Lindsay Clancy & the 13 Medications Prescribed to Her: 48 Hours of No Sleep After New Med

Rotten Mango

This episode explores the complex mental health challenges faced by Lindsay Clancy, focusing on the debate over whether she suffered from po

Key takeaways

• Postpartum psychosis is rare but distinct from depression, often presenting with hidden psychotic episodes that can be mistaken for depression.
• Intrusive thoughts common in postpartum OCD are not indicative of intent to harm, yet they cause severe fear and isolation.

Main topics

• Postpartum psychosis vs. postpartum depression
• Intrusive thoughts and postpartum OCD

Notable quotes

"Postpartum psychosis is not like a new modern day language. It's not a modern day thing. Back in the day, they said it was insanity of lactation."

"I didn't hallucinate that the devil was coming for my baby... I knew I couldn't breathe as easily, but I adapted as I went because I couldn't quite identify what was wrong."

Conclusion

The episode underscores the critical need for better mental health diagnosis,

Transcript preview

Speaker 2 (0:01) Bada bing, bada boo. Speaker 5 (0:02) If you ever find the urge to occupy yourself entirely with learning about the directionality of strollers and the stroller wheels, is it an all-wheel baby stroller? There is dense literature to be read on Reddit forums about parenting and baby strollers. You will come out more educated on strollers and stroller wheels, but also equally confused on which exact stroller you should get for your new baby. But that is the surface level content on these parenting forums. It does in fact get much deeper because you could always stumble upon a post asking, is it normal to hear cries that aren't really there in the middle of the night? Like phantom cries. They used to call it insanity of lactation. Postpartum psychosis is not like a new modern day language. It's not a modern day thing. Back in the day, they said it was insanity of lactation. Postpartum psychosis, however, I will say is not the same thing as postpartum depression. Postpartum depression is quite common. One in eight people who give birth experience it. While postpartum psychosis, it's pretty rare about one to two people per 1,000 births. And that's kind of a distinction that's been lost in this case, where maybe, hopefully, very well-intended commentators out there of other mothers or other parents who are saying things like, well, I had postpartum depression really bad and I would never harm my children. I don't know if it's necessarily helpful or productive or perhaps even accurate input at this point. Postpartum depression and postpartum psychosis are completely different beasts. Just very different. If you take the word postpartum out of it, it's like someone with depression saying that they never heard a voice that wasn't ever there. It's like, okay, well that makes sense. And one would also imagine, because they're so different, that no one could ever mistake postpartum psychosis as postpartum depression. But that's not the case. Because people with postpartum psychosis also do have symptoms of postpartum depression. And from the outside, it could look like they just have postpartum depression, but the psychotic part is usually intermittent and hidden. Hidden meaning it only presents itself for perhaps a small window. Patients can have prolonged lucid periods where they're not really in a state of psychosis. And to, I mean, what are the odds that that times up when you see a provider, when you're talking to your therapist or your psychiatrist? There's also no standardized tool to capture postpartum psychosis. There's standardized tools to capture postpartum anxiety and depression, but not psychosis. One person on Reddit years ago writes, I spent a lot of time scouring the internet for PPP, postpartum psychosis stories that match my own. I don't fall into the category of the most typical presentation of it. So a lot of times people will hallucinate that There's a lot of like religious hallucinations that the devil is coming for their baby. One mom wrote they believed that their husband was the second coming of Christ. And the only way for that prophecy to be fulfilled was if their child died. But it would be okay because the husband would bring the child back. And then they were saying like a lot of the things that they were seeing online just kind of fed into this like second coming narrative. Now, some of these people are not even that religious before they entered into postpartum psychosis. But she says, I didn't hallucinate that the devil was coming for my baby. I didn't even hallucinate that my husband wanted to kidnap him, which is another common thing is like someone wants to kidnap your baby and you're the only one that can protect them. She says it was more subtle. like something growing in my lungs. I knew I couldn't breathe as easily, but I adapted as I went because I couldn't quite identify what was wrong. I lost myself. I fell into a deep depression. She says once that depression hit, the intrusive, like weird thoughts started coming. She says it started off just as