As the murder trial of Massachusetts mother Lindsay Clancy, 36, begins, the severe psychiatric emergency of postpartum psychosis has re-entered the national conversation. Clancy has pleaded not guilty to killing her three young children in January 2023 before attempting suicide, an act that left her paralyzed. Her defense is expected to argue that she was suffering from postpartum psychosis, while prosecutors contend the killings were deliberate.
In the wake of this case, one mother, Aaisha Alvi, who uses a pen name for her work, shared her own traumatic experience with the illness, highlighting how it can be misunderstood and stigmatized, and how it was missed by medical professionals in her own case.
Alvi first heard voices commanding her to harm her daughter, Lina, shortly after a miscarriage nearly two decades ago. "Stab Lina! Stab Lina! Stab Lina!" the voice commanded, accompanied by visions of a knife plunging into her then-4-year-old daughter. She described feeling compelled to act against her will. "I didn’t want to do what the voice was telling me, but at the same time, I felt like it was going to make me do it," Alvi told The Post.
She sought medical help, expressing extreme distress and fear of being forced to do evil things. However, doctors prescribed medication for panic attacks, and she was sent home, a decision that haunts her as a failure of the healthcare system. The prescribed medication reportedly worsened her condition.
Alvi had no prior history of mental illness before becoming pregnant with Lina in 2002. After a smooth pregnancy, postpartum depression and anxiety set in within a week of giving birth. Her perception of reality began to shift, leading to delusions that her baby was not real and that her husband intended to harm their daughter. Her husband, Adam, noted her drastic withdrawal from family, recognizing that something was severely wrong.
Despite these alarming changes, doctors reportedly dismissed her symptoms on two occasions. The delusions eventually led Alvi to attack her husband while he was driving. Four months after giving birth, the psychosis subsided as suddenly as it had begun, and Alvi returned to her baseline without ever receiving a diagnosis.
Years later, Alvi experienced a second episode of postpartum psychosis after a miscarriage. She immediately sought medical help, describing command hallucinations and a feeling of being forced to commit evil acts. This time, her symptoms escalated rapidly. "I clearly expressed that I felt like I was hearing a voice," Alvi said. "I told them I felt like I was being forced against my wishes to do evil things to others."
She experienced terrifying visual hallucinations and believed she was in a different dimension. The most frightening aspect was the loss of her grip on reality. "I began hearing command hallucinations, which were ordering me to stab my daughter to death," she recalled. "I did not want to in any way harm my daughter. That’s why I was actually at the doctor, because I was looking for help."
Her husband observed her deteriorating condition, including significant weight loss, lack of sleep, and disinterest in their daughter. Alvi's mother insisted she move in with her to ensure she was not left alone. Her husband readily agreed, stating, "I could so clearly see something was wrong with her."
Dr. Uruj Haider, a perinatal psychiatrist, explained that postpartum psychosis is marked by rapid clinical deterioration, often onsetting suddenly within days of childbirth. Symptoms can include hallucinations, delusions, and bizarre behavior. Early warning signs like severe insomnia, confusion, irritability, and disorganized thinking can be mistaken for normal postpartum exhaustion or anxiety. Haider referred to these subtle signs as "pink flags."
Postpartum psychosis affects an estimated 1 to 2 in 1,000 births, with about half of affected individuals having no prior psychiatric history, making it difficult to anticipate. The period following childbirth, characterized by sleep disruption and hormonal changes, is the highest risk period.
Alvi's breakthrough came when she found a perinatal psychiatrist familiar with postpartum psychosis. A 90-minute evaluation led to a diagnosis and a prescription for a low dose of antipsychotic medication. The change was almost immediate, and within months, she was well enough to discontinue the medication.
"The fact that I could get better so fast is just so damning," Alvi said. "If my doctor had not spent the time that she spent with me, I would not be alive today, and my daughter would not be alive today."
Alvi now dedicates her time to raising awareness about postpartum psychosis, volunteering with maternal mental health organizations, and writing her memoir, "A Mom Like That: A Memoir of Postpartum Psychosis." She hopes her story will help families, physicians, and policymakers better understand the illness and act with greater urgency. "That’s the most sad part about Lindsey Clancy’s story and my situation," Alvi stated. "We were not hiding our symptoms. We did all the right things. We sought out care multiple times from the systems meant to help and protect us."
She emphasizes the importance of early recognition and specialized psychiatric care for postpartum psychosis, noting that treatment aims for full symptom control with minimal side effects. Haider advises connecting mothers experiencing concerning symptoms to psychiatric clinicians promptly and seeking emergency care if active psychosis or mania is present.
Alvi hopes that conversations about postpartum psychosis will begin sooner, preventing future tragedies, and that the healthcare system will be better equipped to listen. She shared resources for those struggling with postpartum mental health issues, including postpartum.net.