Reviewed byZhanar Tulegenova, MDPsychiatrist and psychotherapist, experience 18 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F41.0
- Who provides care
- A psychiatrist and a psychotherapist
- Where
- Online by video, an office in Almaty, home visits
- Duration
- An attack lasts 10–30 minutes; treatment of the disorder takes 3–6 months or more
- Anonymity
- No documents required and no dispensary registration
- When it’s urgent
- First-ever chest pain, shortness of breath, fainting, weakness in an arm — call 103
- Outcome
- Attacks become rarer and milder, and the fear of another one fades
What you should know
A classic night call: two in the morning, a man of about thirty-five is on the line. He woke up with his heart pounding in his throat, his hands numb, short of breath, feeling he was about to die. An ambulance has already come twice this month, and his ECG is normal. The dispatcher calmly asks questions: is there chest pain spreading to the arm, does he have diabetes or heart disease? If not, the dispatcher connects the on-call psychiatrist by video, and I help him get through the attack right there on the screen.
After ten to fifteen minutes of talking and slow breathing, the attack usually subsides. The person is surprised: “So it’s not my heart?” I explain that a panic attack is a false alarm of the nervous system, an adrenaline surge without any real danger. It is frightening, but it doesn’t kill. Then we arrange a full consultation. It’s important not just to stop attacks but to treat panic disorder so that they stop recurring and don’t start limiting the person’s life.
Panic attack symptoms
- a sudden, pounding heartbeat, a feeling that your heart is jumping out of your chest
- shortness of breath, a choking sensation, a lump in the throat, an urge to open a window
- trembling, chills or a wave of heat through the body, heavy sweating
- dizziness, a sense that things are unreal, “as if in a dream”
- numbness and tingling in the hands, feet, around the mouth, and on the face
- fear of dying, losing control, or going crazy
- after an attack — constantly waiting for the next one and avoiding places where it happened
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.
Why panic attacks happen
Panic disorder develops in people with a sensitive nervous system, often against a background of chronic stress, overwork, and lack of sleep. The first attack often happens just when the person seems to have relaxed: on vacation, on a day off, at night. Attacks can be triggered by coffee and energy drinks, hangovers, stopping alcohol or sedatives, stimulants, and abruptly stopping certain medications.
Then a vicious circle sets in. The person begins to fear the attack itself, listens to their heartbeat, and avoids the subway, traffic jams, and shopping malls where it “hit” them. Many stop driving along Al-Farabi Avenue or through the city center at rush hour because being stuck in traffic is frightening. This is how agoraphobia develops. Anxious anticipation itself triggers new attacks, and without treatment the circle closes.
How help for panic attacks works
During an attack, you can call the dispatcher and connect with the on-call psychiatrist by video. The doctor will help you slow your breathing, shift your attention, and get through the attack. After that, a consultation is scheduled: the psychiatrist asks about how often and in what circumstances the attacks occur, sleep, caffeine, alcohol, and medications. Bring your ECG and test results if you have them. A diagnosis is made and treatment is discussed: psychotherapy, medication, or a combination. Follow-up meetings take place every 1–2 weeks.
Don’t assume every attack is a panic attack if it is the first in your life, especially after age 40 or if you have diabetes, heart disease, or smoke. Chest pain spreading to the arm or jaw, shortness of breath on exertion, fainting, weakness on one side of the body, or slurred speech are reasons to call 103 or 112 right away. Heart and neurological causes are ruled out first, and then the anxiety is treated.
How we help
Help during an attack
The on-call psychiatrist, by video or phone, helps the person get through the attack: slow breathing with a long exhale, shifting attention to surrounding objects, and a reminder that the attack will pass on its own. The person learns these techniques and can later cope without a doctor. If the condition doesn’t look like a panic attack, the doctor will immediately ask you to call 103.
Cognitive behavioral therapy
According to NICE guidelines, this is the main treatment for panic disorder. The psychotherapist explains how an attack works, helps the person stop fearing bodily sensations, and gradually return to places they have begun to avoid: the subway, shopping malls, a car on the highway. A course is usually 8–16 sessions, in person or online.
Medication
For frequent attacks, medications for long-term treatment are prescribed, most often from the antidepressant group. They reduce the frequency of attacks over several weeks. Benzodiazepines for relieving an acute attack are prescribed only by a doctor and for a short time, because of the risk of dependence. The medication, duration, and tapering plan are tailored to each person after a consultation.
Preventing a return
The Narcology 24 doctor and psychotherapist help build a routine: regular sleep, limiting caffeine and alcohol, physical activity, and relaxation skills. The person learns to notice early signs of anxiety and not let them grow into an attack. After treatment ends, you can come back for a consultation at any time.
Myths and facts
MythA panic attack is a heart attack
FactDuring a panic attack, the heart beats fast but is healthy. However, a first attack, especially with chest pain, should be checked by a doctor: only an examination can rule out heart disease. After that, the attacks are treated as an anxiety disorder.
MythYou can die or go crazy from a panic attack
FactAn attack is frightening but not dangerous in itself and doesn’t lead to insanity. Fear of death is one of the symptoms of an attack, not its actual consequence. Understanding this already reduces the intensity of attacks. It can be treated.
MythJust carry a pill with you and everything will be fine
FactA pill “just in case” relieves an attack but doesn’t treat the disorder and can be habit-forming. Constantly reaching for it reinforces the fear. Treatment aims to make it unnecessary.
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
What should I do during a panic attack?
Sit down if you can. Breathe slowly: in through your nose for a count of four, out through your mouth for a count of six. Name five objects you can see. Remind yourself that this is a panic attack and it will pass within minutes. If it is your first attack or you have chest pain, call 103.
Can panic attacks go away completely?
Yes, with proper treatment, most people have attacks rarely or not at all. It is important not to stop treatment after the first improvements and to master the skills that prevent a return. This takes several months, but the result is usually lasting.
Can I drive if I have panic attacks?
If attacks happen while you are driving, it is better to stop driving for a while and discuss it with your doctor. Some medications cause drowsiness at the start of treatment. Psychotherapy helps you gradually return to driving, including on busy highways, without fear.
Why do attacks happen at night?
Nighttime attacks are linked to how the nervous system works during sleep, accumulated stress, and sometimes alcohol the evening before or sleep apnea. They are especially frightening but are treated the same way as daytime attacks. The on-call psychiatrist is available by video around the clock.
Do I need to have my heart checked?
Yes, if the attacks started recently and you haven’t been examined yet: an ECG, 24-hour Holter monitoring if indicated, and a consultation with a cardiologist. This is necessary so as not to miss an arrhythmia or another illness. After that, the doctor can confidently treat panic disorder.
Does alcohol help with panic attacks?
Alcohol relieves anxiety for a while, but during a hangover and withdrawal it triggers new, stronger attacks. Many attacks first occur the day after a party with heavy drinking. If you notice this connection, tell your doctor — Narcology 24 has an addiction doctor.
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
