[Part 1 is here.]
The night we brought my oldest son home from the hospital, I remember sitting at the dinner table. He had been sleeping and I was hoping he would wake up soon -- I needed him to nurse. I remember a sudden wash of hopelessness, as if a veil had been pulled back and I could see what a hideous place the world really was. Close on the heels of this surge of emotion I felt a not-yet-familiar ache in my breasts.
Over the next few weeks this became a very familiar cycle: a sudden conviction that the world was unremittingly bleak, closely followed by spraying milk. I remember talking about it a few months later with a friend of mine, who found it very surprising. It must be prolactin, we agreed.
It made sense to me at the time. I had read about the calming effects of prolactin, but I also remembered the weepiness I'd experienced after taking Valium for outpatient surgery. Maybe, I thought then, one woman's calm is another woman's depressed. I also remembered my experiences with PMS as a teenager, when I would experience a distinctive, physical kind of sadness. "I feel sad in my stomach," I would think to myself, and I would know to tuck supplies in my purse for the next day. There was a kinship between the PMS sadness and the letdown sadness; it made sense to me that a unique emotional reaction could be tied to a hormonal state.
My D-MER was never devastating, though I just dug up an email I wrote more than a decade ago in which I described it as "overwhelming" in the early days of nursing my oldest son. On a bad day, it could bring tears to my eyes; on rare occasions it made me a little reluctant to nurse. I tried to shape my emotional response by saying, "Calm, calm" to myself when the feelings hit (which never worked, FWIW); I reminded myself that I would feel better very soon; I tried to get a little extra rest or a little time to myself on the days when it really bothered me. I was extremely (you might even say militantly) motivated to breastfeed, and I just figured it went with the territory for me.
Still, I felt a surprising relief when I first read about D-MER on an email list for lactation consultants. It wasn't just me. I wasn't some kind of aberration. There was a reason I had needed to push away those feelings, all those thousands of times.
Fifteen years later, I rarely notice my D-MER. When I do, it's always milder. I don't know what has changed, exactly, though I vaguely remember that it always became less pronounced as my babies grew into toddlers. I started taking fish oil five years ago, and there may be an association between fish oil consumption and higher dopamine levels (can't find a good link, though -- LMK if you know of one, please). Additionally, I've experienced that rush of unhappiness so many times that I recognize it easily and think, "Oh, it's you again" without paying much attention to it.
For the women with D-MER who might read this, I hope to offer a little encouragement that things can get better without weaning. And I also want to mention a little silver lining -- three small advantages to D-MER. First, difficulty dealing with the D-MER feelings can be a cue that I'm not taking care of myself adequately, a sign to look again at what else is going on in my life. Second, D-MER gives me much more empathy for a couple of people in my life with substance abuse problems. Part of the addiction cycle is lower dopamine levels during withdrawal, and do you know what? If the world routinely looked as hopeless to me as it used to in those moments when my dopamine level plunged, I might very well have a substance abuse problem of my own. D-MER offers me a bit of insight into the mysterious potency of brain chemistry. Finally, those early days when the feelings are strongest are also the days when the breasts are most likely to leak. That unmistakable flash of misery was a cue for me to apply discreet pressure in time to contain the spray. I might have felt that I was looking out across an empty and barren world, but at least I could do it with a dry shirt. :-)
Here again is the link to the D-MER site, where there's lots more information for mothers with D-MER and their supporters: http://d-mer.org.
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