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Is It Psychological?

No.

This is, understandably, the first question a lot of people ask, since a flood of negative feelings is a hallmark of D-MER. But D-MER being a physiological condition is one piece of the puzzle that is most certain.

Why is it important to know whether D-MER is psychological or hormonal? Because solutions will not be found if we don't look in the right direction. Some D-MER mothers have spent a year or more pursuing ineffective treatment and counseling.

It's also important to remember that not all emotional issues are psychological, something we are especially likely to forget when women are involved. The very word "hysterical" comes from the Greek word for "womb". If a group of men began reporting that every time they yawned, just before the yawn and continuing for up to a minute afterwards, they had feelings of euphoria, would researchers look first at their emotional backgrounds, or at the physiology of the yawn?

Are we saying that a psychological response to breastfeeding isn't possible? No, of course not. But D-MER isn't one of them.

Below you will see why a psychological origin for D-MER is extremely unlikely.

What We Have Heard

  • There are sure to be psycho-dynamic causes of sadness while nursing.
  • I would look into the whole issues the person has with motherhood in general. Did she plan this child? Is she enjoying him?
  • Hormones only activate or accentuate feelings that are already somewhat present.
  • A severe reaction to the hormones of breastfeeding uncovers underlying psychological problems, but the feelings are not caused by the hormones themselves.
  • She is experiencing it because of a past traumatic experience, and the act of breastfeeding or milk ejection reflex triggers the memory.
  • The act of nourishing her child is sure to be reminiscent of past experiences and so full of symbolic meaning for the woman.
  • The birth must have been difficult and the mother is still processing something.
  • It's because of her history with anxiety/depression/eating disorder/panic attacks or other.
  • Repressed memories. The mother was sexually abused as a child and doesn't remember it.
  • The mother's own birth or babyhood was difficult and she is still processing something.
  • It is because of the sexual violence she experienced as an adult and it has caused breastfeeding to bring back the traumatic emotions from that event.
  • The mother is mourning something. For example: hoping for a natural birth and had a c-section... a miscarriage before this pregnancy... going back to work soon... misses her "old self" a little...

Now take a minute and imagine you are a mother who is experiencing these emotions while breastfeeding your baby. When everyone and everyone has told you that you should feel warm and maternal while you nurse, you find yourself feeling dark and hostile. Now imagine that you get up your courage to share your feelings to one of the safest people you can think of: a breastfeeding helper....a best friend...your mother...a mother's group... your doctor...and after you bear your soul to one or more of these "safe" people, you hear only the above comments in return. Would you ever dare to bring up these "wrong" and horrid feelings again?

This is why D-MER is breastfeeding's best kept secret.

Note: We could still be wrong about some of the details about dopamine. Our small team, remember, has not worked on this for very long and most of us are operating partly outside our training. Dopamine seems to be an extremely good fit, based on everything we know and have tried. However, hormones dance together in all sorts of poorly understood ways. We will undoubtedly get a great deal wrong before we get everything right. But we have found no reason to consider D-MER psychologically based. That much, we're sure we have right!
What The Evidence Shows

  • The D-MER mothers themselves don't think it is. Many have avoided mentioning the problem because they know they'll be offered depression-based solutions and they don't feel themselves to be depressed except for those brief periods at milk release.
  • Treatments usually used for postpartum depression, other forms of depression, or anxiety or psychosis appear to be ineffective. Only those chemicals that raise dopamine seem to help.
  • As soon as we experimented with a hormonal approach, we began to be able to affect D-MER.
  • Chemicals that lower dopamine seem to make D-MER worse. It seems to be as simple as that. Women who have had emotional responses to thyroid imbalance may be resonate with this point. Their atypical emotions before treatment had a hormonal, not a psychological, cause.
  • This disorder turns on a dime. It responds to dopamine-altering situations, whether the mother knows dopamine is involved or not. Smoking, stress, caffeine, "post-orgasm glow", various medications...all affect D-MER either positively or negatively, depending whether they raise or lower dopamine levels.
  • 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.
  • The decongestant pseudoephedrine improves D-MER temporarily (it is not a sustainable solution because of its stimulant properties. It seems unlikely to damage milk supply in a D-MER mother, but we don't yet know for sure.) The fact that D-MER responds so decisively to a decongestant makes the likelihood of a psychological connection hard to explain.

  • D-MER varies from one baby to the next, instead of being experienced with each baby a mother has. If childhood trauma or a repressed experience were the origin of D-MER, we would expect a more consistent response.
  • D-MER is independent of birth experience. D-MER mothers may have had beautiful home births or highly complicated hospital births. They may be first-time mothers or last-time mothers.
  • D-MER self-corrects eventually in almost every case. It is not likely that a psychological reaction to breastfeeding would gradually disappear altogether and perhaps resume, or not resume, with the next baby.
  • The feelings a mother has with D-MER do not require breast/nipple contact and often do not begin until a few weeks after birth. These facts don't fit well with breastfeeding being an emotional trigger.
  • The "only and always" nature of the D-MER, and the close and reliable timing with regard to the mothers' MER, all make it appear to be a reflexive, hormonal issue.