Breastfeeding is often portrayed as a beautiful experience, but for some, it can be accompanied by a condition known as Dysphoric Milk Ejection Reflex (D-MER). This condition can be confusing and distressing, so let's dive deeper into what it is, how it affects you, and how to manage it.

What Is D-MER?
D-MER is a reflexive response that occurs just before the milk let down during breastfeeding or pumping. D-MER is tied to hormonal changes, not a psychological issue or a sign of disliking breastfeeding. As your body releases milk, there’s a quick drop in dopamine, a hormone linked to mood and reward, which can lead to feelings of sadness, dread, or anxiety. These emotions usually disappear once milk starts flowing.

Symptoms of D-MER:

• Sadness or Hopelessness: You may experience sudden and deep sadness or a feeling of hopelessness.

• Self-Hate or Low Self-Esteem: Feelings of self-doubt or self-criticism can surface rapidly.

• Sinking Feeling or Dread: You might have a distressing sensation in your stomach or a pervasive sense of dread.

• Anger, Agitation, or Irritability: These emotions can appear suddenly and may be intense.

• Anxiety or Irritability: A sudden spike in anxiety or irritability can occur, often linked to the let down reflex.

When Do Symptoms Occur and How Long Do They Last?
D-MER symptoms typically manifest just before the milk starts to flow—right at the moment of milk let down. This intense emotional experience is brief, lasting from about 30 seconds to two minutes. Once the milk begins to flow and your hormone levels stabilize, these negative feelings usually subside. The emotions are temporary and specific to this moment in the breastfeeding process.

Is D-MER a Sign of Postpartum Depression?
It’s crucial to understand that D-MER is not an indication of postpartum depression (PPD) or any postpartum mood disorder. While some symptoms might overlap with those of PPD, D-MER is unique in that it specifically occurs just before milk let down and resolves quickly afterward. However, it's possible to experience both D-MER and a postpartum mood disorder simultaneously. If you find that negative thoughts and emotions persist beyond the breastfeeding moments or intensify, it's important to consult with your healthcare provider for a comprehensive evaluation and support.

Managing D-MER:
To alleviate symptoms, try:

• Increasing Skin-to-Skin Contact: This can help reduce cortisol levels and promote calmness.

• Practicing Relaxation Techniques: Meditation, deep breathing, or a warm bath can help manage stress.

• Distraction: Engaging in activities like eating or listening to music during let down can help divert your focus.

• Seeking Support: Connect with supportive friends, family, or online groups to share your experience and gain comfort.

Understanding and addressing D-MER can help you navigate breastfeeding with more ease. Some of the time, education is all that is needed to understand what is happening during these intense moments. But women who are struggling with D-MER can seek out more information by visiting https://d-mer.org/ or talk to your medical provider.

If you’re struggling with D-MER or any other challenges as a new mom, our PSI-trained therapists are here to support you. Reach out to us to discuss your experiences, get personalized guidance, and find strategies that work for you. Contact us today to start the conversation and explore the support available to you.