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. All of the suggestions made for treating D-MER are based on our belief that transiently inadequate dopamine is responsible.
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.
D-MER follows the same pattern as any other reflex. You can tell yourself your knee isn't going to jerk when you hit it... but it does, just as much the hundredth time as it does the first, and it stops as soon as the stimulus stops. The D-MER reflex involves e-motion rather than motion because a hormone shift is triggered instead of having a muscle nerve triggered.
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 level 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
Level Two
This level usually includes some feelings from spectrum
one as well, often including intrusive thoughts or thoughts of self
harm. If a mother resonates with five or more words from level two then she would be considered as suffering with level two D-MER. The two emotions most commonly used to describe level two are:
Anxiety
Dread
But level two can also included feelings of being:
Restless
Impatient
Panicky
Resentful
Irritable
Anxious
Annoyed
Frustrated
This level often includes varying emotions from level
one and two. This is the most uncommon level and almost always includes
invasive thoughts and suicidal ideation. If a mother resonates with three or more words from level three then she would be considered as suffering from level three D-MER. Three common words used when describing level three are feelings of being:
Agitated
Tense
Paranoid
But also can include feelings of being:
Angry
Aggressive
Hostile
Distressed
Mild D-MER
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. She may however make some effective lifestyle changes that will lessen her reaction even more. D-MER seems to self correct within the first three months. Feelings fall on level 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 show interest in natural treatment options and lifestyle changes and D-MER can often be lessened with these. 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 level 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 levels. In severe cases often lifestyle changes or natural treatment options will not be effective enough to make a difference in a mother's D-MER and prescription treatment should be strongly considered.