The Gray Area of Severe Mental Illness: A Lindsay Clancy Inspired Conversation
The Gray Area of Severe Mental Illness
The Lindsay Clancy trial has brought some incredibly difficult conversations about severe mental illness back into the spotlight. Her case is devastating, complicated, and extreme, and I would never presume to know what it is like to be any member of that family or to make a determination about another person’s legal responsibility.
But the conversations surrounding her case have made me think deeply about the gray areas of severe mental illness, because so many of the questions being asked are questions I have wrestled with in my own life.
Where is the line between explaining behavior and excusing it? What happens when someone appears incredibly “high-functioning” while profoundly unwell? How much responsibility should families carry for recognizing an illness they may not understand? What happens when we tell people to ask for help, but they’re terrified of what will happen if they tell the truth?
And perhaps the question I struggled with most after my own Bipolar I diagnosis: Where do I end and where does Bipolar I begin? Were all these choices mine, or were they symptoms? I can’t answer those questions for Lindsay Clancy. I can only answer them through the lens of my own experience, and that is the conversation I want to have today.
When My Mind Turned Against Me
I’ve been thinking about dying since 1999, when my mind turned against me for the first time. It was like a switch flipped. Almost overnight, I went from being an innocent, naive, fun-loving teenager to somebody in such a catastrophic depression that I couldn’t function. I turned to self-harm and anorexia, and I spent weeks crying uncontrollably alone in my room.
I documented so much of this in journals, some of which I include in Tainted Love, and I think they show just how painful and sudden bipolar depression can be. My parents absolutely knew something was wrong, and they put me into therapy. But I was presenting with depression and anxiety. I was not presenting with an obvious case of bipolar disorder, so that is what was treated.
Yes, there were warning signs that something was wrong, but I don’t think it’s fair to say my parents had the information or knowledge necessary to identify those signs as bipolar disorder. They weren’t equipped to do that. Generationally and culturally, mental health was also not a conversation they had grown up having. My parents are from Zimbabwe, and this simply wasn’t part of their world.
As I got older, other signs emerged: reckless behavior, drug and alcohol use, impulsivity. But by then, I had adopted this identity of being the “black sheep” or the rebellious middle child. Those behaviors could easily be explained as youth in revolt rather than symptoms of an undiagnosed mental illness.
The first time I remember someone actually using the word “bipolar” with me was my older sister. I was pregnant at the time, in 2012, after becoming pregnant by someone I had known for less than two months during what I now describe as a manic love affair. I remember my sister asking me, “Have you ever given any thought to bipolar?” I dismissed it. I think a lot of people would.
The next time bipolar was seriously put in front of me was in the inpatient unit in 2015. That was ultimately the difference. My doctor was able to take a bird’s-eye view and zoom out completely. Instead of looking at each depression or each high as an isolated experience, which is what I had been doing and what had largely been treated throughout my life, she looked at the entire pattern.
That was how I finally received my Bipolar I diagnosis. Looking backward, I can draw a straight line through so many of these experiences. But the line wasn’t straight when we were living it. My family knew I was struggling. Recognizing that those struggles were pieces of a much larger bipolar picture was an entirely different thing.
This is a huge part of the work and advocacy I do now: empowering people living with bipolar disorder to understand their own patterns, track their moods, recognize when something is changing, and advocate for themselves. It’s also a huge part of why I created I’m Bipolar. Now What? LIVE, my weekly live coaching community, where we talk about the real-life work of building and protecting stability.
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When Mania Looks Like Success
Bipolar disorder can take years to accurately diagnose; for me, fifteen, and there are many reasons for that. But one of the reasons for me was that a lot of the symptoms of mania actually looked like success.
I graduated college cum laude. I went on to get an MBA, also cum laude, which I completed in less than two years. Out of my MBA, I started a business that was profitable within the first year. And I was very successful in my career.
I was able to work incredibly hard, around the clock. I could come up with innovative and creative ideas and immediately act on them. From the outside, those behaviors weren’t necessarily viewed as red flags. Quite frankly, they were viewed as success.
Internally, I didn’t see the red flags either because this was my reality. I didn’t know anything different. I was never able to zoom out and see the whole picture. Yes, I was experiencing devastating lows, but I thought that was what everybody experienced, or that it was simply part of who I was. I never put the pieces together and recognized the pattern of these extreme highs followed by these extreme lows.
