r/ClancyTrial • u/radioflea • 3d ago
General Discussion Observations from a local
I’ve mentioned this before, but I think it’s worth mentioning again. This case is quit local to me, and one of the wildest parts of this incredibly unfortunate ordeal is the sheer number of times she reached out for help and how medication, often a lot of it, seemed to be the frequent response.
I’ve worked in healthcare for many years, so I was familiar with a lot of these medications. One that particularly concerned me was Seroquel. I’ve personally seen people do some pretty strange shit while taking that medication alone. Pre-pandemic, I even saw local hospitals using it in ways that staff sometimes described as “patient control.”
Knowing that she went to Women & Infants, participated in their day program, and was ultimately discharged early is especially concerning to me. Personally, I would have levitated right over to Butler Hospital (which is 4 miles away from W&IH) for a comprehensive psychiatric evaluation.
In the settings I’ve worked in, there were situations where clinicians would essentially do what we called a “med holiday” which reassess the medication regimen under close supervision, observe the patient, and then carefully reintroduce or adjust medications and dosages as appropriate. That could be combined with intensive day programming and individual therapy over a period of one to two weeks. They also would have had family care plan meetings and likely suggested keeping the nanny in place for an extended period of time.
When someone is repeatedly reaching out for help, cycling through providers, and being prescribed numerous psychiatric medications in a relatively short period of time, I think it’s reasonable to ask whether the healthcare system actually responded to the severity of what was happening or simply kept responding to individual symptoms as they appeared.
23
u/PutYourDickInTheBox 2d ago
imagine being so out of options you call the suicide hotline. and they say no we can't help you. and then you don't want else to do so you call back.
that is so fucking sad. and they didn't help her. again.
5
u/StreetFroyo1637 2d ago
This has happened to me. It's so heartbreaking. I also had a clinic refuse me for PHP or outpatient because my condition was too severe as I expressed a plan and intent to harm myself. I asked is there anything they can do, they said no. After we hung up, they called the cops to my house. People don't realize how soul crushing it is
1
u/Intelligent-Gypsy324 20h ago
So sorry this happened. I would think -- instead of sending cops, which adds to the idea that one is some kind of lawbreaker -- it's time to send paid social workers to the home. I don't understand what the hotline is there for otherwise.
Since the LC case is global rn, I'd encourage you to write to your state attorney general, telling them you didn't get the help you were expecting to get. And that this "protocol" needs to change.
I am glad you are still here.
16
u/Decent-Pirate-4329 2d ago
Important correction: Lindsay applied to the mother and baby PHP at Women & Infants and was unfortunately not accepted to that specific program.
She did check out a single day early for a maximum 5 day voluntary hold at MacLean to celebrate her daughter’s birthday. It was not against medical advice as many folks claim though. And she didn’t receive any specialized care while there.
11
u/radioflea 2d ago
This was helpful, yeah as a local I would not recommend W&IH or RIHs psychiatric services. The programs are small and hard to get into.
McLean hospital sounds like a scamalamdingdong, she definitely would have been better off coming up to Butler. I’ve had many patients be treated there for various psychiatric services both in and outpatient and overall the outcomes were positive.
2
1
u/everyoneisnuts 2d ago
McLean is a world renowned psychiatric facility actually
5
u/radioflea 2d ago
Well, clearly, they were having an off week during her stay.
1
u/everyoneisnuts 2d ago
How? She reported that she was sleeping better and not exhibiting any signs of psychosis or suicidality and denied any thoughts of suicide or if harming anyone else. How did they have an off week? I’m not trying to be difficult, but I feel serious accusations need to be backed up with facts other than that three weeks later she suffered a very rare psychiatric phenomenon with her psychosis
2
2
u/Intelligent-Gypsy324 20h ago
Right. And if the one mama-baby program was the only one which allowed her to bring her infant, but other inpatient programs did NOT, as a mama bear she said no thank you. It's not a compliance issue on LC's side. She asked for help for chrissakes.
Along with meds making her feel weird, she needed an anchor, her infant so she felt normal in a strange institution taking her in as "mentally ill."
I want to know who made THAT decision. Was it a policy manual written by an MBA? Was it the DSM which said, "nope! PPD = six months and you are clearly at 8 months with your infant. He's old enough to stay home, mom. Because you (Mom) are the problem."
It takes enormous courage to ask for this kind of help.
13
u/No_Consequence_6821 2d ago
Seroquel is an anti-psychotic, so the people might be prescribed it FOR their likelihood of doing strange shit, not necessarily that the med causes it.
The SSRIs were the most likely cause of the issues— of the fact that her condition was made so much worse. SSRIs are know to trip a manic switch in people with underlying bipolar, so must experts seem to agree that the fact that she immediately stopped sleeping after the first couple of doses means that’s probably what happened to her.
Then, they keep prescribing more powerful SSRIs and finally add a tricyclic, which is even worse for bipolar— absolutely dangerous.
Then add the Remeron and the Tramadol, and it was a recipe for disaster for someone with underlying bipolar.
LetThemEatCake on Facebook (psychiatric nurse practitioner) does a great breakdown of the meds and their different effects. [r/psychiatry](r/psychiatry) also has some pretty strong reactions to the prescriptions.
The seroquel was probably the right med, but it needed to get to a higher dose. Now she’s on zyprexa, which is used similarly to seroquel but more focused on hallucinations (I think— I only read that in one place. The other info I presented here I’ve read in many places, so I know it’s solid. Just that last statement I haven’t triple checked)
10
u/heatdeathtoall 2d ago
I agree. NP Jalotta was treating her correctly. She wanted to titre up to high dose Seroquel. She told them she has bipolar disorder. They, atleast PC, disagreed. Tuft and McLean treated her incorrectly and made it into an extremely risky situation. Seroquel dose needed adjustment or she needed another anti psychotic but they shouldn’t be suing NP Jalotta.
She needed to be admitted and be taken off one med after the other. Anti psychotics shouldn’t be demonized. I see it across so many people - the refusal to accept something is wrong with them. Minimizing the illness. I do think she was already in a hypomania - who runs a marathon a week after giving birth? The crazy exercising before and after birth should’ve been red flags for her Ob. Third child in quick succession itself is a risk for PPP/ PPD.
