Anxiety and Insomnia: First Steps Before Treatment

When anxiety or insomnia takes hold, the temptation is to start with pills right away. But the doctor insists: the first step is not medication — it's understanding what is actually happening in the body and the brain. Otherwise you may waste dozens of visits, time, and money without getting anywhere.

Don't start with medication

The doctor's core point is simple: first try to restore the brain's work and rhythm rather than just silencing the symptom. Medication is not the first rung but one of the later ones, and it makes sense to bring it in only once the picture has become clear.

The confusion around the word "depression"

The doctor highlights a trap in language. For an ordinary person, "depression" means fatigue, low mood, a sense of being down — a symptom. It's like a basket where people toss all their different bad states. But a psychiatrist means something quite different by depression: a mental disorder of a specific register, treated in a completely different way. This creates a "wild confusion," where people and specialists speak different languages about the same word.

First step: rule out the psychiatric register

When it comes to psychosomatics, the doctor proposes a clear order of action. First, separate out whether a mental disorder lies behind the distress — those very "depressions," the schizophrenia spectrum, and similar states. If so, the treatment is entirely different, and talking techniques alone won't do.

Second step: rule out physical causes

Next, the doctor advises ruling out bodily pathology. Sometimes an independent disorder of the body — the thyroid, the liver, the pancreas, and others — secondarily drives all these experiences on its own. So you need an examination: simple blood tests, a urine test, biochemistry, especially liver panels and enzymes. For the brain, the doctor names the EEG as meaningful, and, if needed, an MRI on a 3-tesla machine.

Only then — to a specialist

The doctor stresses: it makes sense to go to a specialist once the examination results are already in hand. Without them, visits risk becoming a pure waste of resources. Once the data is gathered, the picture grows clearer and help becomes more precise.

Practice: a checklist of first steps

1. Don't grab for medication first — try to restore your rhythm and your brain's work.
2. Separate "depression as a symptom" (fatigue, low mood) from the question of a mental disorder.
3. Get simple tests: blood, urine, biochemistry, liver panels and enzymes.
4. For the brain — an EEG; if needed, an MRI on a 3-tesla machine.
5. Go to a specialist once the results are already in hand.