Beyond Depression: The Ignored Postpartum Mental Illnesses

Nearly two weeks ago, the murder trial of Lindsay Clancy, who killed her three children in 2023, ended in a mistrial. Like the jury, communities across the nation remain deadlocked within their own debates over whether she should have been convicted and sentenced to a lifetime in prison or declared not guilty by reason of insanity and institutionalized in a psychiatric facility. Whatever your thoughts, experts agree that, while postpartum depression dominates national discourse, that diagnosis does not represent the range of mental illnesses that women can experience after giving birth.

“Depression has likely gotten the most attention per se,” UMass Memorial Health Chair of Obstetrics and Gynecology Tiffany A. Moore Simas told National Geographic, “but perinatal mental health includes all mental health conditions and not just depression.”

Even experienced mothers and birth workers can be blindsided. Katie Crenshaw is a birthing doula and perinatal mental health advocate who’d survived bouts of postpartum depression after her first two children were born. But her third experience didn’t follow the script. A full year after her son was born she felt overwhelming indifference laced with intrusive thoughts of suicide.

Unfortunately, all postpartum mental illnesses are assumed to be textbook cases of depression. Under that assumption, other symptoms — including anxiety, hypervigilance, mania and detachment — are mistaken for the ordinary struggles of new motherhood. In truth, a spectrum of serious conditions can occur: depression, anxiety, bipolar disorder, OCD, panic, postpartum psychosis and PTSD, just to name a few. They can also be present even when someone appears to be okay.

“Like many other diseases in medicine, such as breast cancer, if you cannot see it, [that] doesn’t mean it isn’t there,” says Veerle Bergink, a reproductive psychiatrist at the Icahn School of Medicine at Mount Sinai. Women often mask it, she adds, because “you don’t want to bring your misery into every conversation.”

The reality of that invisibility is why specific language — and raising awareness about postpartum mental illness — matters. When every tough moment gets filed under “depression,” and those moments are expected to stay confined to the months immediately following birth, true emergencies can go undiagnosed and untreated. If anything that should change after the Clancy tragedy, it should be that more women are heard and given proper help in a timely fashion. For now, there are encouraging signs: support group Postpartum Support International reports that calls to its Massachusetts helpline went up roughly 50% after the trial began.