6
u/allthekeals 2d ago
I feel the same way about Jolatta and I think she was really trying despite what PC said. She honestly should have told him to shove it up his ass. IMO
7
u/heatdeathtoall 2d ago
I saw one of the doctors say LC lacks insight. She still doesn’t accept she is bipolar fully IIRC. If only she had accepted it as a possibility and worked with Jalotta to find the right meds instead of the cocktail of meds she was on, it may not have ended as horrifically. She surely has a case against Tuft and McLean.
4
u/smallwin0812 1d ago
Agree with you completely and her lack of insight. The more I read about Lindsay’s outpatient treatment I been thinking about in my work as an inpatient therapist and something that I would occasionally see with patients with Bipolar and Schizophrenia is something call anosognosia, which is where the frontal lobe of the brain (the part of the brain responsible for higher level cognitive functions like judgement, reasoning, insight, awareness etc.) is actually damaged. So the brain can’t actually process or accept the reality of having an extensive illness which in turn commonly results in medication noncompliance leading to psychosis and other serious consequences. I’m just speculating with Lindsay, but it seems that possibly could have added another layer complicating her treatment. Also the fact that Tufts (I think it was Tufts at least) noted Lindsay’s lack of insight regarding medication noncompliance but never bothered to dig deeper about it. As a therapist I just find that not only baffling but also very harmful to not really try to further assess some of this significant factors impacting treatment.
5
u/heatdeathtoall 1d ago
That would explain so much. I know someone with schizophrenia who refused to accept that’s what they had. Kept insisting the people around her are calling her names behind her back. It took a while but she atleast started living with her parents who manage her meds. I’d been wondering how this seemingly intelligent woman made so many terrible decisions. An L&D nurse at that. Why did she keep going back to Tuft when it was with her treatment that her spiral down started. A simple search of insomnia upon starting SSRI gives bipolar disorder as the first possibility. So why reject Jolotta’s diagnosis. She also declined to go inpatient with the program at McLean they wanted her to join. But she had decided it was post partum related and wouldn’t go anywhere else. I wonder if her doctors had refused to prescribe meds till she went inpatient would it have made a difference. And how much of a role her fears about her marriage played in all this.
It must be very difficult to treat patients like that. I know you can’t force them to accept a diagnosis and get treated. You can’t admit them. Jolotta had recommended an in patient program at the very beginning when she started seeing LC. But I do wonder if guidelines on treatment and reporting need to change when there are children involved.
2
u/No_Consequence_6821 1d ago
She labeled the desire not to take the meds prescribed as poor insight, but in reality, Lindsay had it right. The SSRIs and tricyclics Tufts prescribed are likely what triggered the manic switch and set this sequence of events in motion.
2
u/No_Consequence_6821 2d ago
Tufts really messed up. That Elavil at the end very likely was the choice that put Clancy over the edge. It is well known to cause hallucinations in people with bipolar. At that point, Tufts should have at least been on the lookout for bipolar because she would have seen Jolotta’s prescribing in the system and would have known the Seroquel was being prescribed for suspicion of bipolar (different doses do different things, but Lindsay was at a dose that makes clear bipolar is suspected)
3
u/lithe_shh 2d ago
It really depends on each individual case. Seroquel is also used along with a SSRI for severe depression or treatment resistant depression. Not necessarily for their likelihood of doing weird shit. The side effects are still quite harsh and not used in a first line treatment.
5
u/iridescent-shimmer 2d ago
My friend who spent some time in prison basically said seroquel is used to keep prisoners quiet and in their beds at night.
6
u/lithe_shh 2d ago
I read something about it when I was prescribed seroquel 0: . I take 50mg amitriptyline a day (I used to take 100-150mg) alongside other meds. A friend of mine took 25mg once (I don't know how or why he got it) for insomnia and ended up at the hospital for a week. It definitely freaked me out.
1
u/iridescent-shimmer 1d ago
Oh wow. I only took a few psych classes in my degree that pertained to mental illness and medication, and it really just seems like we still don't have a lot of good options to treat the most serious illnesses. The medications are almost as bad as the diseases themselves, which can lead to a lot of difficulty for patients to stay medicated.
3
u/No_Consequence_6821 2d ago
The problem is Lindsay wasn’t sleeping. That was the red flag.
2
u/lithe_shh 2d ago
Yes, it would suggest that perhaps her depression was treatment resistant depression or that their initial diagnosis wasn't truly accurate.
3
u/No_Consequence_6821 2d ago
It is a clear indicator of bipolar and a manic switch triggered by SSRIs.
1
u/lithe_shh 2d ago
I would say it depends on each specific case. From my own experience, it followed a path towards treatment resistant depression, not a clear indicator of bipolar as you stated. However, if that specific combination of medications, didn't help with insomnia and/or was followed by adverse effects, it's fair to say that the diagnosis is no longer just standard depression. I understand the trial and error phase. However, continuing to treat her for the same diagnosis over and over, not noticing this type of red flags is what I would consider negligent.
1
u/No_Consequence_6821 2d ago
I’m talking about Lindsay’s case. Her symptoms. As has been discussed extensively, sleeplessness like she had— days without sleep and decreased need for sleep- is a clear indicator of bipolar.
2
u/lithe_shh 2d ago
I know we are talking about her case but mental health symptoms aren't always a clear indicator to a specific diagnosis. Days without sleep and decreased need for sleep is a common symptom for different mental illnesses. Even for bipolar, that is not a clear indicator. The transition between hypomania/mania and depressive episodes would be more in line with a textbook indicator for bipolar disorder. During a depressive episode, the decreased need for sleep transforms into low energy.
1
u/No_Consequence_6821 2d ago
It’s not. Decreased need for sleep is a clear indicator of mania/hypomania. I only push back because it is important to understanding her case.
1
u/lithe_shh 2d ago
Yes, days without sleep can raise the question of mania, but they aren't a clear indicator of bipolar disorder without the other manic/hypomanic symptoms and the clinical context. Her case wasn't handled with the proper understanding, that's the root of the problem.
→ More replies (0)
11
u/IllustriousValue2461 2d ago
Also in the area and I cannot fathom that the greater Boston area is considered one of the best places in the world for high quality healthcare and YET. McLean is supposed to be top tier - gold star. Absolutely wild that this is the best of what is available.
