Psychosomatics: Where to Begin Before Seeing a Psychiatrist

When someone is troubled by physical symptoms with no clear cause, the temptation is to reach straight for medication. But Dr. Saulitis stresses: you should not start with drugs, but with understanding what you are actually dealing with. "Maybe the brain's work and rhythm can be set right." The first steps are not pills, but clarity.

Why "depression" is a trap-word

Enormous confusion comes from a single word. For an ordinary person, "depression" means tiredness, low mood, a feeling of being down — as a symptom. The doctor compares it to a basket into which people toss their various bad feelings.

But when a psychiatrist says "depression," he means something entirely different — a mental disorder, endogenous, genetically determined. And it is treated completely differently. So before doing anything, it is vital to realize: one word can hide two utterly different phenomena.

First step: rule out the mental register

With psychosomatics, the doctor suggests proceeding in order. First — determine whether a mental disorder lies behind the physical complaints, shaping the whole clinical picture. These conditions are "set aside," meaning first excluded as a cause.

This is not self-diagnosis — it is the awareness that psychosomatics may be secondary to a deeper process.

Second step: rule out bodily illness

Second — exclude physical diseases that, on their own, secondarily produce the experiences. The doctor names the thyroid, the liver, the pancreas and others — disorders that exist independently yet "secondarily give rise to all these experiences."

For this, examination is needed: blood tests, urine, biochemistry, and especially liver function tests — enzymes and liver panels — to understand whether another disorder is influencing the psychosomatics.

When to see a specialist

The doctor insists: it makes sense to go to a specialist once the test results are already in hand. Without them, he says, a person risks wasting both money and time on numerous visits with no result. Clarity first — then consultation.

Practice

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

1. Don't start with medication — first understand what is actually happening.
2. Distinguish "depression" as tiredness-symptom from depression as a mental disorder — they are different things.
3. Get basic tests: blood, urine, biochemistry, liver panels (enzymes).
4. When indicated, examine the brain by proper methods.
5. Go to a specialist only with examination results in hand.