thoughts. Intrusive, scary. thoughts so this is where it gets even more confusing when she says that she falls into a deep depression when she sees a psychiatrist that could present itself clinically as just postpartum depression then she starts having intrusive thoughts there's also something called postpartum ocd where it is someone who just gave birth and a lot of these people they have a hard time even coming to providers for it because they're scared their baby's going to be taken away There is one woman who says that she had to, every time she went up and down the stairs, she had to sit on her butt and scoot from one step at a time because she had this intrusive visual that she would chuck her baby down the stairs. She didn't want to chuck her baby down the stairs, but she's almost like, why do I keep thinking? This thought, unless I secretly must want it, which is actually a huge thing with people who have regular OCD, not postpartum OCD. They think their intrusive thoughts are some sort of reflection of their deepest wants and desires. But she, that was her postpartum version of it. So she's like, if I don't want to actually chuck my baby down the stairs, why do I keep thinking about chucking my baby down the stairs? Speaker 4 (5:07) There's also a Speaker 5 (5:08) lot Speaker 4 (5:08) of people with postpartum OCD Speaker 5 (5:10) that are too scared to report this to their providers. But they say that. They couldn't even change their kids' diapers because they kept having an intrusive thought of essaying their own child. And they would never, but that is literally what OCD is. I know a lot of people online think OCD is like, I got to tap my foot five times. I got to make sure the stove is off six times. But a lot of OCD are just like really intrusive thoughts that are like compulsion. You can't stop it. Speaker 1 (5:36) So Speaker 5 (5:37) then she's having these intrusive thoughts. So like this is, it's just. The clinical presentation is very confusing. So she goes from feeling depressed to all these intrusive thoughts. And she thought it was nothing more than that. But then they started growing. So she moves out of the intrusive thoughts. She says, while Speaker 4 (5:53) playing peekaboo. I would leave the blanket over his face just a little longer than necessary. Speaker 5 (5:58) I would think more and more about how if I couldn't even take care of him, no one else could either. I dangerously kept quiet about all these thoughts. I previously had passive thoughts wishing I would get hit by a car and require hospitalization just so I could escape. I needed to escape this never-ending cycle of sleep deprivation, crying from me and the baby, and isolation. But those thoughts eventually turned into plans of how I could self-exit. I weighed my options. I mean, I clearly wasn't right. I couldn't put it into any other words. I felt wrong. I felt broken, but I didn't know how to articulate it or ask for help. If I was honest, I was really scared that someone would take my baby away from me. But then things got worse and they got worse really fast. She does ask for help. She gets put on Zoloft and it doesn't matter because a month later, she's taken to a psychiatric hospital for a week after a self-exit attempt. And from reading one too many forums about postpartum psychosis, a lot of people who have experienced it say they presented primarily with symptoms of depression and anxiety. And the people around them saw symptoms of depression and anxiety. Now that's not to say that having postpartum psychosis makes one harm their child, nor does it mean that Lindsay Clancy herself had postpartum psychosis. All this means is there's a big debate. And this debate is not black and white. And this debate is not, oh, take her blood, see if she has something in her system. It's a huge debate of did she or did she not have postpartum psychosis? And that question is going to be life in prison or not. And it's going to play a very big role in her trial and her potential new upcoming trial, if there is one. This is the case of Lindsay Clancy. Speaker 5 (8:03) We would like to thank today's sponsors who have made it possible for Rotten Mango to support Postpartum Support International. Their mission is dedicated to promoting awareness, prevention, and treatment of mental health issues related to childbearing in every country worldwide. This episode's partnerships have also made it possible to support Rotten Mango's team of dedicated researchers. And we'd also like to thank you guys for your continued support. As always, full show notes are available at RottenMangoPodcast.com. This case has a lot of heavy themes of mental health conditions like postpartum depression, psychosis, diagnosis bipolar disorder however the details of this case are not representative of these particular diagnoses and no generalization should be made from this case about those conditions there are mentions of taking one's life as well as the lives of others particularly children and infants we may mention various opinions speculations comments all from the public about this case and those involved