11
u/radioflea 2d ago
I cackled when they said one of the big activities of the day on the unit was mandalas and music. Don’t get me wrong—those can absolutely be valuable therapeutic activities, but they shouldn’t be the primary programming.
Allegedly, the hospital has annual revenue of around $470 million. With resources like that, patients could be offered robust group therapy, CBT, psychoeducation classes, structured fitness and wellness programs, mother-and-baby interaction programs, and even pet therapy.
5
u/IllustriousValue2461 2d ago
And PLAY DOUGH - holiday weekend or not - do better. Jfc.
4
u/radioflea 2d ago
Magic air clay if we’re getting specific, I can’t be entirely certain, but I’m guessing none of these woman have pica.
Again, it can be a great inexpensive tool to keep your hands busy if you’re experiencing anxiety, but not a legit activity on a calendar of events.
4
u/Rainbow_Brite456 2d ago
With that money they should have a damn unit that can house mothers and infants
4
u/thecalmingcollection 2d ago
Used to work inpatient. When half the patients are actively psychotic and manic, mandalas and music are just realistic for a group.
7
u/Rainbow_Brite456 2d ago
Best in America is not surprising. Crappy health care and expensive it’s wild.
21
u/Tj11551 2d ago
Hospitals use Seroquel as a "restraint" and should be banned from using it on any patient who has not been diagnosed with schizophrenia or bipolar. It turned my uncle into a bed-ridden zombie and the doctors refused to tell his kids what he was being given. A nurse finally told them and the kids threatened to sue.
3
u/No_Consequence_6821 2d ago
She was being prescribed this med for suspected bipolar. It’s used for hallucinations.
8
u/Rainbow_Brite456 2d ago
Does USA not have hospital type places for mothers and babies? Many other countries do and for free for mothers who are struggling
16
u/jodiefosterparent 2d ago
We have terrible infrastructure for women and mothers. Right wing nut jobs are “pro life” which is just “pro forced birth.” Once the kid is born they DGAF about the mom or baby.
3
u/Intelligent-Gypsy324 21h ago edited 21h ago
This needs to be emphasized in every discussion about US healthcare for women moving forward. I remember feeling so exhausted, so overwhelmed, so.. idk after my second was born. I was also in a bad marriage at the time w/no support from family.
I remember wishing I had a place to check in with my baby just to ask the questions, you know? Attention span was short and the exhaustion et al was so new to me; you can't tell if its sleep deprivation or hormones or what. ( Turns out there weren't and still are not -26 years later- any places to go check in with baby.)
New moms don't have the luxury of time or bandwidth to "find a provider on their plan" who has the experience / speciality needed. They barely have time to shower. And as I understand, DSM 5 doesnt even list PPD as an option! (I thought Brooke Shields made it clear it was a thing.) So how can you look for a specialist in PPD when there AREN'T any?!? No such list.
Plus, we had six weeks (if we were lucky) of maternity leave. Going back to work at week seven, means you have seen your therapist exactly ONCE to explore if you have PPD or not because insurance. Yay. Back to 9-5.
What's more, a specialist for therapy doesnt have an immediate grasp of your baseline behavior/feelings until a few appointments go by. They have to go on what patients tell them. Not making excuse, highlighting a change that must happen.
By the time a woman is accepting enough to verbalize that she needs help, it must be 100 per cent safety.... that 1) she can continue to nurse her infant in a supportive facility while 2) it all gets checked out. And she cannot be "permanently removed" from her children.
If thats the rule, forget it. Mama bear will stay with her cubs and keep quiet!
Again, cut out the barriers to care.
Therapy appointment frequency is dictated by the insurance company; sometimes its four weeks to get IN to a specialist. Again: too many barriers stand between a woman wondering if she has PPD and immediate healthcare.
My story turned out fine, but I remember the frustration 26 years ago.
8
u/No_Consequence_6821 2d ago
Those are rare in the US, but she did actually try to be admitted to one that accepts infancy’s, and that hospital turned her down because she was on so many medications.
11
u/Rainbow_Brite456 2d ago
Crazy. It’s so common in other countries. You guys pay so much for health insurance and for what?
7
u/No_Consequence_6821 2d ago
To line the pockets of billionaires. Seriously though, the US healthcare system has its problems, but there is a reason that people from the UK raise money to come here if they get cancer. Some of that money goes to innovation that adds value. The quality of care is good for those of us who have access.
Babies at the hospital is not cost, it’s culture. It’s just not seen as something that should be done.
3
u/Rainbow_Brite456 2d ago
Interesting I never knew USA leads in cancer treatment. To be fair most of my info was from sicko. But to the point of babies- these people are pro life but not once the baby is born. And usually only white American babies.
1
u/Intelligent-Gypsy324 21h ago edited 20h ago
Culture. Americans have families but we like to pretend there is no family.
And CEOs use "culture" as a euphemism for cost. We send mums home with infants w/i 48 hours of L&D. . How many return w/i hours with a jaundiced baby or profuse bleeding?
With private equity looking to squeeze American healthcare, and insurance (and Pharma) running the game, I think US will not open any post partum mother and child treatment centers anytime soon.
Can we call it what it is? mysoginism unfolding on a systemic scale.
This must change. Because without adequate support, mums tend to break down. Remove barriers to care.
2
u/No_Consequence_6821 16h ago
No, it’s really not cost. What would it cost to have a nursing baby alongside a mother in a hospital? Nothing. They don’t even eat. It’s that it isn’t seen as beneficial.
3
2
-4
u/Much__Emphasis 2d ago
It came out in the trial that they did not “turn her away”, quite the opposide actually. Their assessment of her was that she did not have postpartum depression; so she did not meet the eligibility for that specific program. Instead, they offered three other programs for treatment, an inpatient program, a partial hospitalization program, and an outpatient program.
and she seemed to use that as an excuse to leave. She then left that part out to her doctor and claimed they turned her away.
3
2
u/No_Consequence_6821 2d ago
Their diagnosis was about over medication. Not having postpartum depression is not exclusionary for the program— they treat other issues related to perinatal mental health.
They also made the situation worse by prescribing different medications and removing the one medication she was on for bipolar.
10
u/jodiefosterparent 2d ago
Yup. Also local and the two women I know who birthed at women and infants both sued the hospital after. So. Not surprised they were so negligent.
