Reviewed byZhanar Tulegenova, MDPsychiatrist and psychotherapist, experience 18 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F41.0
- Who conducts it
- A psychiatrist; a psychotherapist provides cognitive behavioral therapy
- Where
- At the clinic, video consultations, and online support between appointments
- Duration
- A course of psychotherapy usually takes several months; the effect of medication is assessed after a few weeks
- Anonymity
- Anonymous treatment with no registration at the state dispensary
- When it's urgent
- A first attack with chest pain, fainting, or speech problems — call 103 or 112
- Outcome
- Fewer and milder attacks and a return to travel, work, and everyday life
What you should know
Family members often mistake a first panic attack for a heart attack: the person turns pale, clutches their chest, gasps for air, and says they are dying. An ambulance is called, the ECG is normal, the medics leave — and a week later it all happens again, on a bus, in a shopping mall, or at home at night. Gradually the relative stops using public transport and going to the store alone and asks for someone to always be nearby. The family adapts, and life shrinks more and more around the fear.
Panic attacks are not life-threatening in themselves, but they are exhausting for both the person and those around them. In Astana, people often say their first attack happened in a traffic jam on a bridge between the left and right banks or at a bus stop on a frosty evening when no bus came for a long time. A Narcology 24 psychiatrist helps figure out what is going on, select treatment, and teach loved ones how to act calmly and without panic during an attack.
What a Panic Attack Looks Like From the Outside
- a sudden surge of fear with a pounding heart, sweating, and trembling hands
- the person complains that they can't get enough air, their chest feels tight, and their head is spinning
- a sense that things aren't real and a fear of losing control or dying
- the attack passes within minutes, but weakness and fear of another one linger for a long time
- the person has been checked by a cardiologist and a general practitioner, and no serious illness was found
- they avoid the subway, buses, bridges, and lines and ask someone to go with them
- they keep pills on hand “just in case” and won't leave the house without 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 Panic Attacks Happen
A panic attack is the body's false alarm: the danger-response system switches on when there is no real threat. Predisposing factors include heredity, prolonged stress, overwork, lack of sleep, overuse of caffeine and energy drinks, and withdrawal from alcohol or certain medications. Sometimes the first attack occurs after an illness or a difficult life event, and then the fear of another attack takes hold.
The so-called fear of fear plays a key role. The person starts listening closely to their heart and breathing and perceives any increase in heart rate as the beginning of an attack — and the anxiety really does trigger one. Avoiding places where attacks have happened reinforces the cycle. Relatives need to know that trying to shield the person from every situation leads not to recovery but to a growing zone of fear.
How Panic Attack Treatment Works
Before the first appointment, it is advisable to see a general practitioner for an ECG, blood tests, and, if necessary, a consultation with a cardiologist or endocrinologist to rule out physical causes. An online consultation is convenient because the person doesn't have to travel and overcome their fear. The psychiatrist asks about the attacks, how often they occur, the situations in which they happen, and about caffeine, alcohol, and medications. A plan is then drawn up: psychotherapy, medication if necessary, and instructions for the family.
If the person has chest pain radiating to the arm or jaw for the first time, severe shortness of breath, fainting, numbness in the face, or speech problems, don't assume it is “just panic” — call 103 or 112. You should not wait at home if the attacks are accompanied by suicidal thoughts or if the person has started misusing alcohol or sedatives because of them: an in-person examination and sometimes inpatient care are needed.
How we help
Diagnosis
The psychiatrist makes the diagnosis using ICD-10 and ICD-11 criteria and distinguishes panic disorder from generalized anxiety, agoraphobia, depression, and the effects of substance use. The doctor reviews test results and refers the person to other specialists if needed. This is important so that the person stops fearing that a heart condition has been missed.
Cognitive behavioral therapy
According to NICE guidelines, this is the main treatment for panic disorder. The person learns how an attack works, learns to interpret bodily sensations differently, masters breathing and muscle-relaxation techniques, and gradually returns to places they have been avoiding. The clinic's psychotherapist draws up a step-by-step plan, and loved ones help carry it out without doing everything for the patient.
Medication
For frequent and severe attacks, the psychiatrist may prescribe long-term treatment, usually with medications from the antidepressant group. Benzodiazepines are given only as prescribed by a doctor and for a short time, since tolerance to them develops quickly. The effect of long-term therapy builds up gradually, so it is important not to quit treatment after a couple of weeks.
Help for the family
Relatives are taught how to behave during an attack: stay calm, speak briefly, remind the person that the attack will pass, and help them breathe slowly. It is important not to call an ambulance for every familiar attack once a doctor has ruled out heart disease, and not to reinforce avoidance. A Narcology 24 psychotherapist holds sessions with the family so that everyone acts in a coordinated way.
Myths and facts
MythYou can die from a panic attack
FactA panic attack in itself does not lead to death, even though it feels like a deadly threat. But a first attack or unusual symptoms should always be checked by a doctor to rule out heart and blood vessel disease.
MythIt's better to avoid places where you had an attack
FactAvoidance brings relief but reinforces the fear, and the list of off-limits places keeps growing. Psychotherapy helps the person return to these situations gradually and safely, and the anxiety decreases.
MythIf you carry a pill with you, everything will be fine
FactA constant “safety” pill sustains the belief that you can't cope without it, and some sedatives are habit-forming. Treatment should be selected by a doctor and aimed at the cause, not just at stopping an attack.
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
“Panic attack treatment” in Astana is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. If you live elsewhere in Astana and Akmola Region, call us and we'll advise the fastest way to get help.
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 a relative do during a panic attack?
Stay close and speak calmly: “This is a panic attack; it will pass; I'm with you.” Suggest sitting down and breathing slowly, with a longer exhale. Don't shout, rush, or shame the person. If the symptoms are unusual or this is the first attack, call 103 or 112.
How can I tell it isn't the heart?
You can't on your own. An examination by a general practitioner or cardiologist is needed. If doctors have ruled out heart disease and the attacks pass within minutes with typical symptoms, they are most likely panic attacks. But new or different symptoms again require an examination.
Can treatment be done online?
Yes, psychiatrist consultations and psychotherapy for panic attacks are often done by video. This is especially convenient if the person is still afraid to travel. But the tests to rule out physical causes must be done in person, at a regular outpatient clinic or medical center. In Astana, this helps those who live in Kosshy or Koyandy and are still afraid of long trips.
Why did the attack happen at night, during sleep?
Nighttime panic attacks do occur and don't mean the condition is more severe. The person wakes up with a pounding heart and fear. Be sure to tell the doctor about this: breathing problems during sleep, heart problems, and the effects of alcohol need to be ruled out.
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 some time after improvement so that the attacks don't come back. The timeline depends on how severe the disorder is and how long it has lasted.
How can I support the person without reinforcing the fear?
Go with them in difficult situations, but gradually reduce your help as the psychotherapist advises. Praise every step, even a small one. Don't take on all the trips and errands yourself. And don't forget about yourself: fatigue in relatives is a common and natural reaction.
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
