If you are in Ontario, Canada, Camilla provides psychotherapy services and her website can be found here – https://camillaaviss.com

Fahreen Jeshani MSW, RSW – is also certified and available to support you. You can contact her via email [email protected]

For anyone outside Ontario, Canada, you can use this directory to find support – https://psidirectory.com/?fbclid=IwAR3pv8dn50qKAd9FqmYKi1TwV6Q4E5N7MuDy1a5AV1Zp-AIyroQf2joUNr4.

More information on Perinatal Mood Disorders can be found here.

Dysphoric Milk Ejection Reflex (D-MER) is a condition affecting lactating persons that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release “let-down” and continuing not more than a few minutes. D-MER is NOT a psychological response to breast/chestfeeding. It is a physiological response to milk release. D-MER is not postpartum depression nor is it classified as a postpartum mood disorder.

Preliminary anecdotal evidence shows that D-MER is treatable if severe and preliminary investigation shows that inappropriate dopamine activity at the time of the milk ejection reflex is the cause of D-MER. D-MER has been linked to an inappropriate drop in dopamine that occurs whenever milk is released. In a client 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 breast/chestfeeding parents never knew it even happened, in D-MER clients however, it doesn’t drop properly and causes an instant and brief wave of a negative emotional reaction that lasts until the dopamine levels restabilize after prolactin has begun it’s rise.

Treatment ranges depending upon severity (mild, moderate, severe) from education, lifestyle changes (increasing fluids, decreasing caffeine, exercise) to medications used to increase dopamine in severe cases where the client is at risk or weaning due to symptoms.

This is an excellent website to review: https://d-mer.org/