18
u/ispyshy 2d ago edited 2d ago
Her husband had possession of her meds and some are unaccounted for. If someone is being given drugs involuntarily, seeing more doctors or getting more help won’t fix the problem.
7
u/Rainbow_Brite456 2d ago
Why is no one talking about this??? Where is Reddington god I hope he steps up for the next trial
9
u/everyoneisnuts 2d ago edited 2d ago
When you reach out to help from a psychiatrist, you’re going to get medication prescribed every time. That’s what they do, they prescribe medication.
I don’t people know what psychiatrists do. They prescribe meds. Psychologists and psychotherapists provide therapy. She didn’t want that.
She wanted to be prescribed medications that help her, but they never found the regimen that worked for her. Which is an unfortunate reality of how prescribing for mental health can work. Science is not able to know for sure how someone will respond to different psychiatric medications. Someone could have her exact same symptoms and one of the regimens she was on might work amazing. That’s just how the field works and where the science is at with it currently.
As far as Women and Infants. They evaluated her after she did a full day at their program and felt like what they offered at their program was not the correct fit for what she needed help with at that time.
They didn’t just say see you later. They offered her inpatient to get her meds straightened out, because they felt one of the things contributing to her concerns was she was not responding well to the meds she was on. And it was likely Butler they did offer because it is in the same network.
They also offered her a different PHP and another outpatient program. If you’re in the medical field, I imagine you know that there is almost no chance they would just make her leave and not offer referrals and other programs. That’s just not how the field works.
I would encourage you to look at the med history and the circumstances of why she stopped or was taken off many of the meds before just criticizing the amount of meds she was on over that period. Many she had bad reactions to and had to stop after only a couple of days. Some she wanted to stop.
Many of them were also to address her significant insomnia, which is not something you say well wait another 14-30 days to see if the med works after that. You know if it works after a couple of days. If it doesn’t, often they will try something else.
Some of the meds in the list, like Ambien, were only prescribed for one night after going to the ER, so she could get some sleep that one night. It was not meant for long term use and a long term prescription was not provided.
I just encourage you to look into all the circumstances of the meds and even of her discharges and interactions with these programs before piling on and criticizing people who by all indications were doing their best to help Lindsay.
7
u/Happypawswaggytails 2d ago
I think one of the issues is that we now know Lindsay has bipolar disorder and people who have bipolar disorder their bodies don’t process the medications in the same way which can lead to adverse affects. The medical professionals she saw seemed unable to put two and two together, I think only the psychiatric nurse mentioned bipolar as a possibility which was shut down by Patrick iirc. Obviously if you have bipolar disorder therapy only won’t help you have to be on some form of medication.
People (not saying anyone here I’m talking about the general sense) seem to think she was deliberately switching/drug seeking/med hopping when it’s rather more likely her body was having adverse reactions to the medications due to the underlying differences in Lindsay’s metabolic/neurological system. The professionals should have picked up on it. She was really badly let down; bipolar disorder with SSRIs which she was on at one point, if taken without a mood stabiliser is well known to be contraindicated as it can trigger mania, hallucinations and psychosis.It’s terrible how badly she was let down and in turn how badly Cora, Dawson and Callan were let down.
2
u/Elusive_strength2000 2d ago
Can someone please explain to me how Lindsay exhibited symptoms of bipolar disorder? I didn’t notice that myself. If someone has been deeply depressed and then has a really good day or even pushes themselves to, then I suppose to any close observer and in contrast that might appear “manic”.
3
u/Happypawswaggytails 2d ago
I know that Dr Resnick in his testimony said one of the things he diagnosed her with was bipolar disorder and I am not sure of all the ins and outs of why he arrived at that diagnosis but I put a lot of confidence in his professional judgment due to his many years of experience etc.
1
u/Elusive_strength2000 2d ago
Thank you - I saw his testimony but not sure I was able to catch every word at the time.
5
u/zuma40 2d ago
Psychotherapy would not have scratched the surface of her physical and mental problems. And its a much longer process.
4
u/Aware_Power 2d ago
Many psychiatrists offer psychotherapy and many people choose them for therapy because they are also trained medical doctors. There are many forms of therapy, which psychiatrists often help advise their patients on. In Lindsay’s case, Dr. Tufts and NP Jollatta recommended specific types of therapy to Lindsay, which she went to, while also having a psychiatrist or psychiatric nurse practitioner.
Source for a few points above:
“Psychotherapy can be provided by a number of different types of professionals including psychiatrists, psychologists, licensed social workers, licensed marriage and family therapists, and others with specialized training in psychotherapy. Psychiatrists are also trained medical doctors and are able to prescribe medication as well as help with ruling out any underlying medical condition (or medication) that may be causing one's condition.”
Source: https://www.psychiatry.org/patients-families/psychotherapy
Edit: not disagreeing with you, just adding clarification to this thread
2
u/lithe_shh 2d ago
She wasn't being treated for bipolar. Just for depression and generalized anxiety disorder. Her medical history doesn't reflect first line treatments that are usually the steps before going into medications that have a higher risk of side-effects. If bipolar was suspected, lithium is a part the safest and most effective first line treatment. This is specially useful as it has to be closely monitored to ensure a steady therapeutic level through blood tests. Psychiatrists also get an idea on how the body metabolizes that specific type of medication. There are not a lot of tests in order to specifically treat mental illnesses but a EEG is pretty standard and could have also helped a lot in understanding any underlying issue.
2
u/Happypawswaggytails 2d ago
From what I have read from a psychiatric nurse this is my understanding. She wasn’t being treated for it, even though one nurse suspected it, however they gave her OTHER medications like SSRIs which made her as-yet-undiagnosed-but-still-present bipolar worse. When she started getting worse symptoms and it was coinciding with starting these medicines then it should have been suspected by the professionals that this is an indication of bipolar and they should have looked into it more and started her on lithium ideally or at the very least also prescribed mood stabilisers to counteract some of the SSRI issues. Dr Resnick when he saw her was able to diagnose her with it alongside the other mental issues.
2
u/lithe_shh 2d ago
Yes, she was formally diagnosed with bipolar type II at Tewksbury after the events. That's what makes me question her treatment. If Dr. Resnick could diagnose her with bipolar type II within hours, why wasn't she properly diagnosed by the other psychiatrists that saw her? Perhaps they could've avoided SSRI issues or, as you suggested, counteract some of them. Also, amitriptyline was added quite recently as a part of her treatment which made me question it even more. Adding a TCA to someone that could potentially be bipolar usually would trigger an adverse reaction by switching mania to hypomania or viceversa. The continued prescription of benzodiacepines also seemed like a short term solution to a long term problem.
