Psychosomatics: First Steps Before Medication

When someone faces anxiety, low mood, insomnia or bodily distress, the first impulse is to find a medication. But Dr. Saulitis suggests a different first step: understanding what actually underlies the condition. Medication is not the starting point — it may be the outcome of sensible investigation.

Why not start with medication

The doctor's core message is simple: there's no need to rush into pills. Often you can "set the brain and rhythm back in order" without immediate pharmacological intervention. A drug prescribed blindly, without understanding the cause, wastes time and money rather than solving anything.

Depression as a "basket" and as a disorder

Here lies the trap. In everyday speech people call fatigue, low mood and being downcast "depression" — that is, a symptom. The doctor compares this to a "basket" into which people toss all sorts of bad feelings. But for a psychiatrist, depression is something else: a mental disorder of a specific register in the international classification — endogenous, genetically determined. Hence the confusion: one word, two completely different meanings, treated differently.

First step: rule out the psychiatric register

With psychosomatics you must first separate things out: is the picture already driven by an existing mental disorder — endogenous depression, a psychotic-register disorder? If a disorder of that level lies behind the complaints, the approach is entirely different, and it cannot be resolved with "talking."

Second step: rule out somatic illness

Many bodily conditions exist in their own right and secondarily generate distress. The doctor names the thyroid, the liver, the pancreas and other organs. That's why the body needs investigation: blood tests, urinalysis, biochemistry — especially liver function tests (ALT, AST and others). This helps clarify whether other disorders are influencing the psychosomatic picture.

When brain imaging is needed

The doctor mentions an electroencephalogram as part of basic investigation. If you want to examine the brain more deeply, only magnetic resonance imaging on a 3-tesla machine makes sense. The rest, in his words, has no informative basis.

Practice

A checklist of first steps for psychosomatic complaints (strictly following the doctor's logic):

1. Don't start with medication. First understand the cause.
2. Separate the register. Is it a symptom-"basket" or a mental disorder? This changes the whole approach.
3. Rule out somatic illness. Get blood tests, urinalysis, biochemistry — especially liver function tests.
4. Get an EEG, and if deeper brain study is needed — a 3-tesla MRI.
5. See a specialist with results in hand. Without them, visits risk becoming a waste of time and money.

Why this matters

Once the investigation is done and the results are in hand, seeing a specialist becomes meaningful. Without this preparation you may "throw away" many visits in vain. The right sequence saves both time and money and brings you closer to the true cause.