Psychiatrist: “Everyone Is Wrong About The Lindsay Clancy Case”

Lindsey Clansancy case. Give me some thoughts. >> Okay, so let's start with some background for people who don't know who Lindsay Clansancy is. So Lindsey Clancy is an obstetric nurse. Okay. Um who has is married and has three children, has a history of psychiatric illness. Um and after her third child has a psychiatric decline that is characterized by um outpatient care, partial hospitalization program, going to the emergency room, being hospitalized inatient, being discharged. has seven psychiatric providers, uh, psychiatrists and nurse practitioners who prescribe 13 medications over some period of time. So, Lindseay Clancy is also like particularly close to home because I trained at MGH where she went to the emergency room. Um, I know the people who took care of her when she was hospitalized at MLAN. So, I'm I'm very familiar with like >> the the this case. Okay. >> Um, I used to take she's from Ducks where I used to take my wife when she was pregnant. There's a beautiful beach over there in Great Oysters. So, and then what happened is is Lindsay Clansancy um killed her children and then jumped out of a window and um >> cut herself first. >> Cut herself and then jumped out of a window and is now I believe paralyzed for the sternum down. A few months after this happened, I believe her husband divorced her and I think he's in a new relationship. I'm not 100% sure. And then there are two separate legal proceedings. One is the state of Massachusetts is is trying to Lindseay Clancy is on trial in a criminal trial by the state of Massachusetts for murder of her three children. There is a separate civil lawsuit uh by Lindsay put forward by Lindseay Clancy and her ex-husband suing various mental health providers for failure to do their duty of care. I didn't know about the second one. That's fascinating. Okay. >> Yeah. So, first thing is most people don't know much about like like you said, have you read the legal proceedings? I I've read some of the legal stuff, but I don't know anything about ethics or legality, >> but I know a lot about medicine and I know a lot about the internet and I know a lot about how people react to it. >> So, there are a couple things that are like, so this is a thing that So, this is the these are the facts. Okay. Then there's the internet's reaction to it, which is people are blown away that she has has. So I heard, this is not something I verified myself, that her husband started a GoFundMe that raised $1.7 million that is not being used for her her legal defense. I don't know if that's true or not or if that's social media conspiracy hat. >> She >> There is a GoFundMe for about a million dollars now. I think I don't know whether he >> she started a GoFundMe to which uh uh women have raised a million dollars on her behalf and then the other really interesting thing is that this is tearing apart couples. >> So not just off a wedding. >> So yeah, so someone called off a wedding. So, I am a psychiatrist who has done some postpartum work and I went to the Massachusetts General Hospital and trained at Harvard Medical School and I am reading 28 page civil proceedings on this as well as doing a lot of research on postpartum psychosis. And my wife, who is my boss, comes to me one day and she says, "I'm disappointed in you." And I said, "For what?" She says, "For how you're handling the Lindsy Clansancy case." And I mean, like, "What do you mean how I'm handling like I'm I'm reading things. I'm like reading papers. I'm looking at stuff." And and she was like disappointed. I was just blown away. Like this is like like I took paternity leave. I changed diapers. Like I'm pretty sure I'm a pretty good husband. I'm pretty sure I'm a pretty good dad. And I'm pretty sure that I like support women through pregnancy and I've seen postpartum psychosis. We'll get into that in a second. I've helped women through this. And I was just blown away by like my my wife's reaction. She wasn't like super mean about it. She was just like, you know, I'm I'm really disappointed in you. And I was like, what the [laughter] Like what did I do? Like I'm actually like doing like what like I've spent 10 to 15 hours at least like getting into the details of what is going on and like I So, I I was just struck by that and I was like, "Wait, what what is going on?" Right? Because I I know that she doesn't think I'm a bad person or bad psychiatrist or or things like that. Like, I've helped some of her people in her life who have gone through somewhat similar things. So, like I I know I'm not like in the wrong a and and so there's just so much energy around this. And then so what people are getting upset about, right? So people are breaking up over this and a lot of people are like really upset. >> Mhm. >> So So people people are are upset with people are upset at the women for supporting Lindsay and not considering the kids. Okay. >> So >> and people are upset at them for supporting the woman. Full stop which is a separate thing I think to >> the So let's understand a couple of things. So I think the basic issue here is that it's really a lack of understanding for a lot of things. The first is I don't think men or even society as a whole understands how hard pregnancy and the postpartum period is. >> Like we all say it's hard but we don't understand. So the reason that like my take this is some hot takes and I'm not you know I'm not really an