\[ **BT: [[breastfeeding (chestfeeding)|breastfeeding/chestfeeding]]** ] --- # dysphoric milk ejection reflex (D-MER) [[Dysphoric milk ejection reflex (or D-MER) is a condition that causes sudden, intensely negative feelings as a reflexive response to letting down breast milk. It’s entirely physiological and doesn’t last long, but can be very traumatic.]][^1] [[Feelings trigged by dysphoric milk ejection reflex include depression, anger, and anxiety. Less common feelings include hopelessness, homesickness, panic, paranoia, self-loathing, dread, impending doom, and even thoughts of suicide.]][^2] [[It’s been estimated that somewhere between five and nine percent of breastfeeding people experience D-MER. It has no relation to PPD or post-partum anxiety, although some people may experience D-MER as well those conditions.]][^3] [[In most cases, dysphoric milk ejection reflex resolves itself within about three months or, at the very least, becomes less severe over time. Unfortunately, there have been cases where the condition has continued until cessation of breastfeeding.]][^4] [[For some dysphoric milk ejection reflex sufferers, just understanding that they’re suffering from a real, physiological disorder—rather than a psychological or personal failing—can be enough to help them manage the condition.]][^5] [[It’s unclear precisely what causes dysphoric milk ejection reflex. It’s thought that people suffering from D-MER experience an extreme oxytocin-related dopamine drop when oxytocin triggers the ejection of milk at the start of a breastfeeding session.]] - see also: [[health and wellbeing|diagnosis validation]] [^1]: ‘[[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|Dysphoric Milk Ejection Reflex (D-MER)]]’, Cleveland Clinic, last updated 6 April 2023, [https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex](https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex); ‘[[Healthline, ‘What to Know About Depression and Anxiety While Breastfeeding’, 2021|What to Know About Depression and Anxiety While Breastfeeding]]’, Healthline, last reviewed 22 September 2021, [https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex](https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex). [^2]: ‘[[Healthline, ‘What to Know About Depression and Anxiety While Breastfeeding’, 2021|What to Know About Depression and Anxiety While Breastfeeding]]’, Healthline, last reviewed 22 September 2021, [https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex](https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex). [^3]: ‘[[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|Dysphoric Milk Ejection Reflex (D-MER)]]’, Cleveland Clinic, last updated 6 April 2023, [https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex](https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex); ‘[[Healthline, ‘What to Know About Depression and Anxiety While Breastfeeding’, 2021|What to Know About Depression and Anxiety While Breastfeeding]]’, Healthline, last reviewed 22 September 2021, [https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex](https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex). [^4]: ‘[[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|Dysphoric Milk Ejection Reflex (D-MER)]]’, Cleveland Clinic, last updated 6 April 2023, [https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex](https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex). [^5]: ‘[[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|Dysphoric Milk Ejection Reflex (D-MER)]]’, Cleveland Clinic, last updated 6 April 2023, [https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex](https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex).