FREQUENTLY ASKED QUESTIONS
Does Mood Change Medicine offer free initial consultations? – Yes. Mood Change Medicine offers a free, 30-minute consultation to speak with Dr. Meissner to see if we are a good fit.
What conditions do you treat? – Mood Change Medicine treats poor sleep, insomnia and stress. And we offer adjunctive treatments for anxiety and unipolar depression for patients referred by your primary care doctor or psychiatrist. We offer primary treatment for patients with insomnia, poor sleep and/or stress without a referral. Adjunctive treatment of patients with anxiety and/or depression is done in collaboration with your psychotherapist. Mood Change Medicine does not offer primary care. Mood Change Medicine’s sleep program does not treat patients doing shift work or with non-24 circadian disorder, dementia, narcolepsy, hypersomnia disorder, REM sleep behavior disorder and non-REM parasomnias like sleep walking, sleep eating and dream enactment behavior.
How much do you charge? – Mood Change Medicine’s fees are based on a sliding scale down as low as $0/session to income-qualified patients.
What is Adjunctive Treatment for Mental Health? – Mental health conditions like anxiety and depression have both psychological and biological components. Your psychotherapist works with you on the psychological aspects of these mental health conditions and Mood Change Medicine helps you work on the biological components. We take a mind-body approach using evidence-based, drug-free treatments that bolster well-being as well as physical health. These treatments address biological drivers of conditions such as depression and anxiety. Biological triggers can include poor sleep, chronic stress-induced inflammation, deconditioning along with dietary contributors. At Mood Change Medicine, the patient collaborates with Dr. Meissner to decide what treatments resonate with them.
Does Mood Change Medicine do medication management ? – Dr. Meissner is happy to work with patients on medication, but she does not manage, prescribe or taper medications. Mood Change Medicine is an integrative practice that offers evidence-based, drug-free treatments that typically can be given whether patients are taking medications or not. However, patients seeking treatment for insomnia must first be tapered off their sleep medications by their prescriber before beginning treatment at our clinic. Insomnia treatment works better when patients are not on sleep meds.
Is it safe from me to taper off anti-anxiety medications and sleeping pills myself? – If you’ve been prescribed sleeping pills and anti-anxiety medications, it may not be safe to taper off these medications without the help of the doctor who prescribed them. To find out why, click link below:
What is Cognitive Behavioral Therapy for Insomnia? – Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component treatment program for insomnia that targets difficulties with initiating sleep and/or staying asleep. The program provides skills to help patients optimize sleep biology including circadian and natural sleep drives so that the biological drive for sleep is maximized. This resets problematic sleep patterns to prevent nighttime wakefulness.
There are various components of CBT-I designed to target:
- Sleep duration
- Sleep quality and sleep satisfaction
- Circadian sleep timing consistency and regularity of sleep
- The mismatches between time spent in bed and the time actually spent asleep
- Daytime alertness, energy level and performance
- Anxiety or alertness connected to being in bed or in the bedroom.
- Sleep-related worry and helping patients shift their physiology into a more relaxed state.
- Unhelpful thoughts about sleep.
In order to do this, patients:
- Track things like bedtime and wakefulness during the night using a phone app and reviewing it with Dr. Meissner.
- Use biofeedback or other relaxation skills to foster states more compatible with sleep.
- Modify sleep schedules including wake and sleep times.
- Learn about the biology of sleep.
- Develop regularity in daily activities that cue circadian rhythms like when we eat and exercise.
- Optimize exposure to morning and evening light patterns that regulate sleep.
- Change unhelpful sleep and pre-sleep habits.
Learn more about Cognitive Behavioral Therapy for Insomnia (CBT-I) by clicking link below:
What is Cognitive Behavioral Therapy (CBT) and how is it different from CBT-I ? – Cognitive Behavioral Therapy (CBT) is a form of talk therapy that can be used to treat a number of conditions like anxiety and depression. CBT-I is a highly specialized form of CBT that includes modalities that target changing sleep biology along with some of the more traditional elements of CBT to target sleep-interfering thoughts and feelings. Both of these therapies use a highly collaborative treatment approach to promote increased awareness of the connection between thoughts, feelings and actions. CBT-I focuses exclusively on sleep and often incorporates purely physical treatments such as light therapy. CBT-I includes:
Sleep Hygiene Education: Teaches habits that promote better sleep.
Sleep Consolidation Therapy: Limits time in bed so that time you spend in bed is actually spent sleeping.
Stimulus Control: Rebuilds the association between bed and sleep.
Cognitive Restructuring: Replaces unhelpful beliefs about sleep with accurate information that supports sleep.
Traditional CBT provides skills that help patients solve problems and set goals. Depending on the condition—anxiety or depression—CBT helps enhance engagement with relaxing and/or mood-boosting activities that help calm the nervous system and/or uplift mood. CBT for depression is often combined with Schema therapy which helps people understand how core beliefs—often developed in childhood—shape our current feelings and behavior. Whereas CBT-I does not address such issues. CBT for anxiety is often combined with exposure therapy which helps lower anxiety that is triggered by things such as social events like public speaking. Over the years, traditional CBT has taken on new forms like Acceptance & Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) which are rooted in CBT principles. Both ACT & MBCT are used to treat anxiety and depression but not insomnia.
The benefits of CBT for anxiety and depression are backed up by decades of research as Judith Beck PhD—daughter of CBT’s inventor, Aaron Beck MD—explains.
To watch Judith Beck PhD explain how Cognitive Behavioral Therapy for anxiety and depression works, click link below:
Which treatments help people with both insomnia and anxiety or depression? –
Mood Change Medicine adjunctive treatments for anxiety or depression with co-occurring insomnia include integrative therapies including: cognitive behavioral therapy for insomnia with biofeedback-assisted relaxation therapy, hypnotherapy, light therapy to help normalize circadian rhythms and other therapies to address biological drivers of these conditions.
To learn more about integrative treatment of insomnia with co-occurring anxiety and/or depression, click link below:
Can you explain more about why these integrative treatments help people with both insomnia and anxiety or depression? – Mood Change Medicine’s treatments target common biological and psychological drivers of all three conditions.
Read more about why integrative treatments help people with insomnia and co-occurring anxiety and/or depression click link below:
Does Mood Change Medicine accept insurance? – Because billing procedures used by insurance companies are so onerous that they compromise the ability of a small practice to provide optimal quality of care, Mood Change Medicine does not accept health insurance. We will not bill your insurance company. But, if you request it, we will provide you with a bill that you may submit to your insurance company to seek reimbursement. Insurance does not cover the cost of some of the services that we provide. For covered services, the insurance company’s reimbursement rates can be lower than the cost of the service. For more information on what is and what is not covered call your insurer.
How does biofeedback work? – Biofeedback technology helps people learn to shift into a calm state and out of the physiology of stress that drives anxiety and depression and interferes with sleep. It helps people slow speedy hearts, quiet anxious breathing patterns and relax tense muscles. These new skills build a sense of empowerment and safety.
The ‘BIO’ part of biofeedback: You’re hooked up to one or more non-invasive sensors. Skin sensors wrapped around your fingers measure things like your heart rate, temperature and subtle changes in skin sweat. Sensors placed on face, shoulders or neck measure changes in muscle tension. A sensor wrapped around your waist measures the rate and pattern of breathing.
The ‘FEEDBACK’ part of biofeedback: Technology converts these measurements into real-time, audiovisual images and video—the feedback. This content is displayed on a screen in the form of something as straight forward as a line that goes up and down, a simple game, or a YouTube video that changes with changes in your heart rate, breathing, skin temperature or muscle tension.
You will learn ways to calm these readings through techniques like self-hypnosis, breath control, guided imagery and progressive muscle relaxation. With practice, your new skills become automatic and don’t require the training wheels of the instrumentation’s feedback from the audiovisual display. Mood Change Medicine may use biofeedback technology to determine what relaxation technique works best for you.
Skills learned through biofeedback empower people to play an active role in self-regulating anxiety, depression, insomnia and other stress-related disorders. Dr. Meissner is Board Certified in Biofeedback, BCB-L, Biofeedback Certification International Alliance.
Dr. Meissner is Board Certified in Biofeedback by Biofeedback Certification International Alliance.
Read more about research showing biofeedback’s efficacy in the treatment of anxiety and depression by clicking links below:
Read more about how Mood Change Medicine combines biofeedback with CBT-I, the gold-standard therapy for insomnia and about the evidence showing biofeedback’s efficacy for anxiety and depression. Click link below:
Can I lose control while in a state of hypnosis? – Hypnosis is a state of heightened focus and relaxation, not a loss of control. People in hypnotic states remain aware of what they are doing.
Can I get stuck in hypnosis? – The misconception that an individual can become trapped in a state of hypnosis is a fictional narrative. It doesn’t reflect reality. Even if the hypnotherapist walked out of the room and didn’t return, the person would simple come out of the trance without any prompting.
To learn more about hypnosis click link below:
Which nutritional and herbal supplements are used to improve insomnia, depression or anxiety and how well do they work?: Some supplements that people take for these conditions can be helpful, but some of them can actually make these condition worse.
General information on supplements for anxiety, depression and insomnia can be found by clicking link below:
The conclusion of the article below contains links to a number of articles on the safety and efficacy of the most popular supplements that people take for anxiety, depression:
The conclusion of the article below contains links to a number of articles on the safety and efficacy of the most popular supplements people take for insomnia:
The sleep-hormone melatonin is commonly taken as a dietary supplement by people with insomnia and sleep problems.
Learn more by clicking link below:
Cannabinoids like CBD and cannabis tinctures are often taken by people with anxiety, depression and insomnia. But how effective are cannabis products and what are their risks?
Learn more by clicking link below:
Tryptophan plays a pivotal role in the gut-brain axis, a two-way biochemical conversation between our brains and bellies that helps determine the production of melatonin and serotonin, key brain chemicals that affect sleep and mood. Some people take tryptophan supplements for insomnia, depression or anxiety.
Learn more by clicking link below:
5-HTP (5-hydroxytryptophan) is a nutritional supplement that might improve symptoms of depression in some people. It might work as well as some prescription antidepressant drugs like Prozac. It’s likely more helpful when taken in combination with other treatments like talk therapies that can provide lasting benefits.
Learn more by clicking link below:
St. John’s wort is an herbal medicine that works as well as pharmaceutical antidepressants like Prozac and is better tolerated than these medications. It’s likely more helpful when taken in combination with other treatments like talk therapies that can provide lasting benefits.
Learn more by clicking link below:
Valerian root is an herbal medicine colloquially known as “plant Valium.” Its use dates back to ancient times. Hippocrates wrote about the plant’s medicinal properties. In modern times people take the herb for its anti-anxiety and sleep-promoting effects. Valerian can take up to four weeks before its sleep-promoting effects begin to manifest.
Learn more by clicking link below:
The consumption of beverages made with kava, an intoxicating Polynesian herb known as kava kava (piper methysticum) has been a social practice among Pacific Islanders for thousands of years.
Learn more by clicking link below:
Cherries are loaded with health-promoting, anti-inflammatory nutrients. Evidence of sleep benefits is mounting. This amazing superfood contains the sleep-promoting hormone melatonin. But that’s not the only way cherries might work to promote sleep.
Learn more by clicking link below:
What can a person do to enhance the benefits of talk therapies for anxiety and depression? – People can cut inflammation and boost growth of new neurons.
Click links to 2-part article below to find out how and why this could augment better mental health:
How does counseling improve anxiety and depression? – Talk therapy techniques used in counseling teach skills that over time, lead to structural changes in the brain—improvements that are more enduring than oral medications. Click link below to find out how psychotherapy works:
How effective are talk therapies like CBT that are used in counseling for anxiety and depression and how do these psychotherapies compare to the efficacy of other treatments? – To find out how effective counseling is and to learn about the efficacy of other treatments click link below:
What is Mindfulness-Based Cognitive Therapy (MBCT) and how does cultivating mindfulness help anxiety and depression? – MBCT is a type of psychotherapy based on the core principles of mindfulness-based stress reduction. Mindfulness practices including MBCT have profound affects on both mental and physical health. Mindfulness practices include but are not limited to meditation.
