Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F31
- Who provides care
- A psychiatrist, plus a psychotherapist for psychoeducation and support
- Where
- Home visits in Almaty and the suburbs, inpatient unit, in-person and online consultations
- Duration
- Acute phase 2–8 weeks, maintenance treatment for years
- Anonymity
- No dispensary registration, medical confidentiality
- When it’s urgent
- Mania with aggression or dangerous behavior, depression with suicidal thoughts — call 103
- Outcome
- Long-term remission, a stable mood, keeping your job and family
What you should know
You can recognize a call during a manic phase by the relative’s voice. A wife calls at two in the morning: for the fourth day, her husband has barely slept, he has taken out a loan for a business he hadn’t even thought of yesterday, he talks nonstop and gets irritated when interrupted. Meanwhile, he feels wonderful and doesn’t want a doctor. The dispatcher asks whether there has been such a high before and whether it was followed by depression, whether the person takes medication, and whether he drinks. This determines who goes and with which kit.
In the apartment, a person in mania is usually charming, quick, and full of ideas, but their thoughts jump around and they have no insight into their condition. Arguing is pointless; I simply talk with them — about sleep, plans, how they feel. It’s important to build rapport, because without the patient’s consent, treatment at home is impossible. In the depressive phase, the picture is the opposite — silence, low mood, thoughts of death. In either phase, the task is the same: safely stabilize the person’s condition and select maintenance treatment.
Signs of bipolar disorder: mania and depression
- several days with almost no sleep, no tiredness, and an excess of energy
- rapid speech, racing ideas, difficulty following the thread of a conversation
- unjustified large purchases, loans, risky decisions
- inflated self-esteem, grandiose plans, irritability when contradicted
- periods of deep depression with lack of energy, low mood, and thoughts of death
- alternating phases: a high for weeks, then a low, sometimes with stable periods in between
- antidepressants have caused a sharp rise in mood and agitation
If two or three points apply, it is worth seeing a doctor. Phone advice is free and confidential. If life is at risk, call 103 or 112.
What causes bipolar disorder
Bipolar disorder has a strong hereditary component: the risk is noticeably higher if relatives have had bipolar disorder, depression, or addiction. The first episodes usually appear in adolescence or young adulthood and often start with depression, which is why bipolar disorder is not diagnosed right away. A person may be treated for depression for years while regarding their highs as periods of being in good shape.
Episodes are triggered by lack of sleep, crossing time zones, stress, alcohol and stimulants, childbirth, and stopping medication on one’s own. The wrong treatment is dangerous too: antidepressants without a mood stabilizer can trigger mania. That is why it is so important for the diagnosis to be made by a psychiatrist after careful questioning about all episodes and family history, not after a single visit.
How care for bipolar disorder works: from the acute phase to remission
In the acute phase, care usually starts with a home visit: the team goes to any district, from Medeu to Alatau, or to Talgar and Konaev. The doctor assesses the phase, the risks, and the person’s physical health. If the patient agrees, treatment begins on the spot, medications are prescribed, and daily contact is arranged. Have discharge summaries, a list of medications, and information about past episodes ready. After stabilization, follow-up takes place every 2–4 weeks, with blood tests to monitor treatment. Many appointments are held online.
Treatment at home is not possible if, during mania, the person is a danger to themselves or others, takes risky actions, or hasn’t slept for a week, or if the depressive phase comes with suicidal thoughts, delusions, or refusal to eat. Then inpatient care is needed. If there is a direct threat, call 103 or 112. Involuntary hospitalization is possible only under the procedure established by the law of the Republic of Kazakhstan.
How we help
Treating the acute phase
In mania, antipsychotics and mood stabilizers are used; the goal is to restore sleep, reduce agitation, and bring back insight. In the depressive phase, medications with proven effectiveness specifically for bipolar depression are used, and antidepressants only with caution and together with a mood stabilizer. Medications and doses are chosen after an examination, and the acute phase usually takes from two to eight weeks.
Maintenance treatment
After recovery from an episode, treatment continues, usually for years, to prevent new episodes. According to NICE guidelines, this is the main part of bipolar disorder treatment. Some mood stabilizers require regular monitoring of blood levels and kidney and thyroid function. The Narcology 24 psychiatrist provides follow-up and adjusts the regimen in time if side effects appear.
Psychoeducation and routine
The person and their family learn to recognize early signs of an episode: less sleep, faster speech, new spending, or, on the contrary, withdrawal and lack of energy. A personal action plan is drawn up in case of a relapse. The most important part is a stable sleep schedule, avoiding alcohol and stimulants, and a reasonable workload at work and when traveling.
