How could a mother allegedly kill her children? Experts say mental health can distort thinking.

Paradoxically, experts say, the culprit in such deaths is often a loving mother in the throes of mental illness, motivated by love and attachment to her children.

Cheryl L. Meyer, a psychology professor at Wright State University who studies mothers who kill their children, recalled interviewing one such woman who had also tried to kill herself. The mother told her that killing her kids felt logical because they were an extension of herself, as if they were a limb.

”She couldn’t die without taking her arm. She couldn’t die without taking the kids,” Meyer said Wednesday.

As mother of an 7-month-old, Clancy was still in the year-long postpartum period, and she had revealed on social media that she had suffered from postpartum depression in the past.

In rare cases — about 1 or 2 out every 1,000 postpartum women – this depression can progress to psychosis, in which a woman’s brain is “hijacked by a really, really serious illness that distorts reality” and prompts actions they would never take if healthy, said Dr. Nancy Byatt, professor of psychiatry, obstetrics & gynecology and population & quantitative health sciences at UMass Chan Medical School.

Dr. Susan Hatters Friedman, a professor of forensic psychiatry at Case Western Reserve University who has researched parents who kill their children, said the motives fall into five categories: a young person with an unwanted pregnancy kills a newborn; years of abuse or neglect lead to a child’s death; a partner seeks revenge, often in the case of a relationship breakup; and two types of mental illness — “altruistic” and “acutely psychotic.”

The first category is not relevant to the Duxbury deaths, and there is no evidence so far for the second or third. And it is unknown whether Clancy had psychiatric problems.

But the prospect that a mental health condition underlays the Duxbury killings raises troubling questions.

In some cases, Hatters Friedman said, the parent’s motive is altruistic — “murder out of love,” however strange that may sound. A parent may have delusions that the child faces a fate worse than death, such as being kidnapped and murdered, and believes killing them gently is preferable. Parents who are planning suicide may not want to leave their child in a world they perceive as too horrible to live in.

In the acutely psychotic cases, a parent may think God is commanding them to kill their child or that their child is evil, she said.

People are often stunned by such killings because often the mothers were known as perfect and loving, said Meyer, who wrote two books on the subject. “These mothers are often described as just being quintessential moms. They’re the definition of a good mom,” she said. “And so that’s why it’s really shocking when you hear that they do these things.”

Such women are not secretly evil. Instead, mental illness of some kind gets a grip on them. When their identities are so enmeshed with that of their children, they take steps that in their distorted thinking seems best for their children.

“Why would a woman who loved her children kill them?” Meyer said. “She killed them because she loved them. That’s a hard thing to understand.”

The defining factor for women who killed their children was a lack of social support, Meyer said. She recalled meeting a woman who confessed that, during a major life crisis, she had prepared to kill her children and herself by poisoning their ice cream. Just before she served it, her pastor called to see how she was doing. By the time the conversation ended, the ice cream had melted and the plans for murder dissipated.

Cases like the Duxbury killings are rare but unforgettable. Everyone remembers Susan Smith, who drove her two young children into a lake in 1994, and Andrea Yates, who drowned her five children in a bathtub in 2001. Yates was a devoted mother who home-schooled her children, but killed her children while suffering from postpartum psychosis.

In Canada and the United Kingdom, a woman cannot be convicted of first-degree murder if she kills her child during the postpartum period, Meyer said.

In the United States, mothers often get harsh sentences for killing their children. “It’s more horrific in our minds if a mother does this,” she said.

Byatt, of UMass, finds it “concerning” that the Duxbury mother was charged with murder. If she had postpartum psychosis, she had no control over what she was doing, Byatt said.

Postpartum depression, which is triggered by hormonal changes after pregnancy, is more common than postpartum psychosis, but both can be averted with treatment if doctors watch for the warning signs throughout pregnancy and after birth, said Dr. Judith E. Robinson, a Tufts Medical Center psychiatrist.

People who already suffer from a mental illness such as bipolar disorder, or who have had postpartum depression in the past, are at greater risk.

“It’s a very serious condition,” Robinson said. “It’s more than just being sad or crying from time to time.”

Symptoms of depression include persistent sadness, barely getting out of bed, crying all the time, and difficulty with eating, sleeping, and concentration. Psychosis involves delusional or disordered thinking and hallucinations.

“It’s a life crisis to have a baby under a year old and to have some other children,” Robinson said. “You are really at high risk of burning out. And if you have your own psychiatric disorder and you don’t have help — your kids could be difficult, just normal difficult. . . . It can drive you to the point of becoming psychotic.”

If you or someone you know have had thoughts of suicide, call 988 or visit 988lifeline.org to chat online.


Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.

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