About insomnia
Chronic insomnia means difficulty falling or staying asleep several nights a week for months. Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first treatment and works on habits, schedules and the thoughts that keep sleeplessness going.
Psychiatrists are medical doctors specialised in mental health. They diagnose, prescribe and monitor medication and may also provide psychotherapy. They are usually the first choice when medication may be needed or symptoms are severe.
Getting mental health care in North Macedonia
Public health system · Public health system (Ministry of Health and Health Insurance Fund): community mental health centres and hospital psychiatry
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines. More information
How to check that a professional is licensed
- Doctors' Chamber of Macedonia (Лекарска комора на Македонија). The Chamber issues doctors' working licences and publishes a register of doctors and a list of doctors with valid licences. Search the official register
Insurance and coverage
According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines in the public system.
Urgent help in North Macedonia
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 112 · Emergencias
Information reviewed in November 2026 · Sources: who.int, borgenproject.org, komoranapsiholozi.mk, lkm.org.mk
Signs to look out for
Everyone sleeps badly sometimes, especially during stress. Insomnia may need attention when you regularly struggle to fall asleep, wake up often or very early and cannot get back to sleep, or wake unrefreshed, for several weeks, and it affects your mood, concentration, energy or safety during the day. Worrying about sleep itself often becomes part of the problem.
What helps: treatments and professionals
Cognitive-behavioural therapy for insomnia (CBT-I) is recommended as a first-line treatment for chronic insomnia. It includes sleep scheduling, stimulus control, work on unhelpful beliefs about sleep and relaxation techniques. Psychologists and clinical psychologists trained in CBT-I usually provide it, individually, in groups or through guided digital programmes. A doctor should rule out physical causes and other sleep disorders.
When to seek urgent help
Seek prompt medical attention if you stop breathing or gasp during sleep, fall asleep while driving or in dangerous situations, or go several nights with almost no sleep alongside unusual energy, racing thoughts or confusion. If lack of sleep comes with hopelessness or thoughts of harming yourself, contact your local emergency services or go to the nearest emergency department.
What you can do in the meantime
Keep a regular wake-up time every day, including weekends, and only go to bed when you feel sleepy. If you cannot sleep after a while, get up and do something calm in dim light until you feel drowsy. Limit caffeine after midday, alcohol and heavy meals at night. Reduce screens before bed and get daylight and movement during the day.
What does a psychiatrist do?
A psychiatrist is a medical doctor who assesses mental health problems from a medical point of view. Day to day they carry out diagnostic interviews, rule out physical causes, decide whether medication could help, prescribe it and monitor its effects and side effects. Many also offer psychotherapy or work alongside psychologists. They see adults, older people and, if specialised, children and adolescents.
When to see a psychiatrist
Consider a psychiatrist when symptoms are intense or long-lasting, when therapy alone has not been enough, when you are already taking psychiatric medication, or when there are experiences such as severe mood swings, hearing or seeing things others do not, or very disturbed sleep. If what you mainly need is talking therapy for everyday difficulties, a psychologist or psychotherapist may fit better.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in North Macedonia cover psychological care?
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines.
How do I check that a psychiatrist is licensed in North Macedonia?
Doctors' Chamber of Macedonia (Лекарска комора на Македонија): The Chamber issues doctors' working licences and publishes a register of doctors and a list of doctors with valid licences.