@Humpleupagus but why though? The pattern escalated very quickly.

For all purposes, this all started September/October and by January she's strangling her children. That speed of escalation, the fact she was on like 10-13 meds, had like 11 doctors, how can you argue she had enough mental faculties to be planning it?

When you pair the act with the like medical helping seeking it doesn't read like a mentally normal woman making a calculated move. It reads like a desperately stressed out woman seeking help and then deciding killing everyone is the only way to make it stop.