ACT Therapist Dr. Jessica Borushok: Stop Fighting Anxiety—Change Your Relationship to It:
In this episode of Renegade Psych, psychiatrist Ethan and co-host Ellie Jay examine the Lindsay Clancy case, in which a Massachusetts mother experiencing severe postpartum mental health struggles tragically killed her children. They discuss how Clancy's symptoms evolved over months following the birth of her third child, beginning with anxiety and insomnia and escalating into intrusive thoughts, sleep deprivation, and psychosis. Ethan walks through her extensive medication history — multiple SSRIs, benzodiazepines, and antipsychotics prescribed by a rotating cast of providers, including nurse practitioners — arguing that possible bipolar-spectrum misdiagnosis and SSRI-induced manic reactions may have worsened her condition rather than helping. The conversation highlights the difficulty people have conceptualizing psychosis, noting that the conscious mind can be effectively "shut down" during florid episodes, making it nearly impossible for those who haven't witnessed it to understand how someone could act so far outside their character.
The discussion then broadens into systemic critiques of American healthcare: 15-minute appointment slots that leave no time to build trust or gather collateral information and the deep disconnect between specialties like psychiatry, OBGYN, and endocrinology. Ethan makes a compelling case that estrogen's dramatic post-pregnancy drop likely plays a significant role in postpartum psychosis, citing studies showing estradiol treatment resolving psychotic symptoms in women with critically low levels — yet this approach remains underexplored due to the inability to patent natural hormones and the financial disincentives that follow. They close by calling for a healthcare system that prioritizes patient care over profit, with better integration between specialties and more time invested in understanding each patient's full clinical picture.
Timestamp Topic 1:58 Introduction — Ethan welcomes Ellie Jay to discuss the Lindsay Clancy case 3:58 Understanding psychosis — How could someone become so impaired they act against their own character? 5:46 The spectrum of psychotic states — Losing awareness and the "glazed look" of florid mania 12:10 Postpartum psychosis statistics — 1 in 25 untreated women with postpartum psychosis will kill their child 12:28 Why society can't face psychosis — The fear that this could happen to anyone, and the urge to "other" those affected 24:06 Lindsay Clancy's timeline — Birth of her third child and the onset of symptoms 29:46 The tragedy — January 24th: Clancy kills her children and attempts suicide 34:18 Nurse practitioners in psychiatry — Training gaps, time constraints, and culture of fear in prescribing 38:50 Hormones and psychosis — The overlooked role of estrogen fluctuations in postpartum mental health 39:10 Estrogen as a mood stabilizer — The dramatic post-pregnancy estrogen crash and its psychiatric implications 43:32 Research on estradiol treatment — 1999 and 2000 studies showing estrogen resolving postpartum psychotic symptoms 46:46 Systemic disconnection — How specialty silos in US healthcare leave critical gaps in patient care 50:02 Closing remarks — Call to action and contact information
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Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.
