Two weeks after my youngest son’s birth, I started to notice a peculiar sensation when I nursed him.

It was fleeting–gone as quickly as it arrived, like a wave of impending doom rolling over me and then washing away without a trace.

At first, I figured it was anxiety due to the immense pain I experienced the first eight days nursing him, but when I started paying attention, I realized it didn’t necessarily start when I began feeding him–it often began even before he latched, when we hit the three hour mark and my milk let down.

Out of nowhere, my stomach would drop. You know the feeling when you’re calling into the principal’s office and don’t know why, or your parents busted you doing something really bad, or you got in a car wreck? That awful feeling of doom and despair?

The physiological manifestations of that feeling are what I experience every time my milk lets down.

About one minute before my milk lets down, my heart rate increases, I have to take very slow, deep breaths to maintain control, and I experience every one of the physiological symptoms of severe anxiety until the let down has ended. Often, the sensations my body is feeling tricks my mind into believing I am actually experiencing extreme anxiety rather than a simple chemical reaction.

It’s called D-MER, or Dysphoric Milk Ejection Reflex. Basically, there’s a chemical imbalance triggered by nursing which leaves you with really funky hormone levels; those, in turn, turn your emotions upside down.

D-MER is not the same as PPD in that it’s tied exclusively to breastfeeding and typically lasts only for the time a mother’s milk is letting down, and it manifests in three ways: depression, anxiety, or anger. I have the anxiety one.

People don’t talk about D-MER, mostly because very little is known about it. In fact, up until recently, it was hardly recognized as a condition at all. It’s not determined by a woman’s emotional well being, and nobody has identified particular risk factors. It might be more common than we know if women who experience it brush it off as just being something inside their heads–we have no idea. There’s not a cure and it usually goes away as baby gets older, but not always.

Once I knew I wasn’t crazy and there really was a legitimate cause, it became much easier to cope. I wasn’t crazy; there was a perfectly scientific explanation for what was happening.

But then it got worse, sometimes to the point were once my D-MER was triggered by nursing, I would remain severely anxious for the rest of the evening. I never experienced D-MER overnight, and it was mild in the morning, but the afternoons and evenings got rough and I reached out to an IBCLC to get some answers.

If you’re one of the special mamas who gets to experience this lovely condition, I hope this helps provide some insight and hope for you. D-MER sucks (like your baby does, literally–hah!) and there’s so few resources out there to give any type of direction. I can’t give any sort of medical advice, but I can pass on what the IBCLC shared and what has worked for me.

First, the onset is D-MER is biological, but the severity is often environmental.

This piece of information is key. I had assumed that something biological was happening, that my hormones were becoming more imbalanced, while actually, it was environmental stressors that were making my D-MER worse.

My IBCLC asked me to look at patterns in my day and once I started paying attention, I can see them.

Screaming kids? Disagreement with the husband? Everyone needing everything from me at exactly the same time? Suddenly the feeling of doom was sticking around past let down. She was right–when my day was stressful, the onset of the knots in my stomach, the quick heart rate, the feeling of everything falling apart was biological, but the level to which I experienced it felt far worse due to my environment.

Cool realization, right, but what on earth was I supposed to do about that?

Not have stressful days?

Hahahahahaaaaaaa. Hilarious. Ridiculous and impossible.

There have been two other options that have worked for me, since “not having stressful days” isn’t particularly practical with three crazy kids under four.

Thankfully, my D-MER is of the anxious variety, and there are different types of anxiety–nervous anxiety can be caused by something bad (getting pulled over by the cops), or it can be caused by excitement (waiting for a first date).

Emotional responses can be taught, so when I feel anxiety coming on because my milk is letting down, I tell myself it’s nervous excitement because I can’t wait to hold my baby. It’s true–I adore holding my baby and I look forward to nursing him–but logically I know that’s not what’s causing my physiological reactions. Still, interpreting them as positive helps me, and I’m teaching myself a positive emotional response as I remind myself how much I love nursing my sweet baby.

Secondly, I Pavlov (can that be a verb?) myself into feeling happy while nursing with chocolate and being able to sit down for half an hour. It’s conditioning, and it works. Pavlov did an experiment where he conditioned dogs to salivate at the ringing of a bell by ringing the bell prior to offering them food. Eventually, they would salivate when the bell was rung even if food wasn’t offered. That’s what I do to myself when nursing.

It works like this:

I like chocolate; it makes me very happy. My milk is letting down when I start nursing, then I eat chocolate, and I feel happy. Even though my stomach is in knots and it’s as if I’m drowning in doom, I still have chocolate, which makes me happy (not to mention it naturally increases dopamine levels), so I can experience both doom and happiness simultaneously. I do this often enough, and eventually I condition myself to feel happy nursing even when I’m not eating chocolate.

Now in realistic application, do I actually feel happy when my milk lets down even when I’m not eating chocolate? Not quite, because I really want to eat chocolate, but I feel pleasant and that’s enough to offset the anxious emotional response I feel in response to the physiological symptoms of D-MER.

Psychology. Neat stuff, right?

We’re three months into nursing and now that I understand my condition better, I’m able to manage it much more effectively.

It’s important to acknowledge not everyone can manage their D-MER this way, or at all–I’ve talked to mothers who are so debilitated by this condition that they are on the brink of sanity. This is no reflection of their capacity as a mother, nor their mental strength–it is a biological condition, although often made worse by environmental challenges. D-MER is legit and it can be devastating.

So dear friend, if you are the mama huddled on the sofa as your milk is letting down, trying not to cry, taking deep breaths to control your emotions, feeling all sorts of helpless and overwhelmed, you are not alone.

There’s nothing wrong with you, and you’re not failing in your breastfeeding journey.

Acknowledge your emotions and eat some chocolate.

If you have a friend experiencing D-MER, come armed with chocolate, her favorite show, and a listening ear.

Basically, chocolate.

You’ve got this, mama!