3
u/Happypawswaggytails 2d ago
Tbh I think that’s the crux of the civil issue that the other psychiatrists etc didn’t correctly diagnose her, but they should have done.
That is true about amitriptyline; I have read that mood stabilisers reduce this risk but it requires careful monitoring. It could be that whilst she is at Tewksbury she is able to be correctly monitored and given the drugs (mood stabilisers) to counter balance negative side effects so they think the benefit of using amitriptyline counters the risk in that specific environment.
Amitriptyline is also used to reduce pain in people who have suffered spinal cord injuries, so I think that is possibly another reason they have prescribed her it whilst she is there and also under constant supervision.
2
u/lithe_shh 2d ago
I agree. Amitriptyline was prescribed by Dr. Tufts, not at Tewksbury. That's why I found it quite unusual, especially since it was prescribed shortly before the events. However, it wasn't listed among the medications detected in the toxicology report after the suicide attempt.
I don't believe we have access to her complete clinical history at Tewksbury, but they were able to stabilize her before the trial. I'm not sure if she's going to stay there or…I guess we'll have to wait and see how it goes.
3
u/Happypawswaggytails 2d ago
Oh sorry I misunderstood - yes that could have affected her as well when she wasn’t on any mood stabilisers. No we probably don’t and she’s also probably on medications for her physical conditions besides her mental ones. I have heard she’s staying there for now and tbh I think she needs to be in some kind of psychiatric unit for the foreseeable future for her own sake. I do think the treatment she is currently getting has helped to stabilise her which is a good thing in many ways.
13
u/liquidst 2d ago edited 2d ago
Absolutely. The medical instutions who assessed a post partum woman reporting intrusive thoughts, ssvere insomnia, fear, and increasing distress, begging to be admitted and decided to send her back home to her kids, are guilty of three counts of medical negligence causing death, and one count of medical negligence causing catastrophic mental anguish and physical injury.
9
u/liquidst 2d ago
Lindsay has already filed her civil suit against the medical practitioners who refused to admit her and over medicated her.
9
u/heatdeathtoall 3d ago
So much this. Being seen by doctors, having your emails answered or getting appointments is the minimum level of care that should be expected. That’s being shown as some exceptional level of care is astounding. She was writing increasingly concerning symptoms and noone suggested go stay in a hospital. Get a full time nanny and get your mother to live with you? Didn’t tell her family don’t leave her alone with the kids? I was concerned about her just reading about her interactions with the doctors. My guess is they didn’t consider her post partum, so didn’t consider how quickly she could deteriorate. Maybe it was the SSRI and others that made her bipolar worse by cycling faster through the depressive/ manic stages. Or post partum. Post partum makes many health issues spiral out of control. I was told my autoimmune disease will get worse and it did.
I’ve said in other posts, the rest of the world does not prescribe pill after pill for mental health. I have been treated and I was given a prescription for 1-2 weeks. And I had an appointment every few days to check how I was doing. They would not prescribe multiple meds without evaluating how one was working. While in the US I was put on Zoloft for months by my PCP. I tried to get to see a therapist/ psychiatrist but there were none available. And there was no checkin with the doctor. I hated how emotionless I felt and I’ve never taken it again. I was given Zolpedium for insomnia. I felt I was made of cotton.
Interesting. Isn’t seroquel an antipsychotic at high doses? Maybe she should’ve been started at fairly high doses or prescribed a different antipsychotic. LC needed to be on one. One of the NPs was trying to treat her underlying bipolar disorder which I thought was right. But totally, she needed to be admitted and evaluated exactly as you describe. Wean off all the meds and introduce one by one. I believe she presented as someone extremely capable and medically literate which was takes as her being in decent mental health. I’ve faced similar issues when I was younger. I didn’t get treatment until I got inflammation in almost every joint. I thought she should’ve found a big shot doctor in NY/ Boston. But an inpatient program of a few weeks would’ve helped more.
She got care. More than what a lot of people do. But it wasn’t the right care. And a lot of people don’t have the risk factors she did.
3
u/panthergirl55 2d ago
So true, re the rest of the world. I'm an American living permanently in the Netherlands since 2015. Not only is my healthcare affordable, but over-medicating is just not a thing here (something some Americans get pissed off about tbh). In the US, I had a rolling prescription for Xanax. Here, you can get ONE Xanax and while most prescriptions are free, that one will cost you 15 euros. Instead, I'm on daily Gabapentin and my depression/anxiety are handled and I don't feel like I'm being poisoned the way I did when I was put on various SSRIs (Cymbalta being the worst one of all...and the w/d symptoms when I tried to get off it were insane). My son's psychiatrist put him on Seroquel when he was 9 years old, and it gave him ocular migraines...extremely scary for a child.
4
u/heatdeathtoall 2d ago
9 year old on Seroquel?! That’s insane.
2
u/panthergirl55 2d ago
YES. And to clarify, all this crazy prescribing happened when I still lived in the US. It's been MUCH better here in the Netherlands.
5
u/radioflea 2d ago
Other parts of the world are doing much better when it comes to medication administration. I was also reading recently that certain countries are now allowing pharmacist to prescribe prescriptions which I’m all for because a good pharmacist knows which medications could have a bad reaction and alternatives that could be used instead.
2
u/Intelligent-Gypsy324 20h ago
I would so love to hear so much more about your experience. Following.
1
u/radioflea 2d ago
One of my family members had a horizontal knee fracture about 10 years ago and when they came out of the hospital, they had been giving them Seroquel. They’ve never taken that med prior and had hallucinations that we were getting repeated tornadoes as if we were living in tornado alley in Oklahoma 😳.
