You might have D-MER if you experience sudden depression whenever you pump breast milk

• While breastfeeding her third child, Arianna Watry experienced symptoms like agitation and anxiety.
• She was diagnosed with D-MER, a condition that causes depression symptoms while breastfeeding.
• Treatment for D-MER usually involves mindful breathing and avoiding overwhelming distractions.

After she gave birth to her third child this year, 29-year-old Arianna Watry began breastfeeding. "The minute my daughter latched on to feed, I started to feel really weird, like I was really bored and detached," Watry told Insider.

Watry had experienced a similar feeling of boredom when breastfeeding her second child, a son who's now 8 years old. At the time, she stopped breastfeeding after two weeks because she didn't like how it felt. It's been nearly four months since she started breastfeeding her daughter, and the feeling has changed for the worse.

Now, Watry said she has intense feelings of agitation and anxiety as soon as her milk comes down, whether she's pumping or feeding her daughter. "I'll notice my chest feeling tight and I'll start to grip the pump if I am pumping, or I'll get so irritated by my kids if they come to talk to me," she said.

At her first postpartum appointment a few days after delivery, Watry's OB-GYN diagnosed her with a condition called dysphoric milk-ejection reflex, or D-MER, a condition that causes depression symptoms when a person expresses breast milk. Here's what causes D-MER symptoms and how to improve them, according to a reproductive psychiatrist.

D-MER can cause intense feelings of sadness or even suicidal ideation

D-MER is a hormone-driven reflex that affects people who are lactating. Along with breastfeeding and pumping, D-MER can also happen with spontaneous milk let down, or leaking.

It's thought to occur as a result of the hormones released during breastfeeding. "During milk let down, you release oxytocin, which we associate with happiness," Dr. Kailey Caplan, a reproductive psychiatrist with UTHealth Houston, said. "For some people, this oxytocin release briefly inhibits dopamine, another mood-boosting chemical."

As a result, people may experience feelings of intense sadness or even suicidal ideation. D-MER can also cause feelings of anxiety or agitation. Watry says her D-MER symptoms sometimes happen to her multiple times during a pumping or feeding session if her milk stops flowing and starts to come down again. "I have to keep reminding myself it'll go away, and that it's a temporary feeling," she said.

The feeling can be scary, but Caplan said it usually resolves within 30 seconds to two minutes of starting feeding or pumping as the burst of oxytocin balances out. D-MER symptoms can affect people for up to a year, Caplan said, but it usually gets better after a few months.

D-MER isn't common; some research suggests D-MER affects about 9% of lactating people. The primary risk factor, Caplan said, is having had it before (as Watry did). But you can experience D-MER once and never have it again or experience it with one child and not others.

Relaxation techniques and avoiding distraction can help D-MER symptoms

While it can cause sudden, temporary depression symptoms, D-MER isn't considered a form of postpartum depression, though people can have D-MER and PPD at the same time. Doctors don't usually treat it with medication. Caplan usually recommends relaxation techniques such as deep breathing, listening to calming music, or turning on a favorite TV show as a distraction.

You can also make the hormonal response less severe by increasing skin-to-skin contact when you feed. "Taking your shirt off and holding your baby can promote dopamine, along with making the oxytocin release more gradual," she said.

For Watry, minimizing potentially overwhelming distractions has been important. She tries to feed her baby or pump in a quiet room where no one will disturb her. She's also explained it to her husband and asked him to take care of the other kids while she's feeding or have him hold the baby when she's pumping.

Keeping an eye out for signs of postpartum depression is key

D-MER symptoms can feel overwhelming at first, but Caplan said they're often manageable.

If the symptoms feel like too much, talk to your medical provider, especially if you're experiencing suicidal ideation. Look out, too, for symptoms like a persistently depressed mood, difficulty sleeping, or a loss of interest in normal activities that last more than a few weeks (including when you're not breastfeeding). These could be signs of postpartum depression, which can be treated by a medical provider.

And don't hesitate to reconsider breastfeeding if it's starting to take a toll on your mental health or overall well-being. "There's a lot of campaigning for 'breast is best,' but if it's a terrible experience you're dreading, that doesn't mean you don't care about your baby," Caplan said. "You need to be healthy and OK, too."