A Physician Mom's Experience with Dysphoric Milk Ejection Reflex (D-MER)
Content Warning: This post contains candid discussions of postpartum mental health challenges, emotional distress, dark thoughts, and severe dysphoria associated with Dysphoric Milk Ejection Reflex (D-MER). Please prioritize your well-being while reading. If you are experiencing thoughts of self-harm or a mental health crisis, please reach out for immediate support by calling or texting 988 (in the US/Canada) or contacting your local healthcare provider.
Medical Disclaimer: The content shared on this blog reflects the author’s personal experiences, personal journey, and professional perspective as a physician. It is provided for informational and educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions you may have regarding a medical condition, postpartum symptoms, or mental health concerns. Never disregard professional medical advice or delay seeking it because of something you read on this blog.
Okay, baby is born and it is magically time to make some milk, or at least that is what I thought would happen.
I learned quickly that my body takes time to make milk so I did what I had to to feed my baby and gave formula until the milk finally came in!
Not sure if this happens to everyone, but when my milk finally came in, I felt like I had the flu! I had chills, I couldn’t stop shaking and I felt like complete crap. But that didn’t matter because I finally had milk!!
(Editor’s note: This has an old-school term known as “Milk Fever”. It is not the same thing as mastitis, but it is experienced when a mother’s milk first comes in. It generally lasts for 24 hrs. However, if you have flu-like symptoms that last longer than 24 hours, you may want to contact your health care provider to to rule out mastitis.)
Well my little gal wouldn’t latch so here I am, a new mom with some milk that needed to come out but I had to pump in order to do it.
Pumping instructions are hard and somehow I had to figure out how to use this machine to have a “let down”. I had always heard of people knowing when they had this magical phenomenon called a “let down”. Maybe it was a tingly sensation, or a sensation in the breast that only the person having it could explain, or maybe it was their baby gurgling milk because milk came out so fast, I am unsure because I never had it.
Instead I would have a feeling of pure dread, sadness, wanting to scream, feeling worthless and at times suicidal.
I would not be feeling these things before pumping, but the second I put that pump on I had to brace myself because I knew it was coming: that dreaded infiltration of thoughts and feelings into my head. And it would happen every… single… time. It would last anywhere from 1-5 minutes.
Imagine pumping every 2-3 hours throughout the day and night and always having that sensation on top of the feelings one does after having a baby. And this continued until I decided to stop pumping around 9 months. I never said anything to anyone, I thought it was just my baseline anxiety/depression (which I wasn’t taking anything for before, during, or after pregnancy) and to be honest, was embarrassed to share any of that with anyone.
Fast forward to my second child. I tried the breastfeeding thing again but the little guy would bite my nipples raw so I went back to what I knew: pumping. And you want to know what else came back? Those dark dark thoughts every single time I would put the pump on. And they came back with a vengeance!
But this time I told my husband about it because I thought it was so strange that it was happening again. I was actually in a better mental space the second time around, was on the meds that worked for me and genuinely felt as good as I could, so something wasn’t adding up as to why it was happening again.
I debated telling my psychiatrist about it because the thoughts were just dark and I was embarrassed and THANK GOD I told her. She is the one that told me about Dysmorphic Milk Ejection Reflex (D-MER).
I was so relieved to hear her tell me this because oh my god, I wasn’t just being extra crazy or sad, this is a true phenomenon that women can experience when they have a let down. There is no tingly feeling instead just feelings of pure dread.
The only way I can somewhat describe what it feels like (and maybe this is dramatic) but imagine you are cuddling your sweet little puppy who is so playful, you love it so much and you are so happy, but then in one second that puppy runs away and gets hit by a car and is dead. A dramatic change in feelings and sensation, right?
That is what would happen when those pumps went on. A night and day difference in emotions, as if someone sucked the happiness right out of me every single time it was time to pump.
About 5-ish% of women experience this and it is not related to PPD/PPA. I was excited at first because I thought maybe there would be a medication to help but nope there isn’t. My psychiatrist told me to try and distract myself - she told me to pull up Instagram/social media or focus on watching/doing/talking or just doing anything that filled me with some sort of happiness.
I gave it a try and it did help at times, but I felt more in control knowing that this was a true phenomenon that can happen and it had a name. I ended up pumping for a year with my second child and I feel part of the reason that I could go that long was because I was in a better headspace and had more awareness as to what was going on with my body both mentally and physically.
D-MER doesn’t go away the longer you pump, I wish it was something that only happened the first couple of months but no, every time you have a let down this sensation happens even if you have already been pumping for months.
My psychiatrist made the comment that she was wishes this phenomenon was talked about more and I can tell you that I didn’t learn about this in medical school nor residency so I hope that this blog helps get some awareness out there about D-MER and if there is someone you know dealing with this or maybe you are having these feelings, you are not alone. ❤️
Melanie Camejo MD, MHPE
Meet Melanie: mom, doctor, educator, and co-founder of Vervee. A true Midwest girl at heart, she’s been in Kansas City most of her life. After a brief stint in Philly with her husband, she returned to KC as an academic emergency medicine physician, helping educate the next wave of ER doctors.
In 2023, Melanie welcomed her daughter while working full-time as a night doctor in the ER. She’s passionate about teaching and shaping the next generation of healthcare pros. When she’s not saving lives or teaching residents, you’ll catch her making memories with her family-her 2 pups Toki and Caiya, and friends, she loves traveling, and checking out KC with all the amazing things it has to offer.
Verveescrubs.com | Instagram: @Verveescrubs
