Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F32
- Who provides care
- A psychiatrist, plus a psychotherapist for psychotherapy
- Where
- An office in Almaty, home visits, video consultations
- Duration
- First improvements in 2–4 weeks, a course of 6 months or more
- Anonymity
- No documents required and no dispensary registration
- When it’s urgent
- Suicidal thoughts, talk of saying goodbye, refusing food and water — call 103
- Outcome
- Renewed interest in life, restored sleep, and the ability to work
What you should know
With depression, it is most often not the patients who call us but their loved ones. A call on Saturday morning: a daughter from the Medeu district says that since retiring, her mother has stopped leaving the house, barely eats, wakes at four in the morning, and cries. Or a wife: her husband has been lying on the couch for a month, has stopped going to work, and says “everything is pointless.” The first thing the dispatcher asks is whether there has been any talk of death — the answer determines whether the team goes now or a consultation is scheduled.
An apartment with depression is usually quiet. The curtains are drawn, there is untouched food on the table, and the person sits in one position and answers in single words. They don’t make scenes, so the family assumes for a long time that it is laziness or a whim. My task on the first visit is to assess how deep the depression is and the risk of suicide, rule out physical causes, and decide whether treatment needs to start right now. Most often treatment takes place at home, but sometimes a hospital is safer.
Signs and symptoms of depression
- a low, gloomy mood most of the day, nearly every day
- loss of interest in things that used to bring joy: work, hobbies, socializing
- constant fatigue and lack of energy, even after rest
- waking early at four or five in the morning or, on the contrary, sleeping 12–14 hours
- decreased or sharply increased appetite, changes in weight
- feelings of guilt and worthlessness, thoughts that everyone would be better off without me
- difficulty concentrating, making simple decisions, or remembering things
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 depression
Depression develops at the intersection of biology and life circumstances. Heredity, differences in neurotransmitter metabolism, hormonal changes, and chronic illnesses — including thyroid and heart disease — all play a role. The trigger is often a loss: the death of a loved one, divorce, losing a job, moving, or retirement. But sometimes depression starts without any obvious reason, and that does not mean the person “talked themselves into it.”
Alcohol deserves a separate mention. Many people try to lift their mood with drink, and for a while it helps. Then alcohol itself begins to deepen the depression, disrupts sleep, and raises the risk of suicide. Depression can also occur with bipolar disorder, after childbirth, in older people, and as a side effect of some medications. That is why the diagnosis should be made by a doctor, not a search engine.
How depression treatment works, step by step
You can start with a video consultation: the doctor will assess the person’s condition and ask about sleep, appetite, thoughts, and suicide risk. If the person doesn’t leave the house, the psychiatrist will come to them — to the Bostandyk or Turksib district or out to the suburbs, even to Konaev. Have a list of medications and recent test results ready. At the first appointment, a preliminary diagnosis is made and treatment is discussed. Follow-up meetings take place every 1–2 weeks, online or in person, to assess the effect and how well the treatment is tolerated.
Home treatment is not suitable if the person has suicidal thoughts with a plan or past attempts, refuses food and water, has developed delusions of guilt or hears voices, or if depression is combined with a heavy drinking binge. In these cases, inpatient care is needed. If the danger is immediate, call 103 or 112. For children and young people, the 150 helpline is available.
How we help
Diagnosis
The psychiatrist conducts a clinical interview, uses standardized depression rating scales, and asks about past episodes, periods of elevated mood, and family history. It is important to rule out bipolar disorder, because the treatment is different. If needed, thyroid hormone tests, a complete blood count, and consultations with other specialists are ordered.
Medication
For moderate and severe depression, antidepressants are prescribed. The medication is chosen based on symptoms, age, other illnesses, and other medications. The effect builds gradually over 2–4 weeks, so it is important not to stop taking it early. According to NICE and WHO guidelines, treatment continues for at least 6 months after improvement to reduce the risk of the depression coming back.
Psychotherapy
Cognitive behavioral therapy and interpersonal psychotherapy are effective for mild and moderate depression and enhance the effect of medication in severe depression. The Narcology 24 psychotherapist helps work through the thoughts that keep the low mood going, return to usual activities, and improve relationships. Sessions take place in person or online once a week; a course usually involves 8 to 20 sessions.
Follow-up and prevention
After improvement, the doctor continues to monitor mood, sleep, and side effects and decides when and how to gradually reduce the medication. The patient and family learn to notice the first signs of a return. If depression recurs, longer-term maintenance treatment is discussed. Appointments can be held online.
Myths and facts
MythDepression is just laziness — you need to pull yourself together
FactDepression is an illness involving changes in how the brain works. A person can’t “snap out of it” through willpower, just as you can’t cure pneumonia through willpower. Reproaches only deepen the guilt and low mood.
MythAntidepressants are addictive and change your personality
FactModern antidepressants are not addictive and do not change your personality. With proper treatment, people return to their usual selves. They should be stopped gradually and together with the doctor.
MythDepression will go away by itself if you take a vacation
FactMild blues may lift after a vacation, but true depression without treatment can last for months or years, come back, and get deeper. A change of scenery only helps as an addition to treatment.
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 ₸ |
| Follow-up consultation | 12 000 ₸ |
| Psychotherapy session (50 min) | 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
Information about your request, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We do not share it with employers, schools, the police or neighbours; the only exceptions are those expressly set by law. A first name is enough to call us, and paid confidential treatment does not mean a registry entry.
Questions and answers
How can I tell depression from a bad mood?
A bad mood passes within days and depends on events. Depression lasts at least two weeks, takes up most of the day, and comes with loss of interest, disturbed sleep and appetite, and lack of energy. If you recognize yourself or a loved one in this description, it’s worth seeing a psychiatrist.
How long does depression treatment take?
The first improvements usually come after 2–4 weeks. Treatment then continues for at least 6 months after recovery from the episode to consolidate the result. With repeated episodes, it may take longer. The doctor will discuss a specific plan with you at the consultation.
Can depression be treated with psychotherapy alone?
For mild depression, yes — psychotherapy can be the main approach. For moderate and severe depression, a combination of medication and psychotherapy is usually recommended. The doctor makes the decision after assessing the severity, together with you and taking your preferences into account.
What should I do if a loved one talks about suicide?
Take it seriously; don’t argue or shame them. Ask directly whether they have a plan. Remove medications and dangerous objects and don’t leave them alone. If the danger is immediate, call 103 or 112. If not, call a psychiatrist to the home or connect with one by video the same day.
Can I keep working during treatment?
In most cases, yes. Many people continue working, especially with mild and moderate depression. In the first weeks, medications may cause drowsiness or weakness, and the doctor will warn you about this. With severe depression, a temporary break may be necessary.
Can I drink alcohol during treatment?
No. Alcohol deepens depression, interferes with antidepressants, increases side effects, and raises the risk of suicide. If giving up alcohol is hard, tell the doctor: Narcology 24 has an addiction doctor, and treatment can be planned with this in mind.
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