And what did it cost me? Ultimately, the highs became too high, and the lows became too low. On paper, my life looked good. It looked successful. But that wasn’t the whole story.
Alongside the kind of mania that could look like ambition and achievement, I was also making incredibly impulsive decisions. I got pregnant as a result of a manic love affair. Later, I snuck across the country with a convicted felon and my baby as a result of another manic love affair. Behind the curtain, things were not going well.
I was also very good at controlling what the outside world was allowed to see. I didn’t want anyone to see the lows or the darkness beneath the mask. I call it the “under-the-rug syndrome”: you show off the good, you hide the bad, and you share just enough to keep curious minds at bay.
So to someone who says I couldn’t have been that sick because I was “high-functioning,” I would say they were only seeing the part of my life I allowed them to see. Yes, I was performing. Yes, I was achieving. But behind the curtain, I was living my life treading water.
The Crossroads
By the time I reached the crossroads at the Dallas North Tollway and Mockingbird Lane, I couldn’t do it anymore. Everything was too hard. I had just come off a three-month manic high, the highest I had ever been, and as a result, I had been thrown into the trenches of the lowest of lows.
My life had become one of extreme detachment from everything, including motherhood. Feeding my daughter, bathing her, taking her to daycare, putting her to bed—I was just going through the motions. I had previously felt the love a mother should feel in those moments, but in that depression, I became completely detached from it.
I was also using alcohol to medicate something I didn’t have a name for yet. Life became an endless cycle from sunrise to sunset, just waiting until I could drown myself in my sorrows and do it all over again the next day. Weekends were harder because there were so many more hours to fill and nobody there to help me.
What I describe about that day in Tainted Love comes from my own memory. I didn’t have to reconstruct it from records or from other people. I remember the sounds, the smells, the lights, the Texas heat. I remember the gravel crumbling beneath my feet. And I remember her crying.
We took that walk every weekend, sometimes multiple times a weekend, so it wasn’t the first time I had experienced those thoughts. But it was the closest I had ever taken myself to the edge. I remember what happened afterward just as vividly.
After what I describe in the book as the love of my life saving my life, I ran back to my apartment with the stroller and finally asked for help. I made a phone call I desperately did not want to make to my mother in Africa and told her how troubled I was and that I physically felt like I could not survive any longer.
I also have a history with anorexia, and at that point I weighed 84 pounds. I was so terribly weak. I vividly remember sitting on my balcony afterward, bawling my eyes out, because I finally knew one thing with absolute certainty: I could not do this anymore. I could not do it alone.
Diagnosis Was Only the Beginning
When I first received my bipolar diagnosis, it wasn’t something I wanted to accept, and so I very haphazardly accepted it. I was not fully compliant with my medication. I was not honest in therapy. I was absolutely abusing alcohol. I have to take ownership of that piece of my recovery.
Part of any new bipolar diagnosis is also finding the right medication. I was very fortunate that once I received the diagnosis in the inpatient unit, my doctor put me on lithium, and I responded very well to it initially. After leaving the hospital, however, we struggled to find supplemental medications that I responded well to for the continuing depression and anxiety.
That was an incredibly painful process. We just kept trying and trying. But again, I have to acknowledge that I was also drinking and wasn’t being honest about everything that was going on. There is a degree to which the patient must take responsibility for their treatment, too.
One thing I’ve noticed in the years since my diagnosis, especially because we’ve moved around, is how little communication there can be between providers. Yes, you can sign release forms, but you can tell one story to one provider and a completely different version of that story to another, and the outcome can change dramatically. I do think there is an opportunity for much better communication and handoff between providers, particularly when someone is seeing multiple people or their medications are changing rapidly.
For me, though, recovery simply could not happen until I got sober. I was diagnosed in 2015, and for years afterward I continued to struggle with accepting my bipolar disorder. I experienced additional depressions and manias, including several catastrophic events, even after I had the diagnosis.
Things began to change when a loved one, my now-husband, was the first person to tell me that they loved me, bipolar or not, and wanted to embrace me for everything I was. Having that acceptance opened the door to accepting myself. A couple of years later, after about a year of really struggling to stop drinking, I finally got sober on May 16, 2021.
That’s when I like to say the floodgates opened. I could finally focus on recovery and stability. I could be honest in therapy. I could be compliant with medication. I could actually see what my moods were doing without alcohol constantly complicating the picture.