these are not representative of our own or are they legally confirmed everything available for this case that we pulled from is public information, so keep that in mind. And statements, quotes, may be summarized, condensed, or shortened for brevity. This is going to be a multi-part series. There is a lot of ground to cover. And before we even get into the whole Patrick Clancy and Rachel Danis' 60 Minutes interview, which is going to be in the next part, before we get into all of that, I feel like there is some necessary groundwork that needs to be laid. for the legal aspect of this case, the postpartum psychosis debate, as well as all of the medications that Lindsay Clancy was on at the time, and all of the ways that her prescribers are either under fire or are being praised by people online of whether or not they helped or failed Lindsay. There's just so much before we can even get into Patrick that we're all going to cover in this episode right now. So with that being said, Watch with discretion, take care, and let's get into it. It's Speaker 4 (9:57) not impossible to be depressed at a wedding, but hopefully it's not your Speaker 5 (10:02) wedding that you're depressed at. September 17th, 2022. This is four months before the Clancy children are killed. Their parents, Lindsay and Patrick Clancy, are in New Hampshire. So they're from... Massachusetts, but they're in New Hampshire for a friend's wedding. Their family members are helping take care of the two older children, Cora and Dawson, and they brought along the four-month-old newborn, Callan, with them. So he's four months old, and they're walking downtown in New Hampshire, and Patrick recalls Lindsay telling him, I think I'm going to start taking Zoloft. Zoloft is a very common SSRI. It's an antidepressant, and he says that Lindsay told him I think it's really going to help with anxiety and with going back to work. From the statements made by Patrick, it appears like this is the first time Lindsay ever brought up Zoloft, or at least in this time frame since Callan was born, to the point where he was even wondering, like, where are you going to get the Zoloft? What are you talking about, right? He didn't know that by this point when she's talking to him about Zoloft, she already had the prescription for Zoloft. She got it two days before. But the conversation stands. She hasn't started taking the Zoloft, so technically she is informing him, I think I'm going to start taking Zoloft. And she does. Lindsay Clancy starts taking Zoloft about four and a half months after giving birth to their third child, Callan Clancy. Patrick says he doesn't know the exact time frame that she was on the Zoloft, but she just kept getting worse and worse. There is something called the GAD test. It's the generalized anxiety test. It's got a list of questions for patients to answer. It's pretty straightforward, very easy questions. Do you feel anxious? Do you feel anxious a few times a week, several times a week, most days of the week? It's not a very thorough test. I mean, it's a screener. So do you feel restless? Questions like that. And then it spits out this random numerical score and it's just a screening tool. It's not a diagnostic tool. For feeling nervous, anxious, on edge, Lindsay responds that she feels that nearly every single day. For not being able to stop or control the worrying, she feels that nearly every single day. One Speaker 4 (12:08) of Lindsay's providers later says she Speaker 5 (12:10) was significantly high in the GAD-7, which is for generalized anxiety. She scored a 21 out of 21. Which, I mean, they're just screening, so it's not diagnostic, but it did indicate that she was experiencing some extreme anxiety. Now, I was on Reddit and I was like pulling from even my own personal experiences of taking the GAD7 test a few times. I've yet to see many people on even Reddit hitting the 20, 21 mark out of 21. Even at like the peak worst I've ever been in was like 17. And that seems to be on par with a lot of Redditors. Speaker 2 (12:45) It's Speaker 5 (12:45) like a lot of people seem to hit 14, 13 from what I can tell. And then 17, 18 is like, okay, things are not great. But like I could not find many people who were hitting 21 out of 21. So hitting the ceiling of this GAD-7 test, I would imagine, is incredibly concerning. So two days before Lindsay tells Patrick at the wedding that she wants to get on Zoloft, she is meeting with a psychiatrist, Dr. Jennifer Tufts. So I'm just going to give you a quick timeline. September 12th, 2022, Lindsay finds Dr. Tufts online and schedules an appointment. This is really important. So Lindsay looks up. Doctors. And she finds Dr. Tufts. I'm assuming that she goes on her website, sees, you know, everything that she's advertising on her page of the things that she specializes in, and then books an appointment with Dr. Tufts. Speaker 2 (13:33) Online appointment, right? Speaker 5 (13:35) Yeah, it's a telehealth appointment. September 15th, Lindsay has her first telehealth appointment with Tufts. And then September 17th, Lindsay tells Patrick she might want to start Zoloft. Now, she