expert actually. I think a reason that so many people are rallying to their defense is because >> who's defense? >> Uh Lindsay Clancy's defense and re reason they're so many women are giving her money is because they have they have looked down from the cliff that she jumped off of. So I think so many women have had such terrible postpartum experiences including struggling with thoughts of suicide or even killing their kids or all other things. So I think the experience of of many women in not even the postpartum period this is pre-partum and there's all kinds of stuff but like it is like you are fighting against something that is going to kill your kids and you love your kids >> and you're fighting against it day after day after day after day and you're losing and you don't know what to do and it's like everything is falling apart around you and like you don't know what to do and everything is just going to fall apart. I I I know that's hard to understand, but that that's like I think that's why people are supporting her because they know what it's like and they know how dangerously close they came to succumbing to this. So, let's talk about what this is. So, this is the other thing is, you know, I I I you know, the the people who are breaking up with their girlfriends andor boyfriends, husbands, whatever. A big part of this is she killed her kids. If you support her, there's no way I can ma maintain a relationship with you because like I can't how can you support someone who would kill their kid who would kill their kids? I cannot be in a relationship with someone for the safety of my own children. >> I think this speaks to a real misunderstanding of what psychosis is. So, interestingly enough, mental health awareness has increased, but mental health ignorance has also skyrocketed. So people are aware of mental health but they don't know what mental illness is and people don't know what psychosis is. Okay. So let's go through some stats. Two to three women out of 10,000 live births will experience postpartum psychosis. But postpartum depression is experiencing depression within 12 months of having a baby. So, not all postpartum depression is necessarily due to the pregnancy. The diagnostic criteria for postpartum depression is the same as a regular depressive episode. It's just it happens postpartum. Okay. So, then there's a a couple of other statistics. So, um there are I think 6,000 live births. Oh, maybe I'm getting this wrong. 6,000 or 60,000 live births per day in the US. >> Okay. So, I I remember like doing this math and thinking like a handful of people experience postpartum psychosis every day in the US the way that the math works out. So, the >> you're going to have a kid and at some point in the next 12 months they're going to go into >> Yeah. So, so people are experiencing postpartum psychosis like every day like all the time. >> Okay. So, it it's actually like quite common. >> It's prevalent. Um, and so, and then the second thing is I don't think people understand what psychosis is. So, what psychosis, the best way I I'd explain it is like, you know, like your mind tells you to do things and there are some things that it tells you to do that you listen to and some things that it tells you to do that you don't listen to. So, let's take something really basic like let's say you know like when you take a dump and you wipe and you don't like wipe good enough and you like need a second wipe and it's just so natural to like wipe a second time, right? It's like so simple. It's not even something that you would argue against. You never even question it. Imagine the thought is kill your children and you just do it. M >> so so the thing about psychosis is it is like literally like your mind is manufacturing. So what is psychosis? It's a break from reality that is usually involves two or three different things. One is hallucinations. So your mind is literally creating things that are chasing you that you think are real. >> Linda Glansancy said a man's voice told her to kill her children. >> We'll get to that in a second. So I had a patient once who jumped out of a third story window was also broke both of his legs. Thank thankfully wasn't paralyzed because he was being chased by a demon. And like imagine a horror movie, but like you're inside it and the demon is real and is like chasing you. Like you believe it's real. That's what psychosis is. Everyone's like mentally ill by reason of mental defect. And this based on the media is like something that sociopaths do. They pretend to be crazy. Oh, it was a dissociative fugue. It was multiple personalities. It wasn't me. No. Psychosis is a whole different ballgame, right? This is the thing that causes people, including herself, to jump out of window. She's paralyzed for life. >> Okay. >> It can also include things like delusions. So, this is a different kind of delusional disorder is different from from acute psychosis, but it sounds like she was experiencing acute psychosis. Acute psychosis. And there can also be there's like severity of psychosis. So, it's not all the same. So, when you get persecuto hallucinations, that is more common and actually less severe. So, this is a voice actually talking to you. It's not a voice in I mean we talk about it like it's a voice in your head. No, it is someone who follows you around and just constantly calls you a piece of Just wherever you go, think about the most toxic. We talked about cutting out