Postnatal depression and psychosis: Women who kill their children

ON SEPTEMBER 16, 2021, South African doctor Lauren Dickason, 40, allegedly strangled her daughters, twins Maya and Karla, 2, and their older sister Liane, 6, IOL reported. Dickason, her husband Graham, an orthopaedic surgeon, and their three children had emigrated to New Zealand a few weeks earlier. Dickason has been in a secure psychiatric institution since her arrest.

According to IOL, she last appeared in court on June 1, this year. According to the New Zealand media, her legal team are basing their case on a defence of insanity.

Much of my first two years of motherhood are a blur. I look at some pictures of that time and I have no memory of that day, that moment. It’s as if I wasn’t there.

On June 20, 2001, 37-year-old Andrea Yates of Houston, Texas, confessed to drowning her five children – Noah, 7; John, 5; Paul, 3; Luke, 2; and Mary, 6 months – in their bath. She was sentenced to life in prison but the verdict was later overturned.

Yates was found to be suffering from postnatal psychosis, in addition to severe postnatal depression and schizophrenia, at the time of the killings, the New York Post reported.

She had been hospitalised before the murders but had been discharged. Neither her doctor nor her family believed her to be a danger to her children.

Yates was sent to Kerrville State Hospital, a mental institution, where she remains to this day. Although she is eligible to be reviewed for release annually, she’s declined each opportunity, according to the New York Post.

On January 24, this year, Patrick Clancy arrived at his home in Duxbury, Massachusetts, to find his wife, Lindsay Clancy, lying on the ground beneath their bedroom window, the UK Independent reported.

She had spinal injuries and cuts to her wrists and neck. She told him she had attempted suicide, and that their daughter Cora, 5, and sons Dawson, 3, and Callan, 8 months, were in the basement.

When he found them, they had exercise bands around their necks with which they had been strangled, the report said. Cora and Dawson were pronounced dead at the home. Callan died three days later in hospital.

On February 7, Clancy, 32, a midwife, made a virtual appearance in court from her hospital bed.

She is paralysed from the waist down and doctors say she is unlikely to walk again. She has been charged with the murder of her children.

Like Dickason’s legal team, Clancy’s lawyers have put forward a defence of insanity. In May, she was committed to a state mental institution for six months, Boston.com reported. Clancy is due back in court for a case status hearing on July 25.

In the Dickason case, a New Zealand newspaper reported that according to a former colleague, Dickason had been on chronic medication but stopped taking it because she feared it would affect their immigration application.

New Zealand has strict requirements and potential immigrants can be turned down on the basis of a chronic illness.

The former colleague said that stress combined with Dickason not taking her medication could have led to the tragic murders of the children.

“The immigration process for New Zealand is extremely traumatic,” the former colleague, also a doctor, said. “I understand the place where the Dickason family had to spend their quarantine was basically like a prison. You don’t see anyone, your food is delivered to your door, and you are only let out for about an hour a day.”

The condition Dickason was being treated for had not been revealed.

Clancy’s defence team has argued that she was suffering from postnatal psychosis when she strangled her children and that at the time, she was taking a cocktail of 13 psychiatric medications, the UK Independent reported.

Her husband said she had been struggling with anxiety for some time. According to Boston.com, court documents outline Clancy’s reported mental health struggles following the birth of her youngest child, including admission to a psychiatric hospital in Belmont, Massachusetts.

The three women’s husbands have defended their wives, saying they were not to blame.

In a letter read out at a candlelight vigil outside the Dickason’s home in Timaru, Graham said he had forgiven his wife and asked: “Please also pray for my lovely Lauren, as I honestly believe that she is a victim of this tragedy as well. People that know her well will testify to that – I have no doubt.”

Patrick Clancy, in a January 28 post on the GoFundMe page set up by family to raise money to help him pay for medical bills and legal fees, said he forgave his wife and wanted everyone else to do the same.

“The real Lindsay was generously loving and caring towards everyone – me, our kids, family, friends and her patients,” he wrote. “The very fibres of her soul are loving. All I wish for her now is that she can somehow find peace.”

Russell Yates, who divorced Andrea in 2005, spoke out about the Clancy tragedy, saying he did not believe Lindsay Clancy should go to jail.

“But for her (Andrea’s) sickness, she would never, ever, ever have harmed our children,” he told NewsNation.

What is postnatal depression and postnatal psychosis?

According to WebMD.com, it’s not uncommon for women to get the “baby blues” after giving birth. This usually passes within a week or two. In postnatal depression, however, symptoms may be severe and don’t always become evident until several months after birth.

