BOSTON (AP) — Lindsay Clancy was “begging for help” in the months leading up to killing her three children and attempting to end her own life, Clancy's former mother-in-law testified for the defense Tuesday in the fourth week of her murder trial.

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EDITOR’S NOTE: This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.

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“Lindsay was struggling — we were all concerned,” said Susan Clancy. Her son, Patrick Clancy, found the Massachusetts couple's children after they had been strangled in the family basement in January 2023. Lindsay Clancy also attempted to take her own life that night and was left paralyzed. Lindsay and Patrick Clancy are now divorced.

The trial centers not on whether Lindsay Clancy killed her children on Jan. 24, 2023, which her lawyers do not dispute, but on her state of mind at the time. Her attorney argues she should not be held criminally responsible because she was suffering from postpartum psychosis, a rare mental illness linked to the stress, sleep deprivation and hormonal changes that follow childbirth.

Former mother-in-law says Lindsay was open about her struggles

Susan Clancy’s testimony echoed emotional accounts the day before from Lindsay Clancy’s mother and sister, who recounted for jurors how they saw her become increasingly anxious, paranoid and suicidal starting in the fall of 2022.

Susan Clancy, who, like Lindsay, worked as a labor and delivery nurse, said in Plymouth Superior Court that she and her former daughter-in-law were close and described Lindsay as a “wonderful mother” who was “very nurturing, very loving.”

Susan Clancy said that Lindsay was open with her about struggling and asked for her mother-in-law's support. The jury was shown texts between Lindsay and Susan Clancy in which Lindsay spoke about fears that she had developed a dependence on benzodiazepines, but couldn't sleep without taking them.

“I'm not okay and I'm terrified of taking meds tonight,” Lindsay texted her mother-in-law on Nov. 30, 2022, two months before the killings.

On Monday, Lindsay Clancy’s mother, Paula Musgrove, said her daughter was scared of sleeping alone, became increasingly paranoid and believed the medications she was taking “were destroying her mind.”

That December, Lindsay Clancy told her mother and her then-husband, Patrick Clancy, that "she had thoughts of harming the children,” Musgrove said. Lindsay Clancy’s sister Allison Ozga testified that at the end of December, Lindsay told her she had experienced suicidal thoughts every day for a month.

Psychologist who visited Lindsay in the hospital said there's no evidence she's lying

Prosecutors argue that Lindsay Clancy planned the killings and contrived to get her husband out of the house by sending him out on errands. They have pointed to normal activities she performed that day, including taking her children to the doctor and playing with them in the snow.

Lindsay Clancy’s attorney, Kevin Reddington, has argued that in addition to suffering from postpartum psychosis, she had bipolar disorder and that antidepressants prescribed after the birth of her third child worsened her condition.

Dr. Paul Zeisel, a clinical and forensic psychologist who visited Lindsay Clancy in the hospital in early February 2023, described seeing her handcuffed to a hospital bed and unable to move below her sternum. Her memory of what had happened was “fuzzy and foggy,” he said, and she was taking medication for significant pain following surgery.

Zeisel said Clancy knew who she was but didn’t know where she was and wasn’t sure of the time. She asked about Patrick, how he was doing and whether she could speak to him. Two days later, she spoke to Patrick using Zeisel’s cellphone.

“She told Patrick that she loved him very much,” Zeisel testified. He said Lindsay Clancy then told Patrick “that she heard a male voice ordering her,” telling her she had no choice but to kill her children and then herself.

Zeisel has met with Lindsay Clancy dozens of times since then. He testified that psychological testing administered by a government doctor found no evidence she was faking or exaggerating psychiatric symptoms.

Zeisel also testified that before the killings, Lindsay Clancy described having “horrible thoughts” and believing her thoughts were so loud other people could hear them.

He testified that psychotic symptoms can come and go, and that a person experiencing psychosis can still perform ordinary activities such as making a phone call or driving a car.

If convicted of murder, Lindsay faces life without parole

Clancy’s livestreamed trial has generated intense public interest. Over the prior weeks, jurors visited the home where she killed her children, and heard emotional testimony from Patrick Clancy.

At the start of the trial, Patrick Clancy described the horror of returning home to find his dead children. Prosecutors played a seven-minute 911 call in which he can be heard finding the bodies and telling a dispatcher, “She killed the kids!”

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

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