What It Is
How D-MER Presents:
What Mothers Feel
A key piece of D-MER is that a mother with D-MER feels absolutely fine except just before her milk starts to flow. D-MER is a brief feeling, not more than 30 seconds to 2 minutes, only and always beginning before let-down. This is not postpartum depression and most of these mothers feel perfectly fine except for that pre-milk moment. A brief interval after the negative feelings appear, the milk begins to flow. Unless a mother has postpartum depression in conjunction with D-MER, a mother with D-MER feels absolutely fine until just before her milk flows.
D-MER can easily go unrecognized since 1) some mothers have so many closely spaced letdowns per feeding that the feelings do not have a chance to dissipate before the next D-MER is upon her, making her feel that she experiences on long D-MER through most of, if not all of, the feeding 2) many mothers do not physically feel a letdown in their breasts and so does not connect the feeling as to being just prior to letdown and 3) given the fact that D-MER happens with spontaneous letdowns as well, a mother may not immediately connect the way she is feeling to being a breastfeeding phenomenon.
What Causes It
Simply put: D-MER is physiological, not psychological. It is hormones, not past experience or repressed memories, that cause it.
We're quite sure now that D-MER is linked to a drop in dopamine that seems to occur whenever milk is released. In a mother with D-MER at the time of letdown dopamine falls inappropriately, causing negative feelings.
Milk release itself isn't caused by dopamine dropping; it's caused by oxytocin rising. In D-MER, the MER (milk ejection reflex) is a result of rising oxytocin (needed to move the milk out of the breast) but the D (dysphoria) is a result of inappropriately falling dopamine. Dopamine gets involved because it inhibits prolactin (which is what makes the milk,) so dopamine levels need to drop for prolactin levels to rise in order to make more milk. Normally, dopamine drops properly and breastfeeding mothers never knew it even happened, in D-MER mothers however, it doesn't drop properly and causes a negative emotional reaction.
We're comfortable enough with our conclusions so far that we'll be writing a paper for publication soon. The reference will appear here as soon as there's something in print. And we're already talking about possible studies involving volunteer D-MER mothers.
A mother does not feel all of the following emotions with her D-MER, but these are the words that are most often used when a mother describes D-MER. Some mothers only relate to 3 or 5 emotions, some may relate to
20 or more.
This is the most common spectrum. T
An urge to "get away"
General negative emotions
Feelings of being hopeless
Feelings of being apprehensive
But spectrum one can also include the mother feeling:
A low mood
Low self-esteem
Pessimistic
Fatigued
Worthless
Helpless
Indecisive
Gross
Icky
Yucky
Blah feeling
A "twinge"
A "pang"
A "sigh"
Emotional upset
Unhappy
Tearful
Worrisome
Difficulty concentrating
Self Disgust
Depressed
Dissatisfied
Discouraged
Nervous
Confused
Guilt
Disheartened
Lack of focus
Trepidation
Homesickness
Bothered
Disappointed
Shame
Grief
Introspective
Sad
Brooding
A desire to be alone
A fear of having failed
Fear
Angst
Exhaustion
Despair
Harmful thoughts
A sensation of a lump in the throat
Suicidal thoughts
An inability to cope
Oversensitive
Intrusive thoughts
Ill at Ease
Weepy
Concerned
Spectrum Two
This spectrum usually includes some feelings from spectrum
one as well, often including intrusive thoughts or thoughts of self harm. The two emotions most commonly used to describe spectrum two are:
Anxiety
Dread
But spectrum two can also included feelings of being:
Restless
Impatient
Panicky
Resentful
Irritable
Annoyed
Frustrated
This spectrum often includes varying emotions from spectrum
one and two. This is the most uncommon spectrum and almost always includes
invasive thoughts and suicidal ideation. Three common words used when describing spectrum three are feelings of being:
Agitated
Tense
Paranoid
But also can include feelings of being:
Angry
Aggressive
Hostile
Distressed
Mothers often rate the severity of their feelings on a scale of 1-3 before they know that D-MER is to blame and seem to get past their feelings nearly altogether after education about D-MER. Mild D-MER is described as a "pang" or a "sigh"; a mother takes comfort in knowing her feelings are unjustified but does not seek treatment. D-MER seems to self correct within the first three months. Feelings often seem to fall on spectrum number one.
Moderate D-MER
Mothers rate moderate D-MER on a scale of 4-7 before knowing D-MER is the cause. She will often lower her rating to 2-5 after learning about D-MER. Mothers sometimes show interest in homeopathic or natural remedies. Committed mothers do not seem to waver in their determination to breastfeed through it. D-MER seems to self correct between 3-9 months. Moderate D-MER most likely will fall on spectrum number one or two.
Severe D-MER
Mothers rate their D-MER on the scale between 7-10 before and after learning about D-MER. Mothers are more likely to wean, in spite of being committed to extended breastfeeding. Often D-MER presents with suicidal ideation and other thoughts of self harm. Severe cases seem to not self correct within the first year. This type of severity can fall on all three spectrums.
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