Reviewed byZhanar Tulegenova, MDPsychiatrist and psychotherapist, experience 18 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F41.0
- Who provides it
- A psychiatrist and a psychotherapist
- Where
- Office, online, or a home visit in severe agoraphobia
- Duration
- CBT 10–16 sessions, a medication course of 6–12 months or more
- Anonymity
- No registry entry, full medical confidentiality
- When it is urgent
- First-time chest pain or fainting — call 103 or 112 first
- Outcome
- Attacks become rarer or stop, and avoidance fades
What you should know
A panic attack is an episode of acute fear that comes on suddenly, often for no apparent reason, and is accompanied by powerful bodily reactions: a racing heart, a feeling of choking, chest pain or tightness, sweating, trembling, numbness and a sense that things are not real. An attack usually lasts from a few minutes to half an hour. In itself it is not life-threatening, but it feels like a catastrophe, and people often call an ambulance convinced they are having a heart attack.
Panic disorder (F41.0 in ICD-10) is diagnosed when attacks recur and, between them, the person continues to fear another attack and avoids places where one has happened. Agoraphobia — fear of public transport, crowds and shops — often develops as well. Panic attack treatment in Yesik at Narcology 24 begins with ruling out physical causes, after which psychotherapy and, if needed, medication are selected. The disorder responds well to treatment, especially if you do not put off seeking help.
Symptoms of a Panic Attack
- a sudden, pounding heartbeat or a feeling that your heart is skipping beats
- shortness of breath, a choking sensation, “I can't take a full breath”
- trembling, chills or hot flushes, heavy sweating
- dizziness, feeling faint, a sense of unreality
- fear of dying, going mad or losing control of yourself
- numbness and tingling in the hands or lips, discomfort in the chest or stomach
- fear of another attack and avoidance of places where one has 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
At the root is a malfunction of the danger-response system: the body triggers the “fight or flight” reaction when there is no real threat. Predisposing factors include heredity, heightened sensitivity to bodily sensations, chronic stress, overwork and lack of sleep. Attacks can be provoked by caffeine, energy drinks, alcohol — especially during a hangover — stimulants and abrupt withdrawal from certain sedatives.
The disorder becomes entrenched through “fear of fear”: after the first attack, the person starts monitoring their pulse and breathing, and any sensation is perceived as the start of an attack, which in itself causes anxiety. Gradually they give up travel, work and socializing. It is important to rule out conditions with similar symptoms — arrhythmias, hyperthyroidism, hypoglycemia, bronchial asthma — which is why the doctor recommends a basic workup.
How Panic Attack Treatment Works
The stages: 1) a consultation with a psychiatrist — in person or online — to clarify the nature of the attacks, their frequency, triggers and any co-existing depression; 2) recommendations on tests: ECG, thyroid hormones, blood glucose; 3) an explanation of how panic works — this is already part of the treatment; 4) a course of CBT with exercises and a gradual return to avoided situations; 5) selection of medication if needed; 6) follow-up visits and a prevention plan.
Panic disorder in Yesik is treated on an outpatient basis; hospital admission is rarely needed — only in severe co-existing depression, suicidal thoughts, or dependence on alcohol or sedatives. If chest pain, shortness of breath or fainting has occurred for the first time, if you are over 40 or have heart disease, call 103 or 112 first to rule out a heart condition.
How we help
Cognitive behavioral therapy
CBT is the main treatment for panic disorder according to NICE guidelines. The patient learns how an attack builds up, learns to interpret bodily sensations differently, and does interoceptive exercises — safely bringing on similar sensations in order to stop fearing them — and gradually returns to avoided places. A course includes 10–16 sessions and can be done online.
Medication treatment
With frequent attacks, the psychiatrist may prescribe antidepressants, which reduce how often and how strongly attacks occur; the effect appears over several weeks. Benzodiazepines are prescribed only by a doctor, briefly and for specific situations, because long-term use leads to dependence and increased anxiety on withdrawal. Medications are chosen with co-existing illnesses in mind.
Skills for managing an attack
The patient learns slow diaphragmatic breathing, sensory “grounding” techniques and ways to ride out the peak without fleeing the situation. An important part is giving up “safety behaviors”: constantly checking your pulse or carrying pills “just in case,” which keeps the fear going and gets in the way of recovery.
Working with agoraphobia
If avoidance of public transport, shops and travel has developed, a step-by-step plan is drawn up: from the least frightening situations to more difficult ones, consolidating each step. In severe agoraphobia, the first consultations can take place at home or online, after which the patient gradually widens the range of places they can go.
Myths and facts
MythYou can die or go mad from a panic attack
FactA panic attack is extremely unpleasant, but in itself it does not lead to death, a heart attack or psychosis. The sensations are caused by a surge of adrenaline and they pass. Understanding this mechanism is one of the foundations of treatment.
MythPanic attacks are “vegetative-vascular dystonia”
FactThe diagnosis of vegetative-vascular dystonia (VVD), still common in post-Soviet countries, does not exist in the international classification. Recurrent attacks with intense fear belong to the anxiety disorders and are treated with psychotherapy and medication, not with vascular drugs and vitamins.
MythCarrying a pill with you will make things easier
FactTemporarily, yes — but this behavior reinforces the belief that it is dangerous to be without the pill. As-needed medications are acceptable only when prescribed by a doctor and as part of a plan whose goal is to gradually manage without them.
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 Yesik
| Psychiatrist consultation | 12 000 ₸ |
| Follow-up consultation | 9 500 ₸ |
| Psychotherapy session (50 min) | 12 000 ₸ |
| 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 Yesik is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 125 Kamenskaya St., office 38, Yesik and 103 Zhambyla St., Yesik. If you live elsewhere in Almaty Region, call us and we'll advise the fastest way to get help.
Confidential and private
in Yesik 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 tell a panic attack from a heart attack?
Only a doctor can, using an ECG and an examination. In a panic attack, symptoms peak within minutes and gradually subside, but if chest pain has appeared for the first time, you have heart disease or you are unsure, call 103 or 112. Once a cardiac cause has been ruled out, you can focus on treating the panic.
What should I do during an attack?
Slow your breathing: breathe in for a count of 4, pause, then breathe out slowly. Remind yourself that this is panic and it will pass in a few minutes. Focus on the objects and sounds around you. Don't run away if it is safe to stay. These skills are practiced in detail in sessions with a psychotherapist.
Can panic attacks be cured completely?
With the right treatment, most patients find that attacks become rare or stop altogether, and avoidance disappears. The risk of a return is lower if you complete the course of psychotherapy and don't stop medication earlier than your doctor recommends.
Does online treatment for panic attacks work?
Yes, CBT by video call shows good results. An online psychiatrist appointment in Yesik is convenient for people with agoraphobia who find it hard to get to a clinic. After a while, the patient starts doing exercises outside the home, and the format can be combined with in-person sessions.
Are panic attacks linked to alcohol?
Often. Alcohol relieves anxiety for a short time, but during a hangover and withdrawal the likelihood of panic attacks rises. Regular drinking keeps the disorder going. If you notice this link, tell your doctor — Narcology 24 has both psychiatrists and addiction specialists (narcologists).
Will I be put on a registry if I have panic disorder?
No, with paid anonymous treatment no dispensary registration is made. Information about your visit is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and is not shared with third parties without your consent.
Where do doctors visit in Yesik and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 125 Kamenskaya St., office 38, Yesik and 103 Zhambyla St., Yesik. Phone in Yesik: +7 (700) 309-30-65.
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