Click link below to learn about MBCT and how it helps anxiety and depression:
“I’ve tried mindfulness and it doesn’t work for me. I know I am supposed to stay perfectly focused on my breath, but my mind just bounces around to different thoughts, emotions or sensations. Is it possible that some people just can’t do mindfulness? – The question suggests that if the mind is not staying perfectly focused on the breath the entire time then, the questioner is not doing mindfulness correctly. Not true.
Mindfulness is not about clearing the mind of all thoughts, emotions or sensations and complete focus on one thing like the breath. Mindfulness is simply being aware of all these things that are happening in our experience. So, the fact that a person can even ask such questions shows that they have succeeded at mindfulness. Having our minds wander is totally normal. That’s what minds do. Noticing that our minds are wondering—without judging it—is an act of mindfulness.
To get the benefits of mindfulness, don’t I have to sit on the floor with my legs crossed and meditate for hours a day? – No. You can think of mindfulness practice like physical exercise. Just as we don’t have to become Olympic gold medalists in order to get significant benefits from daily exercise, the same is true for mindfulness practice. The more a person does, the more benefits they gain. Fifteen minutes a day—as little as 5-minutes of being present and aware of one’s experience a few times a day can provide significant benefits. For example, mindfulness exercise can be as brief taking a one-minute breathing space.
I’m convinced by the science that mindfulness works but I wonder if I have enough time to do it. – The link below is a 4-minute video describing “STOP”, a one-minute mindfulness practice. Though longer mindfulness practices pay great dividends and power up shorter ones, there are a lot of quick ways to boost our mindfulness quotient.
Click link below to see why time pressures do not mean that mindfulness is out of reach for those with busy lives:
Which nutrients calm anxiety and lift mood? – Nutrition is important for mental health for many reasons. Certain foods feed the biological triggers for anxiety and depression and other foods help quench these triggers. The body requires certain nutrients to make neurotransmitters that play a big role in how we feel. And the health of the GI tract determines which nutrients are absorbed.
To read more about eating for mental health, click link below:
Why would probiotics have anything to do with mental health? – The gut-brain axis is a two-way biochemical conversation between our brains and bellies that plays a crucial role in our mental and physical health.
Click below to find out more:
Why is nutrition a factor in getting good sleep and which nutrients could improve sleep?
I know Cognitive Behavioral Therapy for Insomnia is the most effective treatment for insomnia, but I’m also looking for other things that can help me sleep better. I don’t want to take sleeping pills or supplements. Are there specific foods that could help improve sleep?
Click link below to find out more:
Why is it that anti-anxiety medications and even anti-anxiety supplements can actually make anxiety worse in the long run?
Click links below to find out more:
How do alternative treatments like exercise compare to medications like antidepressants? – Click below to find out more:
Is low serotonin the biological cause of depression ? – There’s a controversy about whether or not low serotonin causes depression. Click link below:
How do antidepressant medications, the selective serotonin reuptake inhibitors (SSRIs) like Prozac and Paxil work ? – There’s a controversy not only about how SSRIs work but also about how well they work. They may help some people but currently the research that proves they are effective seems to be on shaky footing. Some people with severe depression find that hallucinogenic medications like psilocybin mushrooms or ketamine is more helpful than SSRIs but the efficacy and safety of these medications has yet to be established. Click link below:
The supplement I’ve been taking which helped has recently stopped working? – There are many reasons that a supplement may not work optimally such as a deficiency of other nutrients called cofactors. The efficacy of tryptophan is a great example of a nutritional supplement that requires a lot of other factors that support its efficacy. Click link below:
I can’t take St. John’s wort because it interacts with my medications, are there other things I can do for my depression ? – There are even more powerful ways to heal depression. To learn about ways to lower cortisol, calm stress, extinguish inflammation, boost neurogenisis and neuroplasticity, increase brain levels of tryptophan, normalize melatonin, vanquish insomnia and restore circadian rhythms, click link below:
How does one evaluate the safety and efficacy of treatments for health conditions? – There are many factors to consider when looking at taking a new treatment. Many people wonder how to really know if the benefits outweigh the risks. To read more about ways to evaluate a treatment click link below:
The website’s Mood Change Library page contains health related articles on topics of interest to the general public and as well as medical professionals. Mood Change Medicine Library
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