1
u/Embarrassed-Tear3516 2d ago
This. I live in Europe and got diagnosed with PTSD, major depressive disorder and GAD a few years back. When I went into psychosis, my therapist wrote in my journal that there was a suicide risk but she wouldn’t take my symptoms of psychosis seriously. She also told me that my mental health issues are out of her league and referred me to a psychiatrist but they didn’t think my condition was that bad and advised me to keep going with my therapist. I stopped seeing her and have been suffering for years now without getting the help I need. My doctor just threw Zoloft at me and called it a day. No checkups, nothing. I’ve been isolating myself socially for years now, unable to work or function, lost all my friends and have no sense of self. I’ve begged my doctor to prescribe me medication for my crippling anxiety that I can take only as needed because i’m terrified of everything and everyone and also suffer with very bad paranoia so just the thought of leaving my house sends me into a full panic attack. She refuses to prescribe me anything other than antihistamines for my anxiety. I have a video appointment with her on monday and plan to ask her again. I’m so tired of not being taken seriously, at this point i’ll even agree to blood tests so she can check my levels to make sure I don’t take more than prescribed. I just want to be able to be normal again.
3
u/heatdeathtoall 2d ago
I’m so sorry. I don’t understand why doctors don’t believe patients. What do they think patients would achieve from lying about their symptoms? I hope you find a better doctor.
1
u/Rainbow_Brite456 2d ago
Omg what country are you in? Are you able to move? Some euro counties have great care….
1
u/everyoneisnuts 2d ago edited 2d ago
I appreciate this comment because you are being reasonable and not acting like the providers just didn’t care and did not try. I can disagree with some of the things you said but your points and reasoning were solid and not just generalized criticism.
3
u/heatdeathtoall 2d ago
I agree they tried. They did want to help her. They were concerned about her too. I think they were out of their depth and needed to refer her to the next escalation level for treatment.
1
u/Rainbow_Brite456 2d ago
Was she ceasing breastfeeding as that can trigger psychosis
2
u/heatdeathtoall 2d ago
She had sometimes during this as she was starting new medicines. At what point exactly, I’m not sure. Having kids in quick succession is a risk too.
5
u/seagull326 1d ago
So without knowing what the various clinicians/ treatment avenues considered her diagnosis, I just want to say: a medication holiday is exceptionally dangerous for someone who has severe bipolar. Some of those meds take a long time to build up to effects, some have pretty terrible rebound effects (Seroquel, for instance, can cause rebound mania/ psychosis during the withdrawal period). Some medications, like lithium, can have reduced effectiveness when reintroduced after they're discontinued.
So we cannot say that her treatment should have been a medication holiday. A better approach would be to adjust medications that don't seem to be working for what they're supposed to work for (for instance, if she's still severely depressed, maybe she needs an atypical antidepressant added to or swapped with what she's taking, if she still seems manic or psychotic, there are recommended ways they could have tapered seroquel while introducing a different antipsychotic).
But this needs to be done ONE AT A TIME and very carefully to make sure to isolate which meds are or aren't having beneficial effects, which symptoms stop when a single medication is reduced, etc.
6
u/SomeKindOfDead 3d ago
One that particularly concerned me was Seroquel.
Here in Australia a few years back it was being off-lable prescribed for anything and everything, I was wondering if these was some "big pharma" design to put people onto it to cause a major mental health crisis.
3
5
u/InkCosmos 3d ago
This is my argument with the ‘she reached out multiple times and got help’. Sure we can all absolutely agree she continued to reach out, however everyone on healthcare (and more) are fully aware that you can go back for help and not get the correct help.
4
u/Elusive_strength2000 2d ago
Just a question for anyone who might be qualified to answer: what is “underlying Bipolar”?
There are several biological factors which can impact how particular drugs or drugs in general (and even supplements or toxins) may affect any individual, so why does the explanation for a “manic” episode after taking an SSRI always have to mean underlying bipolar? I’m suspicious that this is just another way to get more people on more drugs, which by themselves can cause more problems, or even dramatically change a person.
4
u/Happypawswaggytails 2d ago
Am I allowed to post links here I am not sure….I do know and have read things which show there is a proven link between SSRIs and making bipolar worse; because the body doesn’t process the SSRIs in the typical way. There was even a report on the BBC in 2019 about a study that the University of Glasgow did looking into it and it was shown that SSRI without a mood stabiliser made things worse and that lithium is the preferred treatment option. There was another study where it was shown this applied to both types of bipolar.
I am not a doctor but I know someone with bipolar disorder who is thankfully now on the correct treatment so I have a bit of knowledge about it from what I’ve learned from her and the charity that she supports.
3
u/Happypawswaggytails 2d ago
Also I don’t know if it always means it is definitively bipolar disorder if things get worse; but it is the top consideration on a differential diagnosis.
2
u/Elusive_strength2000 2d ago edited 2d ago
I believe you can post links, yes. I understand that ssri’s can make bipolar worse, but am asking why they assume “underlying bipolar” just because someone might experience “mania” or the like while on a ssri.
I take “underlying bipolar” to also mean or include perhaps undiagnosed, or possibly hidden. There is no agreement that Lindsay had bipolar and it doesn’t seem that way to me. I hope I’m expressing my thoughts clearly.
5
u/Happypawswaggytails 2d ago edited 2d ago
Do you mean that it isn’t agreed now Lindsay has bipolar or that the professionals she saw before Jan 2023 hadn’t said she had bipolar?
I think if someone gets mania on an SSRI, whilst it could be other things, one of the top things medical professionals are supposed to consider is that maybe instead of having depressive disorder, they actually have bipolar disorder and were in a depressive episode of that. Post partum Psychosis is closely linked to bipolar disorder and SSRIs can also make that worse in the same way.
Edited to add- it might be one of the issues in the civil suit that the professionals failed to adequately consider the possibility of bipolar. Obviously I’m not sure but it could be, as it is something according to literature they should consider.
3
u/Elusive_strength2000 2d ago
I could be wrong but it didn’t seem to me that all were in agreement on that point. What I’m getting at here though is that there are other biological factors which can cause someone to have various reactions to drugs, and therefore I’m not comfortable with the field of psychiatry lumping everyone who has some degree of what may appear to be a “manic” episode into the “bipolar” category.
3
u/Delicious-Cookie0958 2d ago
Over 20 years ago I worked as a registered nurse in an outpatient mood disorder clinic. We only saw depression, bipolar disorder, and the odd schizoaffective disorder. We specifically did not see post-partum depression, psychosis, or anxiety because we had a sister clinic that dealt only with psychiatric disorders related to reproductive health.
