By Charlie McKenna

Throughout a month-long period stretching from November to December 2022, Lindsay Clancy consistently reported symptoms suggesting she was suffering from postpartum depression, including trouble sleeping, intrusive and racing thoughts and a feeling of numbness.

But the then-32-year-old showed no signs of psychosis and remained an active participant in her treatment, said Rebecca Jollotta, a psychiatric nurse practitioner who treated Clancy during that period, on the stand Tuesday at Clancy’s trial.

Jollotta is the fourth person who treated Clancy in the months leading up to Jan. 24, 2023, when Clancy killed her three children, to testify for prosecutors at the trial. She is also a defendant in medical malpractice lawsuits filed by both Clancy and her husband.

For the prosecution, Jollotta’s testimony was an opportunity to again highlight for jurors that none of Clancy’s medical providers ever saw signs that led them to believe she was a danger to herself and others.

Clancy has claimed postpartum mental health issues make her not criminally responsible for the deaths of her children. Her defense has used the providers’ testimony to build a case that the deaths were avoidable, and that Clancy was failed by those who treated her.

Jollotta formally met with Clancy just three times between Nov. 29 and Dec. 20, 2022. Still, they interacted many more times than that, often because Clancy messaged her to report new symptoms or concerns about her treatment and medication.

The messages portray Clancy as extremely invested and concerned with her treatment. Both sides are likely to try to shape how jurors perceive them as the trial continues.

For prosecutors, they could be seen as supporting the claim that Clancy misled her providers, reporting side effects that didn’t line up with what she was prescribed, and was unwilling to fully commit to addressing her mental health. Clancy reported not taking medications in the doses prescribed to her, and taking medications that weren’t part of her treatment plan at the time.

But Clancy’s defense will likely argue the medications show her desperate attempts to get help and reflect how her mental health worsened in the lead-up to the killings.

Clancy, who turned 36 on Tuesday, faces three counts of first-degree murder in the deaths of her children: Cora, 5; Dawson, 3; and Callan, 8 months. Prosecutors say she carefully planned the killings because she no longer wanted the life she had; her defense claims she is not criminally responsible for the killings because of mental illness.

Clancy consistently reported that Ativan, a benzodiazepine, was helping her sleep, and that she was having success mixing the medication with Benadryl, an antihistamine. But she was also concerned that she was becoming addicted to Ativan and relying too heavily on it to get to sleep.

Yet Clancy also feared starting new medications and suffering new, different side effects.

“One of your takeaways is she was scared and thought that starting these drugs was scary?” defense attorney Kevin Reddington asked. Jollotta agreed with him.

Both Clancy and her husband told Jollotta they felt the medications were making her mental health issues worse, and traced her problems back to a prescription for Zoloft, which Clancy began taking in October 2022.

But Jollotta warned against discontinuing the medication, telling Clancy that doing so could worsen her symptoms.

Whether the medications were causing Clancy’s symptoms, or if they were purely a result of her mental illness, or instead caused by a combination of the two, remains an open question at the trial. Jurors heard from another psychiatrist who said she believed Clancy was overly attributing her symptoms to the medications.

Reddington, though, has been laying the groundwork to claim that some of Clancy’s symptoms could have been the result of an adverse reaction to some of the medications brought on by bipolar disorder.

Jollotta testified Tuesday that Clancy was exhibiting signs of bipolar disorder, particularly because she reported not feeling tired even after sleeping for only two hours.

Putting someone with bipolar disorder on a selective serotonin reuptake inhibitor, or SSRI, a particular class of antidepressant, can cause “rapid cycling” where they “swing from mania to depression relatively rapidly,” she said.

Zoloft, the first medication prescribed to Clancy, is an SSRI.

By the middle of December, Clancy reported that the Seroquel Jollotta prescribed her was helping her sleep through the night, but said she felt unmotivated and depressed during the day, and was experiencing intrusive thoughts of wanting to die.

But Jollotta emphasized, both on the stand and in messages to Clancy, that the intrusive thoughts were a common symptom of postpartum depression.

Days later, at Jollotta’s urging, Clancy went to Women & Infants Hospital in Rhode Island to seek admission to a partial hospitalization program there. A psychiatrist there recommended Clancy wean off the Seroquel, contrary to Jollotta’s recommendation that she continue taking the drug.

On cross-examination, Reddington pushed Jollotta on why Clancy was not accepted into the program.

“Did you know they wouldn’t accept her because of their concern she had been overmedicated by drugs?” he asked. Jollotta told him she could not speak to that.

He pressed on, asking whether she knew Clancy was “diagnosed with depression due to adverse drug effects?” Jollotta again said she didn’t know.

Reddington noted that the hospital’s medical records indicate they tried to reach Jollotta, but she never called them back. But Jollotta said she had no memory of getting a call, and that she would have called back if she had.

Despite feeling “invested” in Clancy’s treatment, Jollotta told Reddington she never sought records from Women & Infants.

It’s a theme Reddington has returned to in his cross-examination of multiple psychiatrists: the failure to seek records from Clancy’s other medical providers to compare what she was telling them with what was in her records.

Jollotta said the same was true for McLean Hospital, the psychiatric facility Clancy admitted herself to in late December 2022.

She agreed with Reddington that it was “important” to find out Clancy’s diagnosis after her condition had deteriorated to the point she and her husband decided to “voluntarily (admit) her to a locked ward at a mental institution.” But Jollotta said she never took steps to do so.

Reddington also elicited testimony about Jollotta’s experiences with postpartum psychosis, which he has claimed Clancy was suffering from at the time of the killings.

Jollotta told him she had treated five patients with postpartum psychosis, some of whom reported hearing voices — as Clancy will claim she did.

“That’s a real thing, isn’t it?” he asked. Jollotta said it was.

Later, prosecutor Shanan Buckingham followed up on the issue.

“In your experience with postpartum psychosis, were you ever concerned Lindsay Clancy was suffering from it?” Jollotta said she wasn’t.

Reddington then blurted out, “It appears as though she was, doesn’t it?” but withdrew the question after an objection.

Testimony at the trial resumes Wednesday morning. The next witness is likely to be Latiesha Dukes, a mental health counselor at South Shore Health who met with Clancy several times.