Why Do I Feel Depressed While Breastfeeding?
I received a call recently from an otherwise joyous new mom, who was confused and upset by intense episodes of crying during the onset of breastfeeding. She had no name for what she was experiencing and found her symptoms odd. After doing some research, I suggested she ask her doctor about Dysphoric Milk Ejection Reflex (D-MER). D-MER is a relatively unknown condition that affects many nursing moms. In the past few years, more medical researchers, practitioners, and parents have recognized D-MER as worthy of attention, slowly raising awareness.
D-MER was identified in 2008 by Alia Macrina Heise, a lactation counselor and postpartum doula. It is characterized by an abrupt and intense flood of negative emotions occurring just before milk release. Distinguishable from postpartum depression, the direct mood effects of D-MER only last a few minutes. D-MER is also considered distinct from breastfeeding aversion, which is described as dreading breastfeeding all together. These three conditions can occur simultaneously or separately. In addition, even moms who do not breastfeed may experience D-MER symptoms shortly after birth when their milk comes in, before milk production ceases.
D-MER is considered to be a physiological disturbance resulting from a hormonal imbalance. Two hormones – oxytocin and prolactin – are involved in the ejection and production of milk. But when they rise, dopamine drops. This drop in dopamine is what is thought to cause a temporary mood deflation in some women. It is unclear why only certain women experience D-MER. Research into the condition began only recently.
Women experience D-MER as a psychological disturbance. They report feelings of sadness, hopelessness, worthlessness, sinking, fear, guilt, emptiness, and even homesickness. Some women question their role as a mother. Having never heard of this condition, most women feel there is something wrong with them. Many feel guilty about their negative emotions and fail to report them to a doctor. Some who do report their symptoms are misdiagnosed as having postpartum depression. There simply isn’t much information out there about this fairly common phenomenon.
Medicine is not typically required to treat D-MER. For many women, education helps them anticipate the negative feelings and know that they will pass. D-MER.org suggests that women also monitor their daily food and water intake as well as their stress levels and sleep patterns. This will help to recognize when symptoms are worse. Some women find D-MER symptoms to be lessened when they are distracted during breastfeeding, while others find solitude and quiet to be best. Being attuned to your body is critical. Some women even experience D-MER symptoms between breastfeeding sessions when milk letdown is triggered by a baby’s cry. Nutritional supplements and dietary changes can help, and a doctor can make specific recommendations based on a woman’s medical history. For example, certain vitamins, minerals, and herbs may increase dopamine availability in the brain, lessening symptoms.
The distinction between postpartum depression and D-MER is an important one, as drugs commonly prescribed for depression do not act on dopamine and may cause undue harm. Postpartum depression is serious and should be treated, but if misdiagnosed, women may engage in a frustrating, ineffective, and potentially harmful cycle of treatment. Armed with knowledge about D-MER, women can consult with their doctors and receive an accurate diagnosis.
At first, many women are ashamed of their D-MER symptoms. But after being educated about them, most women are reassured to know there is a biological explanation and a community of women out there who share their struggle. If you think you have D-MER, educate yourself – and your doctor if need be. There are blogs about D-MER where women can read about the condition, learn from others’ experiences, and find comfort and support in community.
Jaime earned her Doctorate in Clinical Psychology from Yeshiva University. She works in a private practice doing psychotherapy and evaluations. Jaime’s specialty is in working with individuals of all ages on the autism spectrum. www.spectrumservicesnyc.com. JaimeBlackPsyD@gmail.com. (914) 712-8208.
Examiner Media – Keeping you informed with professionally-reported local news, features, and sports coverage.