Psychosomatics: First Steps Before Seeing a Specialist

When someone faces psychosomatic problems, the main mistake is reaching for medication right away. Dr. Saulitis suggests a different order: first understand what actually lies behind the bodily experiences, and only then choose treatment. This brochure is about the very first, practical steps.

Don't start with pills

The first thing the doctor stresses: don't start with medication straight away. Often it's possible to "set the brain and its rhythm right," but first you need to understand what is actually going on. Rushing into pills without knowing the cause is a path where you can easily waste time and money.

Step one: rule out the psychiatric register

With psychosomatics, you first separate out what might be a standalone psychiatric disorder. The doctor speaks of so-called registers in the international classification — for example, depressive and psychotic disorders. Here a confusion he warns about matters: for ordinary people "depression" means fatigue, low mood — a symptom. But for a psychiatrist, depression is a distinct psychiatric disorder (the F33 register), and it is treated in a completely different way.

"Depression is like a basket — people throw all sorts of their bad feelings into it."

So the first step is to figure out whether the picture is in fact caused by a psychiatric disorder. If it is, the approach will be entirely different.

Step two: rule out physical pathology

Second — rule out bodily illnesses that on their own secondarily produce all these experiences. The doctor names the thyroid, liver, pancreas and others. They can work independently, yet secondarily drive the psychosomatic picture. That's why the body needs to be examined.

What exactly: a blood test, a urine test, biochemistry — especially liver tests (enzymes, liver panel). This helps you see whether some other disorder is influencing the psychosomatic state.

Brain imaging: what makes sense

The doctor also mentions an electroencephalogram (EEG). And if you want to look deeper into the brain — then only magnetic resonance imaging on a 3 Tesla machine. In his words, CT and the rest carry no informative basis in this context.

"With psychosomatics, first we rule out the psychiatric register, second we rule out physical pathology."

Why this order

The point of this sequence is simple: once the test results are in your hands, then it makes sense to go to a specialist. Without them, the doctor says, a person risks "throwing away" visits, money and time. Being prepared saves resources and makes the consultation truly useful.

Practice

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

1. Don't begin with medication — first work out the cause.
2. Separate the psychiatric register: consider whether this is a standalone psychiatric disorder, not "depression" in the everyday sense.
3. Get the basic workup: blood test, urine test, biochemistry with liver panel.
4. If needed — an EEG; for a deeper look at the brain, only a 3 Tesla MRI.
5. Go to the specialist with results in hand — then the consultation will be meaningful.