Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F42
- Who conducts it
- A psychiatrist; a psychotherapist provides cognitive behavioral therapy with exposure
- Where
- At the clinic, video consultations, and home sessions to work on rituals if needed
- Duration
- A course of psychotherapy takes several months; medication is usually long-term
- Anonymity
- Anonymous treatment with no registration at the state dispensary
- When it's urgent
- Suicidal thoughts, refusal of food and water, or severe exhaustion — call 103 or 112
- Outcome
- Fewer obsessions and rituals, and time and freedom restored to the person and the family
What you should know
The family of a person with OCD is gradually drawn into their rituals. At her son's request, a mother rewashes the dishes three times; before leaving the house, a wife confirms to her husband that the stove and iron are off, even though he has already checked ten times; a daughter spends hours washing herself and asks the family to take off their clothes in the hallway. Refusing leads to tears, anger, and anxiety. Loved ones give in to keep the peace at home, but the rituals keep getting longer, and free time keeps getting shorter.
OCD is not “being a perfectionist” or a whim but a disorder that psychiatrists know well and treat successfully. In Astana, people with OCD often hide their symptoms for a long time because of shame and busy work schedules, until the rituals start taking up hours. A Narcology 24 psychiatrist helps the person break out of the cycle of obsessions and helps relatives understand how to stop taking part in the rituals without damaging relationships or provoking conflicts.
How Loved Ones Notice OCD
- the person checks locks, the stove, faucets, and documents many times over
- they wash their hands until the skin is irritated and fear catching something from objects or touch
- they count things or arrange objects in a strictly defined way
- they are tormented by intrusive thoughts that seem alien and horrible even to them
- they ask family members to confirm that everything is fine or to repeat rituals with them
- rituals take up more than an hour a day and make them late or keep them from leaving the house
- they understand that their actions are excessive but cannot stop them
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 OCD Develops
OCD develops from a combination of inherited predisposition, the way certain brain systems work, and life factors: stress, heavy responsibility, and sometimes infections in childhood. The disorder often begins in adolescence or young adulthood and can get worse during periods of strain — for example, after the birth of a child or a change of job. It is not the result of upbringing and is not the parents' fault.
The mechanism of OCD is a vicious circle. An intrusive thought causes intense anxiety, the ritual relieves it for a while, and the brain remembers: “that helped.” The next time, the ritual is needed again, and it gets longer. The family's involvement — reassurance, checking, following the rules — also briefly reduces anxiety but reinforces the disorder. That is why treatment includes not only work with the patient but also changes in the family's behavior.
How OCD Treatment Works
The first consultation can be held by video: a person with obsessions about contamination or checking often finds it hard to get to a clinic. The psychiatrist asks in detail about the thoughts and rituals, how long they take, and how relatives are involved in them, assesses severity using standard scales, and checks for depression. A plan is then drawn up: psychotherapy with exposure, medication if necessary, and sessions with the family. Sessions and homework take place regularly.
Online and outpatient treatment may not be enough if OCD is accompanied by severe depression, suicidal thoughts, refusal of food and water out of fear of contamination, exhaustion, or misuse of alcohol and sedatives. In such cases, an in-person examination and sometimes inpatient care are needed. If there is an immediate threat to life, call 103 or 112.
How we help
Diagnosis
The psychiatrist makes the diagnosis using ICD-10 and ICD-11 criteria and distinguishes OCD from anxiety disorders, depression, tics, and psychotic states. Special scales are used to assess severity. The doctor clarifies which rituals the person performs and how family members are involved — this is important for planning psychotherapy.
Exposure and response prevention
According to NICE guidelines, the main treatment for OCD is cognitive behavioral therapy with exposure and response prevention. Together with the psychotherapist, the person gradually faces what triggers their anxiety and learns not to perform the ritual. Over time, the anxiety subsides on its own. The pace is chosen so that each task is manageable.
Medication
For moderate and severe OCD, the psychiatrist may prescribe medication, usually from the antidepressant group. In OCD, the effect develops more slowly than in depression — sometimes over several months. Treatment is usually long-term and may be stopped only gradually and in agreement with the doctor. It is important for relatives to support regular intake and report any side effects to the doctor.
Working with the family
Relatives learn to gradually stop taking part in rituals — not abruptly and not through conflict, but according to an agreed plan. Instead of reassurance, they use supportive phrases that remind the person of the therapy. A Narcology 24 psychotherapist holds family sessions and helps everyone agree on rules and reduce tension at home. The family receives clear instructions for each week.
Myths and facts
MythOCD is just a love of order
FactNeatness is a personality trait that doesn't interfere with life. With OCD, a person suffers from intrusive thoughts and is forced to spend hours performing rituals, even though they understand the rituals are pointless. It is a disorder, not a habit.
MythIf the family goes along with the rituals, the person will feel better
FactTaking part in rituals relieves anxiety briefly but reinforces the disorder. What helps is a step-by-step reduction in the family's involvement, agreed with the psychotherapist — without sudden bans or accusations.
MythIntrusive thoughts mean the person is dangerous
FactIntrusive thoughts in OCD go against the person's wishes and horrify them precisely because they don't want to act that way. They do not indicate a tendency toward dangerous actions. This is important to discuss with a doctor.
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
In astana you can get help at home, at one of our two branches (6 Auezova St., office 37, Astana, 176 Imanova St., Astana) 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 stop taking part in rituals without hurting my loved one?
Don't do it abruptly. Discuss a plan with the psychotherapist: which actions you will gradually stop and in what order. Warn the person in advance and explain that this is part of the treatment, not a punishment. Support their efforts and praise every step. In Astana, family sessions can be held online if relatives live in different districts.
What should I say when he asks me to confirm that everything is fine?
Instead of answering directly, say gently: “I can see how anxious you are, but we agreed not to answer this question — it helps the treatment.” Keep your tone calm. It's best to work out suitable phrases in advance together with the psychotherapist.
Can OCD be cured completely?
For many people, treatment leads to a significant reduction in symptoms, and they return to a full life. In some people, OCD may flare up during periods of stress, so it is important to know the early signs and see a doctor in time.
Does online psychotherapy help?
Yes, cognitive behavioral therapy for OCD can be delivered effectively by video. Sometimes it is even more convenient: exposure exercises are done right in the home environment where the rituals occur. The format is chosen together with the psychotherapist.
OCD in a teenager: what should parents do?
Don't scold the teenager or make fun of the rituals. Book an appointment with a psychiatrist who works with adolescents, and come to a consultation yourselves. If the teenager talks about suicide, call 103 or 112; for support, they can also call the 150 helpline.
How long does treatment last?
A course of psychotherapy usually takes several months. If medication is prescribed, the effect is assessed after a few weeks, and treatment continues for a long time, often at least a year after improvement. The specific timeline is determined by the doctor based on the person's condition.
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