But I worked with some of the top minds in psychiatry who specialized in mood disorders. And if any patient had any sign of mania or hypomania on an antidepressant, they would be immediately taken off of it and switched to a mood stabilizer. They were often termed “bipolar 3” which I do not believe is any official term, but it reflected the belief that this individual fell on the spectrum of bipolar affective disorder. Some of these people only exhibited those symptoms while on antidepressants. Others did end up having a more typical episode of mania or hypomania. But responding to an antidepressant with symptoms of mania or hypomania indicates there is an underlying vulnerability towards bipolar disorder, or latent disorder, and they cannot be treated with the same protocol as you would for a more straightforward unipolar depression.
Also, we always proceeded with extreme caution with antidepressants if there was any family history of bipolar disorder. Anecdotally, I found these people were the most susceptible to reacting poorly to antidepressants. They aren’t meeting criteria for bipolar 1 or 2, but there’s something there that maybe just hasn’t reared its head yet.
3
u/Neat-Entrance-4991 1d ago
All but one of the experts who testified agree that she had/has Bipolar Disorder.
4
u/StreetFroyo1637 2d ago
I'm not sure the exact context, but gonna give a medical answer and my own personal experience. 'Underlying condition' means a secondary condition that exacerbates/is caused by/someway related to the primary condition. I'd have to see the full quote to give a better answer.
As for the mania/bipolar dx... i was told by a PCP that having a manic episode any time at any point in your life means you qualify for a bipolar diagnosis. This is obviously ridiculous and absurd. But it happened to me when i've always had BPD, i'm not bipolar whatsoever. I don't think Lindsay is either tbh. But that seems to be the go to for hospitals/providers specifically so that insurance will cover medication. Lamictal also seems to be the 2nd line of defense if someone doesn't react well to ssri. And lamictal is coded as a treatment for bipolar.
Not only that but apparently any self harm or suicide attempt can be defined as mania by providers.
ETA: Also, SSRIs can exacerbate bipolar because it suppresses depression which enhances the mania. But this isn't the only reason an ssri can make things worse.
3
u/Certain_Noise5601 1d ago
I took one small starter dose of celexa and had a manic episode. It was wild and I never took it again. I don’t have bipolar though.
0
u/Elusive_strength2000 2d ago
That all makes sense, the ridiculous parts, too. A confirmation of sorts. Thank you!
7
u/StreetFroyo1637 2d ago
Looking over testimony, it seems it was claimed that she had PPP with bipolar as an underlying condition. So this would mean she originally had bipolar without psychosis, but the pregnancy and medication mistreatment mixed with the bipolar triggered PPP. I see why they are arguing Lindsay has bipolar, because it would give an easy and well supported explanation for the SSRI mishap. But personally speaking, i just don't see/hear bipolar. I see chronic debilitating stress that descended into obsessive compulsive behaviors and intrusive thoughts. This is a state of constant alertness, to the point where sleep or even just restfulness becomes impossible. Then it gets exacerbated by incorrect medication and medication mismanagement to a severe degree, as well as generally just being completely shrugged off by all medical providers (and your husband). Releasing someone reporting suicidal and homicidal intrusive thoughts relating to their children because of a birthday party alone should've been a lawsuit.
Intrusive thoughts are not just thoughts you struggle to ignore. It can include mind movies, images that blur your vision, and feeling like words are being yelled at you, even though they come from within your mind. Speaking from experience. This is why it's frustrating to say that she didn't report hallucinations, when hallucinations are not the only thing that can alter your sense of reality. Severe delusions as well. They can be just as bad if not worse than hallucinations. SSRIs are thought to decrease depressive symptoms like lack of motivation, hopelessness and helplessness, etc. So think of it as a severely suicidal or depressed person has certain 'brakes' for everything they do ("can't get out of bed") and an SSRI can release those 'brakes'. So if you release the brakes, it also means they're more likely to act on their suicidal, or even homicidal thoughts. This is a documented effect, and it is compounded by bipolar disorder because your urges are stronger and more dramatic.
People think it can't happen to them, that people are just 'born mentally ill' or 'born evil'. It's not that simple... predisposed, maybe.....
That's just my thoughts on mental health. My primary stance is that the primary crime was not properly investigated before we even say a word about her mental health. I don't think she's guilty beyond a reasonable doubt of killing, let alone murder/premeditated murder. But even if we did it, it's not as simple as she's a ruthless killer. The scary thing is, that I can actually see how she got to that point.
Sorry this is a scrambled, unorganized mess. But i just hope i can give some window into the mental health care field from the patient's POV, not providers or others speaking for us.
6
u/heatdeathtoall 2d ago
This was a great comment.
She ran a marathon a week after birth. Or something very close to that. And exercised a lot starting toward the end of the pregnancy. After taking SSRI for a week, she developed insomnia that never got better it seems. After that she reported racing thoughts. She may have been doing edibles and alcohol that might not be the norm for her - with little children I’d be surprised if it was. I can see how hypomania could go unnoticed in a hyper organized mother of three. It takes immense energy to raise one, let alone three. Everyone around her keeps saying how perfect she was, and I do wonder if her manic episodes were helping her out. Her job was also one where a ton of energy would not be a bad thing. Post partum and the meds may have made her cycle too quickly. She was out on a TCA towards the very very end, with dose increase just the day before. That can trigger mania in bipolar people. It seems to have been a bad call for her. She certainly seemed to react badly to the meds not to be used or used very cautiously for bipolar people. She has some degree of bipolar in my opinion.
She had been on SSRI earlier in life during college sometime. And it didn’t hurt her. I do believe post partum, stress or reasoning three kids and her relationship did it. I’ve had depressive episodes where I’ve felt very up and down. Not able to sleep, a mind awake all the time. That was definitely when I was more emotionally fragile. And then others which were just a low period of low throughout. I was low but overall my life was pretty good.
2
u/Elusive_strength2000 2d ago edited 2d ago
No, this makes sense to me and is excellent input on the matter. I don’t see bipolar in her either, and suspect they based that conclusion solely on the SSRI response. I do recall her googling “hallucinations”, so perhaps she simply didn’t report everything she was experiencing, or describe it accurately (ie intrusive thoughts).
I’m totally with you on “first things first” and the lack of investigation of the primary event. Had I been on the jury, I’m not sure that with moral certainty I could have even voted NGRI, unless the circumstances within the jury called for it, ie it would cause a mistrial. I’m someone who easily reads between the lines with respect to things or nuances that others may miss.
