The psychiatric hospital discharged her on January 5, 2023. She had been admitted days earlier, struggling with sleep, racing thoughts and the weight of caring for three young children. Nineteen days later, her three children were dead.

Lindsay Clancy's murder trial in Massachusetts has thrust postpartum mental health into the national spotlight, but not as a cautionary tale about rare psychiatric breaks. It's an exposé of how little we understand about common mental health crises that go unrecognized and untreated.

Postpartum depression affects roughly 1 in 7 women. Postpartum psychosis , the condition at the center of the Clancy trial, is far rarer: 1 in 500 to 1 in 1,000. But here’s what matters: the vast majority of women who experience postpartum mental health crises never seek help . They don't recognize what's happening. Their doctors don't catch it. Their partners don't see it coming. The Clancy trial is revealing the gap between what we know about postpartum mental health and what we actually do about it.

Postpartum Depression Symptoms: What It Actually Looks Like (And Why Most Women Miss It)

Most people think postpartum depression looks like sadness. It doesn't. That's part of why so many women miss it in themselves.

Postpartum depression manifests in ways that don't fit the depression stereotype, so women don't connect the dots. A mother might be experiencing intrusive thoughts — persistent, unwanted images of harm coming to her baby — that terrify her precisely because they contradict how much she loves her child. She might experience rage she doesn't recognize in herself, or profound numbness toward her baby despite desperately wanting to feel connected.

“In my experience, the numbness is often the symptom women hide the longest. Rage or intrusive thoughts feel alarming enough to mention to someone. “Numbness feels like failure.” notes Dr. Nazlim Hagmann, MD, MPH, MBA, MSc , board-certified psychiatrist and strategic advisor to Willow Health, a virtual behavioral health company focused on increasing access to crisis support.

Common presentations include:

  • Intrusive thoughts: Persistent, unwanted thoughts about harm that contradict what you actually want
  • Rage: Disproportionate anger that doesn't feel like you
  • Numbness: Disconnection from your baby, life, and partner despite going through the motions
  • Brain fog: Cognitive impairment so pronounced that basic tasks feel impossible

In the weeks before her hospitalization, Clancy documented desperation and confusion in her diary, as if her mind wasn’t working. "I feel like I’m drowning every day," she wrote. "I have crazy brain fog."

These aren't weaknesses. They're symptoms of a treatable medical condition. But if you're experiencing them, you might tell yourself: I should be happy. What's wrong with me? Other mothers manage fine.

You probably won't say, "I have postpartum depression" unless someone names it for you.

Why Most Women Don't Get Help for Postpartum Depression: 5 Critical Barriers

Roughly 50% of women with postpartum depression never receive professional treatment. Why?

Stigma: The mythology around motherhood is suffocating. You're supposed to feel joy, be grateful and handle it. When you don't, the narrative is that something is fundamentally wrong with you, not with your brain chemistry. Women interpret their depression as a character flaw instead of a medical condition, and guilt becomes part of the symptom.

Lack of recognition: An overworked OB-GYN might ask, "How are you feeling?" and accept a quick "fine." Partners might think you're just adjusting to new parenthood. Postpartum depression doesn't announce itself in obvious ways.

Screening gaps: Not all hospitals screen comprehensively for postpartum mental health before discharge. Not all OBs do screening at postpartum visits. Screening tools exist and work, but there's a gap between best practices and what actually happens. If nobody asks the right questions in the right way, depression goes undetected.

Access barriers: Finding a therapist takes time and navigating insurance. Coordinating childcare to attend appointments is a logistical nightmare. Cost often becomes the barrier.

The discharge gap: Trial testimony reveals what care Clancy received during hospitalization. What's less clear is what happened after. There's often a critical gap between inpatient and outpatient care. You're stabilized in the hospital, then sent home. If the outpatient plan isn't robust, meaning if follow-up is scheduled for weeks instead of days, you're vulnerable.

“The discharge gap is the gap we see most often. When people come out of the hospital, they might be stabilized but they are still very fragile. Virtual care matters here because it removes barriers that can keep a postpartum woman, especially one without much support, from getting to a follow up appointment in the first place, like childcare, transportation etc. Same day or next day access shouldn't be the exception for anyone but especially not for this population, it should be the standard,” emphasizes Dr. Hagmann.

Postpartum Depression Red Flags: Warning Signs for You and Your Family

  • Sleep disruption that persists even when the baby is sleeping
  • Intrusive thoughts about harm (to yourself or your baby)
  • Inability to enjoy things that normally bring joy
  • Persistent anxiety, rage, or disconnection from your baby
  • Brain fog or difficulty concentrating
  • Thoughts of self-harm
  • Withdrawal or unusual quietness
  • Expressions of hopelessness or feeling like a burden
  • Unusual irritability or anger
  • Not sleeping even when able
  • Any mention of harming herself or the baby—seek help immediately

How to Get Help: Treatment Options and Resources

Start with your OB-GYN. Be specific about symptoms. "I'm having intrusive thoughts about my baby getting hurt" is more useful than "I'm not feeling great." Ask:

  • What postpartum depression screening do you do?
  • What are my treatment options?
  • What medications are safe if I'm breastfeeding?
  • When is my follow-up appointment?

Understand your insurance before you need it. Mental health coverage varies wildly. Does therapy require prior authorization? What's the copay? What medications are covered? If you're planning for parenthood, this should be part of that conversation.

If your doctor doesn't take it seriously, find a new doctor. Postpartum mental health is medical, not moral. If you're being told to "just relax" or "all new mothers feel this way," you need someone who understands the urgency.

Therapy works. Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) are evidence-based. Teletherapy can reduce barriers.

  • National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262)
  • Postpartum Support International: 1-800-944-4773
  • Crisis Text Line: Text HOME to 741741

The Lindsay Clancy case is tragic and rare. Postpartum mental health crises are not. Most women who experience postpartum depression recover well with treatment.

But recovery requires recognition. Someone has to see what's happening and take it seriously. That someone might be you, your partner, your doctor, or your financial advisor.

If you're planning for parenthood, conversations about postpartum mental health should include your healthcare provider — and also whoever helps you think through your financial and health picture. Postpartum mental health is part of family planning. It affects decisions around leave, childcare, healthcare spending.

Read the warning signs. Know the questions to ask. Understand your insurance. Have the conversation with your partner before the baby arrives. Get help if you need it.

You're not failing if you struggle. You're struggling if you don't get help.