Bipolar disorder diagnosis takes center stage

A forensic psychologist testified Monday that Lindsay Clancy has bipolar disorder and was experiencing anxiety, depression, insomnia, and suicidal thoughts in the weeks before she killed her three children, according to multiple reports.

Kirk Heilbrun, who examined Clancy over three days this year, said he reached a different conclusion than a forensic psychiatrist who also evaluated her and testified Friday that Clancy neither had bipolar disorder nor psychosis. Both Heilbrun and Dr. Avram Mack testified as rebuttal witnesses for prosecutors in the case, which centers on Clancy's mental state when she strangled her three young children before jumping from a second-story window in January 2023.

Heilbrun said he struggled to reach a diagnosis of bipolar 2 disorder "because of all the diagnoses in the records and all the symptoms that she experienced." He explained that people with bipolar 2 disorder experience cycles of depression and hypomania, which is less intense than the mania seen in bipolar 1 disorder. "I was having a hard time finding something that looked like it was a manic episode," Heilbrun said, noting that Clancy described feeling good after the births of her children, but it did not look like mania.

Heilbrun also noted that Clancy never reported hallucinations or suicidal thoughts during a psychiatric hospital stay about two weeks before the killings, with her main concern being insomnia.

Conflicting expert opinions

Mack, who testified Friday as a prosecution rebuttal witness, said he found no evidence of mania or hypomania to support a bipolar diagnosis, nor psychosis. Heilbrun disagreed, but his testimony also painted a complex picture. He said there was some evidence Clancy experienced acute psychosis, primarily her claim of hearing a male voice telling her to kill herself and her children, but she did not report that voice before or after the killings. "To put it mildly, that would be a very, very unusual pattern or manifestation of how this kind of thing comes about," Heilbrun said. He added that he is "always very careful" when someone reports a symptom only during the commission of an offense, calling it "a convenient way of lessening your own culpability."

Heilbrun concluded that Clancy likely did not have acute psychosis and instead killed her children because she planned to attempt suicide and wanted them "with" her so they wouldn't suffer. He described the killings as "altruistic filicide" — killing out of love. He testified that Clancy told him she said "Go to God, baby" while strangling each child, expecting they would be together in heaven.

This explanation was strikingly similar to that offered by defense expert Dr. Philip Resnick, who testified Friday that Clancy was "clearly psychotic" and not in control of her actions. Resnick also described the killings as "altruistic filicide," but attributed them to a command hallucination and a "psychotic distortive belief." Heilbrun, however, said Clancy's belief that her children would suffer if she left them behind reflected a motive, not a delusion.

Mistrial request and judge's rebuke

Heilbrun's testimony was interrupted when he mentioned Clancy's Catholic religion, prompting a defense motion for a mistrial. Heilbrun had described Clancy's expectation that she and her children would be together in heaven with God, and he asked her whether suicide was a "mortal sin." He noted that as a Catholic, "that's not necessarily what happens."

Defense attorney Kevin Reddington called the comment "over the top" and argued it was intentional misconduct. The prosecution said the comment was unintentional. Judge William Sullivan denied the mistrial request but sharply admonished the testimony, telling jurors: "The religion that the defendant was raised with is absolutely an inappropriate area of testimony. It is to be stricken. It is not to be considered."

This was the second time religion had come up in the trial. The judge dismissed the jury for the day after the ruling, with Heilbrun expected to conclude his testimony Tuesday.

The case against Clancy

Clancy, 36, a former labor and delivery nurse, has pleaded not guilty to three counts of first-degree murder in the deaths of her children Cora, 5, Dawson, 3, and Callan, 8 months, at their Duxbury, Massachusetts, home in January 2023. She survived an alleged suicide attempt after the killings and remains paralyzed from the waist down.

Reddington does not dispute that Clancy killed her children but argues she should not be held criminally responsible because she had postpartum psychosis, a rare mental illness linked to the stress, sleep deprivation, and hormonal changes that follow childbirth. He says she also had bipolar disorder, which was worsened by antidepressants. Prosecutors argue Clancy planned the killings and acted "intentionally, rationally and swiftly," sending her husband out to pick up medicine and dinner for the family.

Heilbrun is the second witness in the prosecution's rebuttal case, with Dr. Gregory Saathoff expected as the third and final witness. Jurors could get the case as soon as Wednesday, though the timeline is subject to change. Closing arguments are expected later this week.