was already prescribed it September 15th, two days before. But back to this very first meeting. Lindsay reports to Dr. Tufts that she feels okay. I mean, okay, right? Dr. Tufts takes notes that Lindsay appeared a little bit anxious, which makes sense considering that seems to be Lindsay's biggest concern for this appointment is she just seems to have a lot of anxiety. She just gave birth to their third child in May of 2022. It's now September, so only about like four months. Lindsay's not feeling well. This is peak postpartum period. A lot of people say it's about a year. Some people will go as far to say the last two years is the postpartum period where you got to look out for postpartum depression and psychosis. But Dr. Tufts prescribes Zoloft. And Lindsay is really hesitant about this because she remembers that she was prescribed Zoloft when she gave birth to her second child, Dawson. And she just had concerns about breastfeeding while taking the Zoloft. I will say that Zoloft is probably one of the safest medications to breastfeed on, but I think everybody has different standards for safety when it comes to their own children. And that seems to be what applies here. She seems very hesitant, but yet still kind of open to the idea. She even brought it up to Patrick. And eventually, two weeks later, she starts taking the Zoloft. So she doesn't take it in September. She gets prescribed it September 15th. She doesn't take it until like... Mid-October. So actually more than two weeks. A month. Yeah. The original dose was 25 milligrams. And then it gets increased to 50 milligrams because it's how it works. You ramp up. Speaker 4 (15:20) And Speaker 5 (15:21) this is not an abnormal dosage for Zoloft. This is nothing concerning in terms of the dose. And once Lindsay hits that 50 milligram dose, Lindsay hates it. She reports that she... has such severe insomnia. She was awake for 48 hours. She had racing thoughts, worsening anxiety, which is like the whole point that she's going on Zoloft. This is just miserable. So she tells this to Dr. Tufts and they stop the Zoloft. Speaker 4 (15:54) I discussed with her and her husband the possibility of potentially an underlying bipolar disorder. I based this on Speaker 4 (16:08) Several factors, one of them being that she had such what we call an activating response to the Zoloft. Speaker 4 (16:18) It's unusual for somebody to describe taking Zoloft and then going 48 hours without sleep and not being tired. There is a Speaker 5 (16:27) huge, very, probably meaningful conversation about Lindsay's reaction to Zoloft. A big, bold preface here is Zoloft is the brand name. The drug is Cetraline. Cetraline does not create bipolar disorder. Speaker 2 (16:42) Okay. Speaker 5 (16:43) But there is an argument that if you take Zoloft or similar SSRIs, it can push someone who already has an underlying bipolar disorder out of depression and straight past what they describe as normal and into a state of hypomania. Some psychiatrists call it the antidepressant-induced mania. And there are lots of anecdotal stories of people saying like, hey, I didn't even know that I was bipolar until I was prescribed Zoloft because I went into my psychiatrist and I was showing symptoms of being depressed. So they thought that I had major depression. Then I took Zoloft. Then I took all these other SSRIs and I went into a state of mania. And that's when they're like, oh, so actually your diagnosis is not major depression. Your diagnosis is bipolar disorder, typically bipolar disorder too. Right. The FDA has straight up stated, in patients with bipolar disorder, treating a depressive episode with Zoloft or any other antidepressant may precipitate a mixed manic episode. The FDA instructs prescribers to, quote, screen patients for any person or family history of bipolar disorder, mania, or hypomania. which hypomania is similar to mania, but instead of the duration being like seven days and needing to be hospitalized, it's at least four consecutive days of very hyperactivity. And hypomania, the scary thing for a lot of people is that from the outside, it could appear that you're functioning completely normally when you are in a state of mania. So from the outside perspective, you actually seem like you are functioning better than most people. You might even be more productive. You get four hours of sleep. You're talking fast. You start three new projects. You're running on some sort of high in life. You have this very sure feeling that you can take on everything. But also your attention span is kind of shot. So you're switching between tasks nonstop. But somehow you feel upbeat. You got high energy levels, even if you're not sleeping as much. But Speaker 2 (18:42) what happened after that period? Speaker 5 (18:43) Usually it is a very depressed state. Yeah, and it's very dangerous because there is really, it doesn't appear that there's a strong guideline for how long these manic states last. And there's different types of mania and different types of mania can be scary. For one, it's hard for a lot of providers to identify that you're manic when you're in certain