Lott Behavioral Health

12/16/2025

The holidays are a marathon, not a sprint. For our introverted community, the endless string of gatherings, forced small talk, and constant 'on' time can feel less like joy and more like an energy crisis.

Your social energy is a limited resource. Here’s how you can set proactive boundaries, the kind that refuel, not drain, you, so you can actually enjoy the season:

3 Boundary Rules to Recharge Your Holidays:
1. The 90-Minute Rule: You do not have to stay until the bitter end. Decide on your exit time before you arrive (e.g., "I'm staying until 8:30 PM"). This gives you an 'out' without awkward fumbling. When you're ready to leave, simply say, "Thank you so much, I've had a wonderful time, but I need to call it an early night!" No justification needed.

2. Establish a "Sanctuary Spot": Scope out a quiet corner when you first arrive—a nearby hallway, the kitchen counter, or even the bathroom for a quick five-minute break. This isn't anti-social; it’s a vital re-regulation tool. Step away when you feel the overwhelm creeping in. 5 minutes of quiet can buy you 30 minutes of presence.

3. The RSVP Strategy: You don't have to say yes to every single event. Look at your calendar and ask: Does this gathering truly bring me joy, or am I going out of obligation? It is okay to prioritize rest. Declining one event gives you the energy needed to be truly present and engaged at the one you do choose.

Remember This: Setting boundaries is not always selfish. It is a necessary act of self-preservation. When you protect your energy, you show up as your best self for the people you care about most.

Tell us your secret! What is your non-negotiable holiday boundary? Share it in the comments below!👇

12/11/2025

New science just proved your depression is NOT just a serotonin problem. It's also a structural one. Here's how we're rebuilding your brain with the NMDA Receptor.

The Key Player: The NMDA Receptor
What it is: The N-methyl-D-aspartate (NMDA) receptor is the brain's main "on switch" for communication and learning, primarily regulated by the neurotransmitter glutamate.

How Depression Affects It: In chronic depression and stress, the NMDA system can become overactive or dysregulated. This can lead to a shrinking or pruning of vital neural connections (synapses) in critical brain regions like the prefrontal cortex.

🛠️Ketamine/Spravato as a Rapid Repair Tool
Instead of just adjusting chemical levels, ketamine and esketamine work as an NMDA receptor antagonist (blocker). By temporarily blocking this receptor, a cascade of events is triggered that rapidly promotes neuroplasticity:

Release of BDNF: This block triggers the release of Brain-Derived Neurotrophic Factor (BDNF).

Synaptogenesis: BDNF acts like "Miracle-Gro" for the brain, causing the rapid growth of new dendrites and synapses.

Repair: The damaged, shrunken connections are rapidly repaired and new ones are formed, allowing brain regions involved in mood, cognition, and emotion to communicate effectively again.

This rapid synaptic repair is why many patients may feel relief much faster than with traditional medication, sometimes within hours or days.

If you are struggling with Treatment-Resistant Depression (TRD), ask your doctor if exploring the NMDA-pathway with Spravato or therapeutic ketamine might be the right next step for you.

12/09/2025

Have you ever felt that sinking feeling? The one where you automatically say "yes" to a request, then instantly regret it? You spend the next few days dreading the commitment, canceling your own plans, and feeling totally drained. That's the people-pleaser trap.

Avoiding the guilt that comes with disappointing others. But that avoidance comes at the cost of your mental wellness and self-respect.

The real shift happens when you understand that saying 'no' to others is saying 'yes' to yourself.

We teach our clients that setting healthy boundaries is essential for stress relief and preventing burnout. It's not about being harsh; it’s about clear, simple communication. The scripts inside this post are your cheat sheet for protecting your time and energy.

Use them to:
> Reclaim your downtime.
> Improve relationship health.
> Practice essential self-care.

12/08/2025

Stop Confusing Your Band-Aid with a Cure! (You're Not Alone)
Have you ever thought you were "over" something, only to have the same old feelings hit you months later? That’s the difference between Coping and Healing. We often use short-term fixes to manage pain, but true change requires digging deeper.

Why This Matters:
Many people mistake their effective coping mechanisms (like distraction or mindfulness) for completing the hard work of healing from trauma or resolving core issues like anxiety or depression. At Lott Behavioral Health, we teach you to use coping strategies to stay afloat while you do the work of healing.

Coping = Symptom Relief (Immediate)

Healing = Root Cause Resolution (Long-Term)

Both are essential for mental wellness, but knowing the difference is the first step toward personal growth.

Which side of this scale are you prioritizing right now? Type "Cope" if you're just getting through the day, or "Heal" if you're actively working on the root cause!👇

Ready to find a clear path to healing? ➡️Visit lottbehavioral.com

11/24/2025

Dr. Lott at the APA Assembly meeting this past weekend in Chantilly, VA.

11/21/2025

Stop measuring your holiday joy against the filtered feed of your friends. Start measuring it by how present you feel.

If every “perfect” holiday photo on your screen makes you feel a little worse, your brain might be asking for a digital detox, not a better life. Here’s how constant scrolling during the holidays can hit your mental health:

🚨Comparison overload → “Everyone’s doing better than me.”
🧠Nervous system on high alert → harder to relax or sleep
💭Less time in real life → more time in your head
😔Increased anxiety, depression, and loneliness (even in a full room)

Try a Holiday Digital Detox Plan that still fits real life (no, you don’t have to throw your phone away):

Create “no-scroll zones”
Mealtimes, family traditions, bedtime = phone-free. Put the phone in another room, not your lap.

Limit apps that tank your mood
Notice which apps leave you anxious, irritable, or comparing. Set a 15–20 minute daily limit or delete them for the week.

