Psychosomatics: First Steps Before You See a Specialist

When it comes to psychosomatics, the main mistake is reaching for medication right away. First you need to understand what is actually happening in your body and brain. Often the picture can be clarified with a few simple diagnostic steps — and only then should you go to a specialist with results already in hand.

Don't start with medication

The doctor's first point: don't begin with drugs. Sometimes you can restore the brain's function and rhythm without them. To understand what exactly is disturbed, you need to get examined — to do tests.

"The main thing is not to start with medication right away — maybe you can restore the brain's function and rhythm."

Depression as a "basket" and as a disorder

Here lies a confusion that matters precisely for psychosomatics. Ordinary people use the word "depression" for tiredness, low mood, feeling down — that is, a symptom. It's a "basket" into which people throw various forms of feeling bad. But psychiatrists mean something else entirely — a mental disorder, endogenous, genetically determined. It is treated differently.

So in psychosomatics it's important to first sort out: what a person calls their distress may be a symptom of a completely different disorder that is driving the clinical picture.

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

Two steps: rule out the psychiatric register and the physical one

The doctor's logic is simple and sequential. First — rule out the psychiatric register: severe depressions, the schizophrenic spectrum, organic and psychotic disorders are set aside. Second — rule out physical pathology: the thyroid, liver, pancreas and other diseases on their own can secondarily cause all these experiences.

Only once this is done does the picture become reasonably clear.

Which examination makes sense

The doctor names them specifically: a blood test, a urine test, biochemistry — especially liver panels (ALT, AST and others). This helps clarify whether other disorders are affecting the psychosomatic complaints. In addition — an electroencephalogram. If you want to study the brain more deeply, only magnetic resonance imaging on a 3-tesla machine makes sense. Everything else, in his words, offers no informative basis.

Practice: a checklist of first steps

1. Don't rush for medication — first clarify what's happening with your body and rhythm.
2. Get basic tests: blood, urine, biochemistry, liver panels (ALT, AST, etc.).
3. Do an EEG; if a deeper look is needed — MRI on a 3-tesla machine.
4. Mentally separate: is what you call "depression" a symptom of tiredness, or possibly a mental disorder?
5. Come to the specialist with results in hand, not empty-handed.

Why get examined first

The doctor warns plainly: if you go to a specialist without examination, you can waste dozens of visits — throwing away money and time. But when the results are already in hand, the conversation with the specialist becomes meaningful, and you can move forward.