Psychosomatics: When You Need a Psychiatrist

Psychosomatic complaints — pain, exhaustion, tension without a clear organic cause — often lead people straight to a psychologist, coach, or psychotherapist. Dr. Saulitis argues this is frequently the wrong route, because it bypasses the essential question: what state is the brain itself actually in?

Diagnosis first, everything else second

Before choosing any method of help, you need to understand what is actually happening. A diagnosis is made by a qualified medical specialist. Without it, any intervention — behavioural, conversational, or body-based — risks addressing surface symptoms rather than their root causes. The same outward symptoms can have entirely different origins: burnout, attention deficits, age-related changes, chronic stress. They look identical from the outside; the causes differ — and it is the causes that must be treated.

A broken leg needs a cast

Dr. Saulitis uses a straightforward analogy: prevention and training are excellent things, but if a leg is broken, you need a cast first. When the neurochemical balance is disrupted and a person is overwhelmed by intrusive thoughts and anxiety spirals, homeostasis must be restored first. Only then does it become possible to move forward — toward psychological work, building new skills, or changing behaviour.

Why a psychologist is not enough

A psychologist or psychotherapist works with behaviour and thinking. But thinking is an informational phenomenon that directly affects neurons and synapses — it shapes neuroplasticity. If you do not understand the state of the "hardware" — the brain itself — you cannot know whether any given intervention is helping or causing harm. That is precisely why a psychiatric assessment must be the starting point, not something to be bypassed.

When to see a psychiatrist

• Symptoms persist after rest and cannot be explained by organic causes
• Your usual self-regulation strategies have stopped working
• Anxiety, low mood, intrusive thoughts, or sleep disturbances are intensifying
• You have already seen a psychologist but experienced no improvement, or symptoms returned

A psychiatric consultation is not the end of the road — it is the right place to begin.