Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F41.1
- Who conducts it
- A psychiatrist; a psychotherapist provides cognitive behavioral therapy
- Where
- At the clinic, video consultations, and home visits if needed
- Duration
- A course of psychotherapy usually takes several months; medication support is at the doctor's discretion
- Anonymity
- Paid anonymous treatment, no registration at the state dispensary
- When it's urgent
- Chest pain, shortness of breath, or fainting — first rule out heart problems by calling 103
- Outcome
- Lower anxiety, restored sleep and ability to work, and calm in the family
What you should know
The family of a person with an anxiety disorder lives in a mode of constant calls and checking in. A mother texts her adult daughter “where are you?” ten times a day if she doesn't answer within a minute; a husband lies awake at night replaying a conversation with his boss; a wife refuses to let the children go to after-school activities because “what if something happens.” Relatives first try to reassure, then grow irritated, while the anxiety only grows and takes over more and more areas of life.
An anxiety disorder is not a personality trait or “hypochondria” but a condition that responds well to treatment. In Astana, it is fueled by busy work schedules, long commutes between the left and right banks, and separation from family for those who have moved from other regions. A Narcology 24 psychiatrist helps the person reduce their anxiety and helps loved ones understand how to provide support without reinforcing fears through endless reassurance and giving in.
How Loved Ones Notice an Anxiety Disorder
- the person constantly worries about health, work, money, or the children for no obvious reason
- they find it hard to relax, are tense, and jump at phone calls and messages
- they often ask to be reassured that everything will be fine, but calm down only briefly
- they have trouble falling asleep and wake up in the middle of the night with anxious thoughts
- they complain of headaches, muscle tension, and stomach problems
- they avoid trips, new tasks, and meetings that used to come easily
- they have started drinking more often or taking sedatives “for their nerves”
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 Anxiety Disorder Develops
Predisposing factors for an anxiety disorder include heredity, temperament, prolonged stress, traumatic events, and chronic illnesses. Sometimes anxiety is intensified by caffeine, energy drinks, lack of sleep, or withdrawal from alcohol or certain medications. Similar symptoms can occur with thyroid and heart problems, so the doctor first rules out physical causes and only then makes a diagnosis.
Anxiety sustains itself through avoidance. The person cancels a trip, feels calmer, and the next time the fear is even stronger. Relatives, trying to help, often get drawn into this cycle: they do things for the person, reassure them endlessly, and change plans. This brings relief for a moment but reinforces the anxiety. A psychotherapist helps the family break out of this pattern gently and without conflict.
How Anxiety Disorder Treatment Works
It is often convenient to hold the first consultation by video: a person with anxiety finds it easier to talk from home, and relatives can join in. The psychiatrist asks about the symptoms, how long they have lasted, sleep, and the use of caffeine, alcohol, and sedatives. If necessary, the doctor recommends lab tests and an examination by a general practitioner or cardiologist. A plan is then drawn up: psychotherapy, sometimes medication, regular sessions to assess progress, and instructions for the family.
The online format is not suitable if the anxiety is accompanied by suicidal thoughts, if the person hasn't eaten or slept for several days, or if they are misusing alcohol or sedatives. Chest pain, severe shortness of breath, fainting, or numbness in an arm or the face require an immediate call to 103 or 112: a heart attack and stroke must be ruled out first. Inpatient care is rarely needed — only for a severe condition or when combined with addiction.
How we help
Diagnosis and ruling out other causes
The psychiatrist relies on ICD-10 and ICD-11 criteria and uses anxiety rating scales. It is important to distinguish generalized anxiety disorder from panic disorder, social anxiety, depression, and the effects of substance use. If necessary, lab tests and consultations with other doctors are ordered so that a physical illness is not missed.
Cognitive behavioral therapy
According to NICE guidelines, psychotherapy is one of the main treatments. The person learns to notice anxious thoughts, test how realistic they are, gradually return to what they have been avoiding, and manage tension with breathing and relaxation techniques. A Narcology 24 psychotherapist gives homework assignments, and relatives help the person complete them without doing the work for them.
Medication support
For severe anxiety, the doctor may prescribe medication, most often from the antidepressant group, which is used long-term. Benzodiazepines are given only as prescribed by a doctor and in short courses because of the risk of dependence. It is important that family members don't give the person their own sedatives: self-medication makes it harder to select therapy and can be dangerous.
Family education
Loved ones learn how to respond to requests for reassurance without getting irritated or reinforcing the anxiety. Instead of “everything will definitely be fine,” try “I can see you're anxious; let's remember what the doctor advised.” The family learns to gradually hand responsibility back to the person while also respecting their own boundaries and need for rest.
Myths and facts
MythAnxiety is just a personality trait; nothing can be done about it
FactAnxiousness as a trait and an anxiety disorder are different things. The disorder interferes with life and responds well to treatment: psychotherapy and, if needed, medication significantly reduce anxiety in most people.
MythOver-the-counter sedatives will solve the problem
FactSedatives provide temporary relief and do not treat the cause. Some of them are habit-forming. Therapy should be selected by a doctor who takes into account all the symptoms and any coexisting conditions.
MythIf you keep reassuring the person, the anxiety will go away
FactConstant reassurance brings relief for a few minutes but reinforces the anxiety. It is better to offer support, acknowledge their feelings, and help them use the skills taught by the psychotherapist. That way the person gradually gains confidence.
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 Astana
| 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
Narcology 24 in Astana: our duty team makes home visits day and night, usually within an hour (all city districts and nearby settlements). Two branches for appointments and procedures — 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. When indicated, we arrange admission and transport.
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 ordinary worry from an anxiety disorder?
Ordinary worry is tied to a specific situation and passes. With an anxiety disorder, the worry persists on most days for months, is hard to control, and interferes with work, sleep, and relationships. Only a doctor can determine this reliably after a conversation.
What should I say to a loved one during intense anxiety?
Speak calmly and briefly: “I'm here,” “let's breathe together,” “this is anxiety; it will pass.” Don't argue with or make fun of their fears. If the person is learning skills from a psychotherapist, gently remind them of those skills without pressure. After the episode, talk about what helped.
Can treatment be done entirely online?
In many cases, psychotherapy and follow-up can be done by video. But the initial diagnosis sometimes requires lab tests and an in-person examination, especially if there are complaints about the heart, blood pressure, or thyroid. The doctor will tell you what you need.
Does alcohol help with anxiety?
Alcohol relieves anxiety for a short time and then makes it worse, disrupts sleep, and can lead to dependence. If your loved one regularly “calms down” with alcohol, tell the doctor: help from an addiction medicine specialist may be needed.
How long does treatment last?
A course of cognitive behavioral therapy usually takes several months. With medication, the effect is assessed after a few weeks, and treatment continues for some time after improvement. The timeline is determined by the doctor. Many people in Astana combine treatment with work by choosing evening video sessions.
How can relatives avoid burnout?
Agree on boundaries: how many times a day you are willing to answer calls and which decisions the person makes on their own. Protect your own sleep and rest. A psychologist consultation for the family helps you cope with the load and not blame yourself. Asking for help is normal.
Where do doctors visit in Astana and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. Phone in Astana: +7 (700) 309-30-17.
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
