlin Hart LCPC NCC PMH-C