Dear colleagues,

I met a new patent yesterday, a perinatal woman with a four weeks old child.

She had symptoms according to a Borderline PD diagnosis, but also described symptoms of severe dysphoria during lactation which lasted a bit more than a few minutes. The symptoms always disappeared after the breast feeding had ended. She reported so intense suicidal ideas that I became a bit worried, especially since she also could have these dysphoric episodes in association with the milk ejection reflex before she started to breastfeed. I found it reasonable to believe that she had symptoms of dysphoric milk ejection reflex (D-MER), which is putatively caused by a fall in Dopamine level during lactation.

Does anyone have experience with medical treatment of this condition? The mother receives psychological treatment twice a week, but was herself worried about her suicidal impulses and discussed medication with me. I would also appreciate suggestions regarding updatet research knowledge on the subject.

Magnhild Høivik