Psychotherapy and family work
Cognitive behavioral and family-focused therapy reduce the risk of relapse and help deal with the aftermath of episodes: debts, conflicts, and guilt. The family learns to talk with their loved one about symptoms without blame and to notice the start of an episode early, so they can see a doctor while treatment can still be provided at home.
Myths and facts
MythBipolar disorder is just frequent mood swings
FactOrdinary mood swings last hours and are tied to events. In bipolar disorder, episodes last days, weeks, or months, change sleep, energy, and behavior, and get in the way of life. It is a medical diagnosis made by a psychiatrist.
MythWhen you feel well, you can stop the pills
FactStopping medication on your own is one of the main causes of relapses, which are often more severe. Feeling well is the result of treatment. Decisions to reduce or stop medication are made only together with the doctor.
MythWith bipolar disorder, you can’t work or have a family
FactWith regular treatment, many people with bipolar disorder work, raise children, and build careers. It’s important to keep a stable routine, see a psychiatrist regularly, and know your own early warning signs.
How a home visit works
- Call or message usThe dispatcher answers 24/7 and in 3–5 minutes checks the person's condition, age, how long the drinking or use has lasted, chronic conditions and the address. No surname needed.
- The doctor sets offAn addiction doctor or psychiatrist comes with equipment and medication. Travel time depends on the district — usually within an hour. If inpatient care or an ambulance is needed, we'll say so straight away.
- Examination and treatmentBlood pressure, pulse, oxygen saturation, blood sugar if needed and a neurological check. Then an IV drip or other treatment as indicated, 1–3 hours.
- A plan for the next daysAdvice for the family on what to do overnight and tomorrow, phone follow-up and a repeat visit if needed.
- Further treatmentCoding, psychotherapy, rehab or psychiatric follow-up — once the acute state has passed and the person is ready.
Prices in Almaty
| Psychiatrist consultation | 15 000 ₸ |
| Psychiatrist home visit | 40 000 ₸ |
| Family consultation | 15 000 ₸ |
| Phone advice | free |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
In almaty you can get help at home, at one of our two branches (84 Zhandosova St., Almaty, 21 Seyfullina Ave., office 11, Almaty) or online if you need a consultation rather than a procedure. The dispatcher answers 24/7 and will tell you straight away which option is safest.
Confidential and private
in Almaty our doctor can come in ordinary clothes in an unmarked car. Treatment documents are given only to the patient. If you need a certificate or sick note, this is discussed separately and only at your request.
Questions and answers
How can I tell mania from a good mood?
In a good mood, a person gets enough sleep, keeps their judgment, and makes realistic plans. In mania, they sleep little without feeling tired, talk fast, jump from topic to topic, spend money riskily, and get irritated when contradicted. If you see this in a loved one, call a psychiatrist.
What should I do if a loved one in mania refuses treatment?
Don’t argue or threaten; stay calm. Limit access to bank cards and large sums of money if possible. Call a psychiatrist to the home: an experienced doctor knows how to build rapport. In case of aggression or dangerous behavior, call 103 or 112.
Can antidepressants be taken for bipolar disorder?
Only as prescribed by a psychiatrist and usually together with a mood stabilizer. Without a stabilizer, antidepressants can trigger mania or speed up the cycling between phases. That is why it is important to tell the doctor about all past highs, even if they felt pleasant.
How long do I need to take medication?
Bipolar disorder is a chronic condition, and maintenance treatment usually continues for years. The exact duration depends on the number and severity of past episodes. Decisions to reduce or stop medication are made only together with the doctor, gradually and under supervision, never on your own.
Can I drink alcohol with bipolar disorder?
It is not recommended. Alcohol disrupts sleep, triggers both depressive and manic episodes, and interacts with medications. Addiction is more common among people with bipolar disorder. If it is hard to quit, an addiction doctor and a psychiatrist at Narcology 24 will plan joint treatment.
Can follow-up be done online?
During remission, yes — video consultations are convenient for checking how you feel, discussing test results, and adjusting treatment. This is especially helpful for residents of the suburbs. When a relapse begins, an in-person examination or a psychiatrist home visit is needed, and sometimes inpatient care.
Where do doctors visit in Almaty and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. Phone in Almaty: +7 (700) 309-29-88.
Sources and methodology
This page was prepared by the Narcology 24 medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) guidelines on alcohol and drug misuse and mental health conditions
- WHO recommendations on the treatment of substance use disorders
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
