After an opening week of emotional testimony and a jury visit to the home where Lindsay Clancy is accused of strangling her three children, her murder trial resumed on Monday with diary entries written in the months before the killings in a coastal Massachusetts town in 2023.

The entries describe Clancy feeling anxious and overwhelmed by motherhood, including her struggles to get her newborn son, Callan, to sleep and her constant fears that he was sick. She also wrote about her concerns over returning to work as a labor and delivery nurse, being unable to breastfeed and feeling disconnected from both her children and her then-husband.

“I’m so desperate to get a mental break from taking care of everyone that my mind is trying to find something physically wrong with me,” she wrote in an entry dated November 18, 2022.

Clancy’s defense says she was a loving mother who was suffering from postpartum psychosis, a rare but serious mental health condition that can develop after childbirth and affect a person’s grasp on reality.

Prosecutors contend that she acted intentionally and should be held criminally responsible for the deaths of Callan, Dawson and Cora Clancy, who ranged in age from 8 months to 5 years.

Clancy’s lawyers don’t dispute that she killed the children. But in the criminal trial and a medical malpractice lawsuit, her attorneys say the 35-year-old had bipolar disorder that wasn’t fully diagnosed until after the killings.

Her attorneys say her condition seemed to worsen on an ever-shifting lineup of psychiatric prescriptions, some of them problematic for bipolar patients.

Her diary sheds light on the mental health issues at the heart of the case

In the three months before the killings, various clinicians prescribed a range of antidepressants, sleep aids, an antipsychotic and other medications while she reported increasingly profound insomnia, anxiety, despair and confusion about what was real, according to her lawsuit.

Both the prosecution and her defense attorney read pages from her journal Monday as she chronicled those difficult months.

“I want help. I want to be well,” Clancy’s attorney Kevin Reddington read from one journal entry.

She also wrote of feeling “incredibly sad and guilty” about not breastfeeding and was “obsessed” with Callan’s sleep and nap schedule.

“I have crazy brain fog. I feel like I can’t make a plan,” she wrote in another, undated entry. “I live moment to moment waiting for the next nap time. I’m terrified of Cal getting overtired now because I feel can’t help him.”

In separate lawsuits, Lindsay and ex-husband Patrick Clancy allege that various providers failed her, and should have recognized she was a risk to herself and the children. The providers, at least those who have responded to date, deny the allegations and dispute that she clearly told them she intended to harm the kids.

Lindsay Clancy was seeking help before the killings

When she sought care at a postpartum depression program in late December 2022, providers noted that her symptoms might be due to medication, according to her lawsuit. It says those clinicians told her to taper off the antipsychotic drug and then discharged her after a day.

Clancy checked herself into a psychiatric hospital that New Year’s Eve and spent several days there. Once home, she resumed appointments with her psychiatrist, who last saw her for 17 minutes on Jan. 23, 2023, according to her lawsuit.

The next day, she believed a commanding voice was telling her to “kill the children so you can kill yourself,” according to her lawyers.

That evening, she asked her then-husband to run some errands, a request that prosecutors cast as a ploy to get him out of the house.

Father returns home to a shocking scene

Lindsay Clancy wept at the defense table last week as Patrick Clancy and other witnesses testified.

He told jurors about returning to a horrible scene at their house: a bloodied bedroom, an open window, his wife on the ground below it, the children in the basement, throttled with exercise bands.

“She killed the kids!” he told a 911 dispatcher on a call played in court.

Lindsay Clancy remains paralyzed from the waist down because of the fall.

In the hospital two days later, when a forensic psychologist asked Clancy how she felt, she responded: “horrified.” She also asked if she had a lawyer and whether her body and legs were broken. She was intubated and could only communicate through written messages on a whiteboard, the psychologist testified.

“She then asked, can she have visitors, and where her family is,” Dr. Jhilam Biswas of Brigham and Women’s Hospital recalled.

Doctors testified Monday that 8-month-old Callan was in cardiac arrest when he arrived at a hospital in nearby Plymouth. He needed a ventilator at Boston Children’s Hospital to help him breathe, but did have a heartbeat. He died after three days.

Prosecutors will try to keep the spotlight on Clancy

Prosecutor Shanan Buckingham sought in an opening statement last week to keep jurors’ focus on the defendant, not her doctors.

“This is not a public debate about women’s mental health and how the medical system treats women,” Buckingham said.

If convicted of murder, Lindsay Clancy faces life in prison without parole. If found not guilty due to a lack of criminal responsibility, she would be committed to a state mental health facility.

If you are based in the USA, and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week.

If you are experiencing feelings of distress, or are struggling to cope, you can speak to the Samaritans, in confidence, on 116 123 (UK and ROI) or visit the Samaritans website to find details of your nearest branch.

If you are in another country, you can go to www.befrienders.org to find a helpline near you.