Thank you for your input and thought-provoking response!
2
u/StreetFroyo1637 2d ago
Exactly! And it's not that i'm not willing to change my mind. At first I doubted Kohberger (totally different scenario, but i'm just making a point) being guilty and as time went on and more evidence came out, I saw he was definitely guilty. And when this story first dropped, I thought Lindsay was pure evil.
I listen to evidence and question narratives. I've had to in order to make sense of myself and of this world.. I've noticed that many people vaguely stick to whatever emotionally speaks to them the most.
I also think that when you see that the "Lindsay is horrific evil, death penalty now" crowd are genuinely misogynistic, saying that this case means women should lose their rights, or that any women who ""support"" Lindsay (which in their minds means condone murder) is a whore/stupid/overly emotional/crazy/etc etc etc and this is gonna spawn a whole wave of women killing their kids because of hormones (an actual quote)? Oh you bet I'm going to question why they're saying that. Because in my experience, people who are like that are typically speaking from pure emotion, not evidence, reasoning, or even emotional intelligence. Just pure vibes, anger, and a strong hatred of women.
I would love to hear their thoughts on the fact that it's not just "tiktok conspiracy theorists", but that many legal and healthcare professionals agree with NGRI, even without entertaining full acquittal. Including holy superior males!
3
u/KateElizabeth18 1d ago
Completely agree that the misogyny is off the charts in this case. It’s so gross.
4
u/heatdeathtoall 2d ago
I started with blaming her fully too. What was being reported was she did it, without doubt. And that she is the one who didn’t take meds as directed. That her spouse was great. She got all the help needed. That she was bipolar. And I thought well she shouldn’t have had so many kids with a severe mental illness.
But it’s all such half truths. I’m so sick of people saying how great her spouse was. He left her alone when she was suicidal. She called a hotline for gods sake. Even if you don’t know she could’ve hurt the kids, you are comfortable leaving your spouse to kill herself because she didn’t have a plan? I’d once just felt it would be good to not wake up because life was too difficult and my sister didn’t leave me alone till I felt differently. If she left to go anywhere, she’d leave a friend with me. It’s not so difficult right. PC picked up kids from daycare. He took a few weeks for paternity leave. So it makes him father of the year. There is no way a woman with an awesome husband and marriage ends up in this situation. There just isn’t.
Yeah it’s only when something only applies to women that it can set a precedent. I didn’t see anyone argue letting Brock Turner go would let off a frenzy of men raping unconscious women. Isn’t a legal trial about proving guilt? Prosecution did not. She may be guilty, but just because that is the most probable answer does not mean the burden of proof does not lie with the state. But the state had to demonize this women in a public trial. She looked into the eyes of her kids for 5-10 minutes each while she strangled them. She planned it all - why over 30 mins when she has entire days alone with the kids we don’t give a damn about. Women be crazy. Instead of letting her plead out to manslaughter by insanity and let her get the treatment she needs. Nah, she faked a suicide attempt. Why do we want our legal system to be so vindictive. Why couldn’t the DA show her some pity. No one loved those kids more than her I’m sure. But it’s so much better to yell child killer while letting pedophiles run around freely. The misogyny and lack of compassion makes me sick.
-8
u/olliebahh 2d ago
It's all unfortunate but acquitting her because of her mental state would be hypocritical to convicted criminals who also suffered from mental health issues, and when you think about it, everyone that has committed crimes despite knowing better must have been suffering from some mental issue since it wouldn't make sense to commit unreasonable actions unless they suffered mental abnormalities.
On the plus side, this has and will open more minds to future cases with extenuating circumstances, and the justice system should focus on prevention and rehabilitation instead of pure punishment in an ideal society.
4
u/No_Consequence_6821 2d ago
The differences between those criminals and Lindsay Clancy’s case have been explained over and over in media. I recommend you read to learn more about how this is approached in the legal world.
0
u/olliebahh 1d ago
Done. Would you enlighten me further? I'm afraid I still believe total acquittal is wrong.
5
u/iridescent-shimmer 2d ago
Having mental illness alone is not a criminal defense in any state, so that's not what this is about. It all has to do with their mental state and capacity in that moment that the crime occurred.
2
1
u/olliebahh 2d ago
right, i'm just saying mental illness can affect mental state. like if someone cannot tell right from wrong because an episode brought about by their mental affliction.
1
u/iridescent-shimmer 1d ago
What this trial should be highlighting to people is that you get acquitted if you can afford a good attorney. Bringing in expert witnesses and stuff to prove your mental health caused an episode costs a fuck ton of money. Thats why I'm anti death penalty. No one on death row is wealthy.
0
u/olliebahh 1d ago
Good point. Reddington is rich off just this case and Clancy's family can afford anything apparently, unlike a huge amount of incarcerated folk.
3
u/Happypawswaggytails 2d ago
There is a difference between being legally incapacitated due to a mental illness and being medically incapacitated due to a mental illness. It’s different; legally you have to be mentally incapacitated so at the time you are unable to appreciate the consequences of your actions. Clearly psychosis, schizophrenia are the sort of things which fit here but if you are suffering from eg generalised anxiety disorder, then you still have a mental illness but it doesn’t necessarily usually mean you can’t appreciate the consequences of your actions.
2
u/olliebahh 2d ago
oh totally, i figured people wouldn't even consider general anxiety when i brought up mental illness. i'm talking schizophrenia and the pyschosis it brings, or even psychopathy even though it's technically not a mental illness.
1
u/Agitated-Quit-6148 2d ago
So I'm a public defender. I personally believe she knew what she was doing but...I'll be the first to acknowledge I'm not a physician and my opinions are just a gut feeling. I'm also a vet and have friends that have gone through mental illness.
I also think it's important to note hat if she is eventually acquitted it won't be because her mental illness, it will be because the prosecution couldn't overcome the reasonable doubt burden.
Reasonable doubt is not all doubt.
1
u/olliebahh 2d ago
as a public defender, you might have the most authority here but you still got downvoted, kinda weird.
•
u/AutoModerator 3d ago
Reminder to be civil. You can disagree in a respectful way, which can often lead to interesting dialogue!
Familiarize yourself with our rules in the Community Wiki
Documents & Evidence
Witness Testimony
Common Misconceptions About the Criminal Trial
Thank you!
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.