But one of the most important things I share about my story is that bipolar disorder stays with us for our whole lives, and sometimes you can be doing everything “right” and still get sick. In 2024, I was sober. I was going to therapy. I was honest. I was taking my medication. I was working on nervous system regulation, doing neurofeedback. You name it, I was doing all the things.
And I still slipped into a devastating depression that lasted eight months. We had to add another medication, and then I had to have a tremendous amount of patience while we went through that process. It was a stark reminder that managing bipolar disorder is not something you figure out once and then move on from. Now I’m 43 and entering perimenopause, and hormones have introduced an entirely new variable into how my mood disorder behaves.
So is this ultimately a story about individual illness or a treatment system that handles complex psychiatric illness badly? I think there are pieces of both. I believe the individual has a tremendous responsibility to participate honestly in their treatment. At the same time, we are asking people who can be profoundly unwell to navigate multiple providers, medications, diagnoses, and transitions in care, often without enough coordination between the people treating them.
Compassion Without Abandoning Accountability
I can’t change my past, but I can change what I do with it. I have to look at my past with compassion without abandoning accountability. My diagnosis gave me context for my choices, but it did not erase my responsibility for them.
For much of my life, I believed there was something fundamentally wrong with me. I was always on the outside looking in. I searched for answers through love, achievement, work, alcohol, and constantly becoming the next version of myself. I thought if I could find the right person, achieve enough, or finally become better, I might feel whole. If I could somehow erase parts of my past, maybe I would feel whole.
Receiving a Bipolar I diagnosis gave me language for my experience, but even a diagnosis didn’t immediately answer the question of who I was. I spent years wondering: Where do I end and where does Bipolar I begin? Were all these choices mine, or were they symptoms?
Eventually, I realized that perhaps that wasn’t the most useful question. The deeper shift for me was moving away from judgment and toward curiosity. Instead of asking, “What’s wrong with me?” I started asking, “What do I need right now?”
Sometimes the answer is my psychiatrist, a medication change, or therapy. Sometimes it’s rest, movement, connection, fewer commitments, or simply permission to have a difficult day.
But when we’re talking about severe mental illness and moral responsibility, I think we also have to acknowledge something uncomfortable: there are states of mental illness in which a person’s perception of reality can become profoundly impaired. Psychosis, by definition, can alter a person’s ability to understand what is real. I don’t think acknowledging that is the same thing as saying that every action committed during mental illness should automatically be excused. Those are two very different statements.
I don’t think “postpartum psychosis” should be treated as some kind of legal loophole. It is a serious psychiatric condition, and whether it affected a particular person’s legal responsibility is a question that has to be examined individually, based on the facts, the medical evidence, and the law. I’m not qualified to make that determination for another person.
What I can speak to is my own life. Understanding my bipolar disorder allowed me to have compassion for myself without pretending the consequences of my choices disappeared. I can acknowledge that mania influenced relationships, addiction, impulsivity, and decisions I deeply regret while still taking responsibility for the harm those choices caused.
What Happens When We’re Afraid to Tell the Truth?
In the advocacy work that I do, I love to find the gray area. In this instance, finding the gray area is devastating, because it’s hard to find an answer that keeps both mom and baby safe. High-profile cases like Lindsay Clancy’s can deepen stigma precisely because they exist at the extremes. They don’t necessarily offer a look at everything that exists in between, and as a result, representation for that enormous gray area isn’t served.
And where is the line? Is it black and white that an intrusive thought about wanting to die or hurt someone else needs to be disclosed? What about “just” self-harm? What about the mother who is meeting her child’s most basic human needs but feels completely detached from motherhood and incredibly far from the mother she wanted to be? What does she disclose, and what does she fear will happen if she does?
I absolutely worry about this because the outcome of these conversations could very well determine whether women feel safe enough to disclose what they are actually experiencing. Women are already so accustomed to having our feelings, emotions, experiences, pain, and hormones dismissed. The more times we have doors slammed in our faces, the less likely we are to keep knocking.
But there is another fear on the opposite side: What happens if I tell them everything? Will they think I’m dangerous? Will they take my baby away? Will they understand the difference between an intrusive thought and an intention to act? I know that fear personally.
