Before Lindsay Clancy was accused of killing her three children, she had been having "one of her best days" after a long struggle with anxiety, her husband told officials.
After his children were strangled Jan. 24 at the family's Massachusetts home, Patrick Clancy told police that his wife had been "smiling" and "happy" earlier in the day, prosecutors said Tuesday in court.
Lindsay Clancy has been charged in their deaths and was arraigned Tuesday in Plymouth District Court. She is hospitalized following a suicide attempt and appeared at the court hearing by a video link.
On the morning of the killings, she had taken 5-year-old daughter Cora to the pediatrician for an appointment, where medical staff members noticed nothing out of the ordinary about Lindsay Clancy's behavior, Assistant District Attorney Jennifer Sprague said in court. After they returned home, she built a snowman with Cora and 3-year-old Dawson, texting photos to her mother and her husband, Sprague said.
But when Patrick Clancy left the house at his wife's request to pick up children's medicine and food, the day took a horrifying turn.
He returned home to find his wife lying in the backyard after having attempted to die by suicide, Sprague said. A 911 call captured Patrick Clancy "screaming in agony and shock" upon finding the couple's three young children in the basement strangled with exercise bands, Sprague said.
Cora and Dawson were pronounced dead at a hospital that evening, and 8-month-old Callan died at the hospital three days later.
Lindsay Clancy, 32, is charged with two counts of murder and three counts of suffocation or strangulation. A plea of not guilty was entered on her behalf Tuesday.
Prosecutors requested Tuesday that she be held without bail. They rejected her attorney's claims that she was a "zombie" who had been overmedicated with antidepressants and other psychiatric drugs.
"She had to strangle each of them … and then make sure the bands were squeezing their little necks for several minutes," Sprague said. "She could've changed her mind at any point during time … and she did not."
A case 'both horrific and tragic'
The arraignment marked Lindsay Clancy's first public appearance since her children's deaths in a case that District Judge John Canavan III described as "both horrific and tragic." She attended virtually from the undisclosed Massachusetts hospital where she has been treated, and she was wearing a mask and what appeared to be a neck brace.
Defense attorney Kevin Reddington said his client is paralyzed below the waist because of a spinal cord injury and a broken back and ribs she sustained during the attempted suicide. He said she remains under 24/7 suicide watch.
"She's extremely emotional. However, she's unable, and has been unable, to express any happiness or sadness or cry," Reddington said.
But her emotions were muted even before the deaths, he said.
Reddington said that a month or two ago, Lindsay Clancy had said, "I just wish that I could feel something."
On Tuesday, from her bed, Lindsay Clancy spoke to the judge only once, responding, "Yes, your honor," when she was asked whether she could hear him. She showed little emotion other than when she closed her eyes and appeared to wipe away tears after Sprague described how the children died.
The judge ordered her held without bail in the hospital for mental health treatment. It's possible she could be ordered to home confinement, Canavan said, adding that a hearing would be held before that could happen.
She is next due in court May 2.
A history of 'bad thoughts'
Both Lindsay Clancy's lawyer and the prosecutor said her parents and husband were aware of what Reddington described as the mother's "worsening depression" and "bad thoughts" since the birth of her son Callan in May.
But while Reddington contends she was suffering from postpartum depression "and possibly postpartum psychosis" - a rare condition in which hallucinations and delusions can alter people's sense of reality after childbirth, sometimes driving them to harm themselves or their children - prosecutors said Lindsay Clancy was told she didn't have postpartum depression or any symptoms when she was evaluated at the Women and Infant Hospital Center for Women's Behavioral Health in Providence, Rhode Island, last year.
She was diagnosed with generalized anxiety disorder, Sprague said.
The day before the killings, Lindsay Clancy wrote a note in her phone that said she had a "touch of postpartum anxiety around returning to work," Sprague said. A representative for Massachusetts General Hospital previously confirmed to NBC Boston that Lindsay Clancy had been an employee.
Sprague said Lindsay Clancy never used the word "psychosis" to describe her symptoms until after she was arrested while speaking to her husband on a cellphone belonging to a forensic psychologist whom her lawyer arranged to examine her. During that call, she told her husband she killed the kids during "a moment of psychosis" when she heard a voice ordering her to do so, Sprague said.
Sprague pointed to an October note in which Lindsay Clancy is alleged to have written: "I think I sort of resent my other children because they prevent me from treating [Callan] like my first baby. And I know that's not fair to them, I know that. I was feeling so depressed last evening when Cora and Dawson came home from school. I know it rubs off on them so we had a pretty rough evening. I want to feel love and connection with all of my kids."
She also wrote in the entry that she hopes to have more children, Sprague said.
The prosecutor also said that three days after the children's death, while intubated, Lindsay Clancy allegedly wrote a note asking, "Do I need an attorney?"
It was one of the first questions she asked after she regained consciousness, Sprague added.
"She knew that she had murdered her children, and she had the clarity, focus and mental acumen to focus on protecting her own rights and interests," he said.
Medications and a stay at a psychiatric facility
Lindsay Clancy checked herself into McLean Hospital, a psychiatric facility in Belmont, Massachusetts, on Jan. 1 after she told her husband in December that she had had thoughts about harming the children. She had also written in a journal about having suicidal ideation, Sprague said. She was discharged from the facility Jan. 5.
After she returned home, she "appeared to be getting better," Patrick Clancy told police, noting that she had stayed alone with the children and told him in mid-January that she was no longer having suicidal thoughts, prosecutors said.
But Reddington alleged that Lindsay Clancy had been "thoroughly destroyed" by several medications - including Valium, Prozac, Klonopin and Zoloft - which he claimed masked her symptoms rather than treated them.
"Our society fails miserably in treating women with postpartum depression or postpartum psychosis. It's medicate, medicate, medicate," he told the court.
Fifty family members, friends and former colleagues submitted letters to the judge testifying to Lindsay Clancy's character, her lawyer said.
When Reddington toured the Clancy family home recently, he found a "wish vase" with "dozens of these little pieces of paper that talk about Lindsay's wish for happiness and health, for her children, that she could get pregnant again … that [her children] would be happy, healthy and successful."
"This is not a woman that had any reason to harm those innocent children," Reddington told the court.
If you are pregnant or a new mother and you are in crisis, the National Maternal Mental Health Hotline provides free, confidential support 24/7 in English and Spanish. Call or text the hotline at 1-833-9-HELP4MOMS.
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
This article was originally published on NBCNews.com
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