Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F32
- Who conducts it
- A psychiatrist; a psychotherapist provides psychotherapy and family sessions
- Where
- At the clinic, home visits, video consultations for ongoing support
- Duration
- Treatment takes effect within a few weeks; the course usually lasts at least several months
- Anonymity
- No registration at the state dispensary; medical confidentiality under the law of Kazakhstan
- When it's urgent
- Suicidal thoughts with a plan, saying goodbye, giving belongings away — call 103 or 112
- Outcome
- Restored mood, sleep, and ability to work, and a lower risk of recurrence
What you should know
Loved ones notice depression through small things that add up to a worrying picture. A wife has stopped calling her friends and spends entire weekends in bed; a husband comes home from work and sits silently in front of his phone, not answering questions; a daughter at university has abandoned her studies and says that “everything is meaningless.” Family members try to shake the person out of it, suggest a vacation, or tell them to “pull themselves together,” but this doesn't help and sometimes only makes things worse.
Depression is one of the most common reasons people see a psychiatrist, and it is very treatable. In Astana, it is fueled by long, dark winters, frosts that keep people indoors, work without days off, and separation from family for those who have moved from other regions. A Narcology 24 psychiatrist helps both the person and those around them: explains what is happening, how to talk, what not to do, and how to recognize dangerous thoughts.
Signs of Depression That Family Members Should Watch For
- low mood and indifference have lasted two weeks or longer
- the person no longer enjoys what they used to love: hobbies, get-togethers, their children
- they are constantly tired, stay in bed for long periods, and struggle to get up in the morning
- sleep is disturbed: waking early at 4–5 a.m. or sleeping almost all day
- they have lost their appetite or, on the contrary, eat constantly, and their weight changes noticeably
- they say things about guilt, worthlessness, or being a burden to everyone
- they have started talking about death or showing interest in ways to end their life
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 and Why You Can't Just “Wait It Out”
Depression develops from a combination of factors: inherited predisposition, the way a person's nervous system works, prolonged stress, losses, chronic illnesses, and alcohol misuse. Sometimes it appears for no apparent reason, against a background of outward well-being — and that does not make it any less real. Depression is often accompanied by anxiety, physical pain, and problems with memory and concentration.
Without treatment, depression can last for months, recur, and become more severe. The person loses their job, grows distant from the family, and starts numbing their state with alcohol. The most serious risk is suicide, so talk of death should never be dismissed as manipulation or attention-seeking. According to WHO and NICE guidelines, timely treatment significantly improves the outlook.
How Depression Treatment Works
You can start with an online consultation attended by the person or their relatives. The doctor asks how long the condition has lasted, what has changed in sleep, appetite, and work, and whether there have been thoughts of death. Next comes an in-person appointment at the clinic or a home visit, where the psychiatrist conducts an examination, uses rating scales, and decides what treatment is needed. Therapy is then prescribed, and follow-up can be done by video: the doctor monitors the effect and how well the treatment is tolerated, and the family reports any changes.
Treatment at home is not appropriate if the person states an intention to kill themselves, has a plan, has made attempts before, has stopped eating and drinking, or if the depression has developed psychotic symptoms. In these cases, inpatient care is needed, and if there is an immediate threat, call 103 or 112. For teenagers and young people, the 150 helpline is available around the clock. Don't leave your loved one alone at such a moment.
How we help
Diagnosis and risk assessment
The psychiatrist makes the diagnosis using ICD-10 and ICD-11 criteria, assesses the severity of the depression, and rules out other causes: thyroid disease, anemia, and the effects of alcohol and medications. Lab tests are ordered if necessary. Suicide risk is always assessed, and the family is told which signs require an immediate response.
Medication
For moderate and severe depression, the doctor usually prescribes antidepressants, sometimes in combination with other medications. The effect does not appear right away but after several weeks, so it is important for loved ones to support regular intake. After improvement, treatment continues for several more months to reduce the risk of another episode; it must not be stopped without the doctor.
Psychotherapy
Cognitive behavioral therapy and other evidence-based methods help change gloomy thoughts, restore activity and daily routine, and learn to cope with stress. For mild depression, psychotherapy may be the main treatment. A Narcology 24 psychotherapist works with the patient individually and, if needed, holds sessions with the family.
Support for the family
Relatives are taught how to talk without reproaches or advice to “cheer up,” how to help with day-to-day tasks without taking over all responsibility, and how to notice when things are getting worse. It is important that your loved one can voice difficult thoughts without fear of judgment. The family needs support too: caring for a person with depression for a long time is draining, and asking for help is normal.
Myths and facts
MythDepression is just a bad mood; you need to pull yourself together
FactDepression is an illness that involves changes in how the brain works, in sleep, and in metabolism. It can't be overcome by willpower, just as pneumonia can't be cured by a cheerful attitude. Urging someone to “get a grip” deepens their sense of guilt and loneliness.
MythAntidepressants are addictive and change your personality
FactAntidepressants do not cause drug addiction and do not change personality. Stopping them abruptly can cause discontinuation symptoms, so the course should be ended gradually and only with a doctor. The person becomes themselves again, not “someone else.”
MythIf he talks about death, he just wants attention
FactAny talk of death in someone with depression is a serious warning sign. Calmly ask directly about thoughts of suicide: this does not push the person toward it but gives them a chance to talk. If there is a threat, call 103 or 112.
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
in Astana 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 persuade a loved one with depression to see a doctor?
Talk about what you see: “You're sleeping badly and hardly eating; I'm worried.” Don't argue about the causes. Suggest a specific step: book a consultation together or start with a video appointment. You can also see the psychiatrist yourself first.
What shouldn't you say to a person with depression?
Avoid phrases like “others have it worse,” “pull yourself together,” “you're just being lazy,” or “stop whining.” It is better to say, “I'm here,” “this is an illness, and it can be treated,” or “let's find a doctor together.” Even simply being there without giving advice is supportive. Sometimes listening matters more than talking.
How long does treatment last?
The first improvement usually appears a few weeks after starting therapy. A full course of depression treatment generally lasts at least several months, and longer for recurrent episodes. The specific timeline is determined by the doctor.
Can depression be linked to winter?
Yes, for some people symptoms get worse in autumn and winter, when there is little daylight. This is noticeable in Astana with its long, frosty winters. But a seasonal pattern doesn't mean you should wait for spring: the condition is worth discussing with a psychiatrist. Light and walks help but do not replace treatment.
Can treatment be combined with alcohol?
No. Alcohol worsens the course of depression and sleep and can interact dangerously with medications. If your loved one drinks to cope with their low mood, tell the doctor: a psychiatrist and an addiction medicine specialist may need to work together.
How can I look after myself while my loved one is ill?
Keep up your own routine, stay in touch with friends, and set aside at least a little time for yourself. Share caregiving among relatives. At the clinic, family members can get a consultation with a psychologist to manage their anxiety and avoid burnout.
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