toxic parents. Think about the most toxic person you know and just imagine that you had AirPods in your ear and they were just commentating on whatever you do. >> Interesting that the categorization is persecuto like that this is the defining characteristic of this guy. They're not following you around going, "Dude, you look so great today." >> No, no, no. They're not. Yeah, it's persecutoy, right? >> That's interesting. >> So, and then what's even more severe than that is command auditory hallucinations. So, command auditory hallucinations is there's someone in your ear that's giving you commands. So, this isn't thoughts, okay? This is like commands that sometimes people feel compelled to obey. >> And in my experience, and I I've worked with a lot of psychosis. Um I trained at MLAN hospital. MLAN is amazing. It's like where she was hospitalized. And so the cool thing about MLAN is most hospitals will have a psychiatric floor. MLAN is a psychiatric hospital. All the floors are different kinds of psychiatry. So when we do when I rotate, there's a unit there called AB2. 3 months on AB2 is bipolar disorder and psychosis. So every patient that I see every day for 90 days, not to mention all the days that I'm on call and covering the unit is all psychosis. So command auditory hallucinations are more severe. And they like and the the whole point of like like this level of of psychosis is that the reason we can we hospitalize people against their will is because we know from a medical perspective that these people, this is what's kind of interesting. It's not even that they can't control it. It's that they start to believe it. >> Right? So like like like and this is what's really hard for people to understand. It's not about control, it's about belief. So psychosis makes you believe something. So when I was an intern at MGH, I was on my first month of inatient and this patient I mean I don't think there's anything identifying here. It's chimera. Okay. Patient comes up to me. I she's not my patient. I'm not taking care of her. I pass her in the hall and she says, "How you doing today, son?" And I say, "I'm doing well." She's like, "You know, you're my son, right?" And I'm like, "I'm not your son." And then we we like have this little back and forth in the hallway and then she's like, "Get a DNA test. Then you'll know." She's like 10 years older than I am. I'm like, "All right, lady, whatever." So, I come back the next day and she's like, "How you doing, son?" I'm like, "I'm not your son." She's like, "Did you get the DNA test?" And I was like, "No." She's like, "See, I knew you wouldn't. You get the DNA test, then you'll know." And for the rest of the hospitalization, she was sure that I was her son, and I'm not going to get a DNA. Like, I'm not going to go get a DNA test to And then I have to get her DNA, which like I I'm not, you know, that's not even possible. It's not ethical, whatever. And she really believes this. She had a delusional disorder where she would just think people were her son. And she really believes that. and and you know and then like as I denied that I was her son she like forgave me and she's like you know even if you don't accept it like you know you should really get it and then you'll know but like if you don't know like >> I love you no matter what. Yeah. She's a great mom. >> Great mom. >> Right. So this is what people don't understand about like psychosis is you take the things that you really believe and then you just change them. >> Yeah. Yeah. So there is an element of valition in there. You're following something. It's not derangement. It's uh uh it's deranged belief and then downstream from that you are you're not doing crazy things. The things that you do are crazy but the beliefs that you have are completely logical to you. >> Yeah. But and the beliefs are dist are break from reality. Right. So so you believe and and and so there there are there all are you there is an element of loss of valition as well with command auditory hallucinations for sure. Right. So so then >> that's kind of intrusive and Yeah. >> Yeah. And then then you feel like you can't resist, right? A and so or you resist for so long and then all it takes is one moment for you to like follow the command and then you feel like you can't resist anymore or you choose to follow because you think it's the right thing to do. We don't know. I wasn't a doctor. I wasn't there. Right? This I'm just talking about psychosis in general. So everyone's like, "Oh, mental illness." Like there's some pre this is what people don't get about psychosis. there's some preser preservation of agency in every other diagnosis, >> right? But this is why psychosis is like, you know, by reason, not guilty by reason of mental defect. I'm not a forensic psychiatrist, but I think that this is the situation for which that exception exists. Tell me if this sounds familiar. You train regularly, you eat reasonably well, you feel fine, but you're just kind of going off vibes. Most people have absolutely no idea what's going on inside their body. And that is why I partnered with Function. Function gives you access to more than 160 advanced lab tests spanning hormones, heart health, kidney function, and even detects early signals linked to more than 50 types of cancer. To put that in perspective, your typical annual physical might test 20 markers. Function runs over 160. It's huge. 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