Replace doom scrolling with micro-rituals
Hot tea, a quick walk, deep breaths in the bathroom during gatherings, journaling for 3 minutes before bed.

Unfollow or mute on purpose
If an account regularly triggers comparison, mute it. Protect your brain first, be polite later.

Ask yourself in real time:
“Am I living this moment… or performing it for my feed?” Then gently come back to what’s in front of you.

If you notice your mood, sleep, motivation, or appetite changing for more than a couple of weeks, it might be more than “holiday stress.” A psychiatrist can help you sort out what’s seasonal stress and what might need treatment or extra support.

Save this post for when you need the reminder.

11/11/2025

He didn’t say “I’m sad.”
He said, “I’m snapping at everyone,” “I’m failing,” and “I don’t feel anything.”

Three different sentences.
Rage.
Shame.
Numb.
All signs of male depression.

In session, I met a dad who swore anger was his only problem. We mapped his week and saw the pattern: short fuse → guilt spiral → late-night scrolling → waking up flat. When we named the face...Rage. Shame. Numb. The plan got clear. He practiced a 90-second pause before reacting, scheduled one “10-minute win” each day to cut the shame loop, and added morning light + a brief walk to jump-start pleasure. Not instant magic...measurable progress.

Why it matters (November = Men’s Health Month):
Men often present depression as irritability, overwork, or shutdown, not tears. Recognizing the face you’re in helps you choose the right intervention instead of white-knuckling it. This is mental health literacy, not weakness.

Some things to try today:
• Rage → pause + breath, move your body, repair with a plan
• Shame → capture/schedule worries, one small action now, kinder self-talk
• Numb → morning light + steps, 2 micro-pleasures, 2 connections this week

If you’re ready for professional help:
At Lott Behavioral Health, we provide evidence-based psychiatric care and collaborative therapy plans for men’s mental health, depression, anxiety, and performance stress.

Safety note: If you’re in crisis or having thoughts of self-harm, call 988 (US) or your local emergency number.

health

11/10/2025

The Addiction Psychiatry () conference wrapped up over the weekend in San Francisco. Highlights included perinatal substance use, fetal alcohol spectrum disorder (FASD), GLP-1 and GIP meds, and a debate on psychedelics. Also more friends and colleagues like Subhadeep Barman, MD from Wisconsin. I saw a lot of driverless Waymo cars but ended up taking the cable car instead!

11/07/2025

Dr. Lott is at the AAAP () conference in San Francisco for updates in addiction treatment. Some of the highlights so far include the board of directors meeting and an outstanding symposium on behavioral addictions from Drs. Jon Grant, Timothy Fong, Kenneth Rosenberg, and Lisa Goldfarb, as well as an interesting ketamine workshop. Looking forward to more great content today!

10/28/2025

She didn’t expect magic, just a little room to move. After her monitored ketamine session, the noise in her head dipped a notch and the day felt…wider. Her therapist called it a window.

That afternoon, she tried one small script:
Name it → Reframe it → Small action.
“Anxiety says I’ll mess this up. Reframe: I can send a draft. Action: 3-sentence email.” She hit send. Then she took a short walk, showered, and put protein on a plate. Nothing dramatic, just traction.

She booked therapy for the next day to use the window while it was open. In session, they did a quick CBT thought record and the beliefs didn’t feel welded shut. For anxiety, they chose one tiny exposure: reading the email reply without rechecking it 20 times. Later, in a quiet moment, she journaled a bit of parts/trauma work, and the words came easier than usual.

The plan stayed grounded: sleep, hydration, movement, repeat. No heroics. Just stacking doable wins while the brain was more flexible.

And yes, this is structured care. Medical evaluation → monitored dosing (IV/IM or esketamine/Spravato®) → recovery → integration plan. Short-term effects can include dissociation, dizziness, nausea, and BP changes. It isn’t right for everyone but for some, that brief window is enough to change the pattern.

If you’ve “tried everything” for depression and still feel stuck, consider a ketamine evaluation to see if this approach fits your story.

Educational only. Not medical advice.

10/24/2025

The rise in ADHD diagnoses among adult women isn’t about over-labeling; it’s about better recognizing a condition that’s been consistently missed or misunderstood. Masking, quieter symptom profiles, and biased diagnostic norms has left many women undiagnosed for decades. Increasing awareness means more women are finally getting answers and support.

Does it seem like more adult women than ever are being diagnosed with ADHD? There’s a reason why.

Recent research shows these diagnoses are rising—not because the disorder is new, but because studies and surveys are finally highlighting how ADHD presents in women. Factors include subtle symptoms, decades of underdiagnosis, and social “masking,” while telehealth and awareness campaigns have made it easier for women to seek evaluation.

Learn more about what the latest research reveals about ADHD in adult women: https://on.natgeo.com/47CBNsv

10/23/2025

Perinatal mental health spans pregnancy through 12 months postpartum, far beyond “baby blues.” PMADs include postpartum anxiety, perinatal OCD, birth trauma/PTSD, depression, and (rare) postpartum psychosis. If you’re noticing intrusive thoughts, panic, rage, or numbness, you’re not alone and you’re not broken. Evidence-based care works. From CBT/IPT to medication options compatible with pregnancy/breastfeeding, plus sleep scaffolding and nervous-system tools. Partners can struggle too. Early support protects bonding, sleep, and recovery. Comment SUPPORT for our Perinatal Calm Checklist. If you need immediate help, call 988 (US) or go to the nearest ER.

Sarah Masri, PA-C has extensive experience with the psychiatric management of women during pregnancy and the postpartum period, as well as during fertility challenges. Contact us today to schedule an appointment.