Thirteen years ago, while I clutched my baby, I lied to the police about hurting myself. I lied about my intention to hurt myself. I lied about wanting to die. I was terrified of what would happen if I told the truth. Thirteen years later, I’m still not sure I want to know what would have happened if I had been completely honest.
We need to be able to talk about the most devastating outcomes of severe mental illness without allowing those outcomes to become the face of the illness itself. And we need to create a system where women can tell the truth about frightening thoughts and experiences without automatically believing that disclosure will be interpreted as dangerousness. Because if our message is simply “tell someone,” but women are terrified of what happens after they tell, we haven’t solved the problem.
Why I Keep Telling My Story
My daughter is 13 now, and she has asked to read her copy of Tainted Love when she turns 18. Thirteen is not an age at which I would recommend this book, even to my own daughter. Her copy is wrapped in a time capsule with a letter from Mom, waiting for her when she is ready.
Today, she is growing up in a home with the understanding that mental illness is something families can talk about openly rather than hide. We also talk about the dialectic of our past. We can hold shame and guilt around our experiences while also taking accountability and responsibility for them. Both things can be true at the same time.
I have never once viewed Tainted Love as the worst moments of my illness becoming public material. Once I started writing, I felt an overwhelming sense of obligation to myself to process trauma in a way I never had in 30 years of therapy, and then an obligation to share it in an effort to create survival guides from our collective stories.
Through writing, I discovered a deeper purpose, one shaped by everything that built me, broke me, and pieced me back together. In that realization, I stopped seeing “worst moments.” Instead, I found what I hadn’t even known I was searching for: the simple truth that I am enough. And with it, a quiet, undeniable peace.
Why Talk About Lindsay Clancy at All?
Tainted Love has been years in the making, and its publication date was set long before I engaged in conversations surrounding the Lindsay Clancy case. I did not write this book in response to her case, and I certainly did not choose when her trial would take place.
I have always chosen to participate in a broader conversation about severe mental illness because I have lived experience that I believe has value in that conversation. I’ve been speaking publicly about bipolar disorder, suicide, addiction, motherhood, stigma, and psychiatric treatment long before this trial began, and I will continue speaking about them long after it ends.
I would never presume to know what to say to a father who has experienced an unimaginable loss of that magnitude. Patrick Clancy has publicly asked people to show compassion toward his wife, and I think his words deserve to stand on their own. My heart is with an entire family living through something most of us cannot begin to comprehend. I don’t need to insert myself into their grief to advocate for better understanding of severe mental illness.
What I can do is keep talking about the questions their story has brought to the surface—the questions that exist far beyond one family, one diagnosis, or one courtroom. That conversation continues every week on the I’m Bipolar. Now What? podcast, where we talk honestly about what living with bipolar disorder actually looks like: medication, addiction, relationships, stability, identity, recovery, and everything in between.
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And that is really why I wrote Tainted Love: A Bipolar Memoir. For so many years, I carried tremendous shame around the choices I made, the relationships I had, and the things I experienced before I understood my bipolar disorder. Instead of drowning in that shame, I can use what I’ve learned to help someone else feel seen, heard, and less alone, and maybe suffer a little bit less than I did.
Once I stripped away all the noise, I eventually reached a realization that was incredibly simple but took me decades to believe: I am enough without having to earn it. I am enough despite my past. The goal was never to separate myself from Bipolar I, pretend it isn’t part of me, or pretend the past doesn’t exist. It is woven into my life, but it does not have to determine my worth.
Tainted Love: A Bipolar Memoir comes out October 6.
I really believe our stories can become survival guides for one another.
Louise
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Empowering people living with bipolar disorder to understand their own patterns, track their moods, recognize when something is changing, and advocate for themselves. It’s also a huge part of why I created I’m Bipolar. Now What? LIVE, my weekly live coaching community, where we talk about the real-life work of building and protecting stability. We meet every week.
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LOUISE BARNETT
Bipolar. Sober. Mom.
Finding the Gray Areas in All Things
I'm Bipolar. Now What? LIVE!
Tainted Love: A Bipolar Memoir
This newsletter reflects my personal experience living with Bipolar I disorder and addiction. It is intended for education and peer support and is not medical advice or a substitute for individualized care from a qualified healthcare professional. Alcohol and other substances can interact with medications, and suddenly stopping alcohol can be medically dangerous for someone who is physically dependent. If you're concerned about your alcohol or substance use, mental health, or medications, please speak with a qualified healthcare professional.
