There's also the idea of functional pain, in which the nervous system
overinterprets sensations as pain (way oversimplified explanation)  so that
while we don't see any trauma to the nipple, the mother still feels pain. I
don't think it's depression per se, though antidepressants can sometimes be
used.
University of North Carolina has a patient info sheet (first link) and if
you scroll down in the second link, you'll find a page on functional pain
for providers of care:

http://mombaby.org/PDF/functional_pain_ho.pdf
http://mombaby.org/PDF/PainProtocols.v3.pdf

Susan Lawrence in Berkeley

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