Postnatal depression can last for up to three years, according to the US National Institutes of Health, and may affect a mother’s ability to care for her baby.

In very rare cases (1 in 1,000 births), doctors believe that the hormonal changes before and after childbirth may help to trigger postnatal psychosis. Some women who get this disorder have been previously diagnosed with bipolar disorder or schizophrenia, for example, but most have no previous history of mental illness.

Postnatal psychosis can appear within a couple of weeks after you give birth. Usually, it happens suddenly, although in some cases women with untreated postnatal depression and severe anxiety can experience psychosis, particularly those who have been previously diagnosed with other mental illnesses.

Symptoms of postnatal depression include:

• anxiety and agitation, panic attacks;

• irritability and anger;

• feeling isolated;

• feeling worthless;

• feeling rejected by your baby;

• worrying a lot about your baby, to the point of obsession;

• loss of joy and humour;

• disinterest in things that previously brought pleasure;

• not bothering to wash/dress;

• changes in sleep patterns;

• changes in appetite;

• concentration problems or confusion;

• sadness, excessive crying;

• constant exhaustion/lethargy;

• reduced ability to cope with daily life; and

• thoughts of harming yourself and/or your children.

– Source: South African Depression and Anxiety Group (Sadag)

According to Sadag, approximately one in three families in South Africa are affected by postnatal depression – about 50,000 women per year.

Symptoms of postnatal psychosis include:

• delusions;

• hallucinations;

• agitation;

• heightened energy;

• depression anxiety, or confusion;

• severe insomnia;

• paranoia;

• constant mood swings; and

• feeling disconnected from your baby.

– Source: Health Service Executive, Ireland.

According to the Royal College of Psychiatrists, sleep deprivation is a major risk factor for developing postnatal psychosis, as is a family history of mental health conditions, especially postnatal psychosis in a close relative. Multiple pregnancies can also play a role. Dickason, Yates and Clancy had several young children to care for, a tough task even for a mother without other stressors in her life.

When I read about the Dickason, Clancy and Yates cases, I thought: that could have been me. Although I never experienced full-blown psychosis during my postnatal depression, at times I felt as if I was losing my mind. I had some dark thoughts that I knew were not “normal”, and I felt very isolated.

My baby was premature and hardly slept; I didn’t have the time or energy to prepare healthy meals, let alone eat them. I had been overjoyed when I fell pregnant after our first round of IVF, but now all I felt was guilt that I couldn’t enjoy my baby.

Fortunately, I already had a psychiatrist who had been treating me for depression for several years before my pregnancy. However, I was not willing to admit, even to her, that I was struggling.

I was ashamed that I was failing to be the perfect mom. I became paranoid, thinking that my baby would be taken away from me or that my doctor would put me in hospital and I would be separated from my son. I was convinced that something bad would happen to him if I wasn’t there.

Eventually, my husband, at his wits end, phoned my psychiatrist. At the time I was angry, feeling he had betrayed my trust and just wanted to have me “locked up”. Delusional? Definitely.

I wish I could remember more of the first two years of my son’s life. I wish I could have been more present. I still feel guilty sometimes. But, thanks to my husband who didn’t listen to me when I insisted I was “fine”, and the help of my psychiatrist and medication, I survived, as did my son, who is now a healthy teenager and has no memory of the time his mom wept for hours in the spare bed next to his cot every night, getting up frequently to check he was still breathing.

What I learnt

You don’t have to be a perfect mother; there is no such thing, so ditch the guilt. The saying: “It takes a village to raise a child” is true. Ask for help. If you don’t have family who can help, ask a friend to come round. Arrange for your husband or someone else to babysit so you can have some me time or catch up on sleep once a week. Don’t be ashamed to admit that you aren’t coping.

Where to find help

Contact your GP or obstetrician. If necessary, they can refer you to a psychologist or psychiatrist.

Visit the South African Depression and Anxiety Group (Sadag) website: www.sadag.org, phone their 24-hour helpline on 0800 456 789 or, in the case of an emergency, phone 0800 567 567.

What you can do to help yourself

• Find someone to talk to – a therapist, friend, family member or someone who will listen to you and help you.

• Join a support group for new parents.

• Get help with household chores or errands.

• Try to eat healthily and find time for exercise.

• Rest whenever you can.

• Keep in contact with friends, even if you don’t feel sociable – don’t isolate yourself.

• Find time for self-care and doing things you enjoy, like reading or other hobbies.

– Source: Healthline.com and https://my.clevelandclinic.org

IOL