Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F32, F33
- Who provides it
- A psychiatrist, with a psychotherapist on the team
- Where
- Office, home visit, online; inpatient care for severe forms
- Duration
- Effect assessed after 4–6 weeks, course of 6–12 months or more
- Anonymity
- No registry entry, full medical confidentiality
- When it is urgent
- Suicidal thoughts or a plan — call 103 or 112 straight away
- Outcome
- Remission: mood, sleep and the ability to work are restored
What you should know
According to ICD-10 (category F32), a depressive episode is defined by a combination of core symptoms — low mood, loss of interest and pleasure, and increased fatigue — with additional ones: disturbed sleep and appetite, reduced concentration, feelings of guilt and worthlessness, pessimism, and thoughts of death. For a diagnosis, symptoms must persist for at least two weeks. If episodes recur, the condition is called recurrent depressive disorder (F33).
Depression is not a weakness of character or a “bad mood” that goes away through willpower. It is an illness involving changes in how the nervous system, sleep and hormonal regulation work. Depression treatment in Zhezkazgan at Narcology 24 is provided by a psychiatrist: they determine how severe the episode is, rule out bipolar disorder and physical causes, select treatment and follow the patient until stable remission is reached. In mild depression, psychotherapy may be the mainstay of treatment; in moderate and severe depression, it is combined with medication.
Symptoms of Depression
- low mood for most of the day, nearly every day, for more than two weeks
- loss of interest in and pleasure from things you used to enjoy
- constant tiredness and a feeling that every task takes enormous effort
- waking early at 4–5 a.m. or, conversely, sleepiness during the day
- reduced or increased appetite with noticeable weight change
- feelings of guilt and worthlessness, thoughts that you are of no use to anyone
- difficulty concentrating and making even simple decisions
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.
Causes and Types of Depression
Depression develops through the interaction of several factors: hereditary predisposition, chronic stress, traumatic events, physical illnesses (thyroid disease, cardiovascular and neurological conditions), certain medications and alcohol use. Often there is no obvious external cause. That is why the question “what caused it” matters less for treatment than an accurate assessment of the severity and type of the disorder.
Depressive episodes are classified as mild, moderate and severe, as well as severe with psychotic symptoms. Postpartum depression, depression in older adults and dysthymia — a chronic, moderately low mood lasting two years or more — are considered separately. It is important to distinguish depression from the depressive phase of bipolar disorder, because these conditions are treated differently.
How Depression Treatment Works: Step by Step
The stages: 1) an initial consultation — in person, at home or online — with an interview, depression rating scales and a suicide risk assessment; 2) recommendations on tests to rule out physical causes; 3) choosing treatment: psychotherapy, medication or a combination; 4) a check-up after 1–2 weeks to assess tolerability; 5) assessment of the effect after 4–6 weeks; 6) maintenance treatment for at least 6 months after improvement to reduce the risk of symptoms returning.
Outpatient treatment is not enough if there are suicidal thoughts with a plan, refusal of food and water, psychotic symptoms, or a complete inability to look after oneself. Hospital admission is then needed. If there is an immediate threat to life, call 103 or 112; teenagers and young people in crisis can call the free helpline at 150.
How we help
Antidepressants
Medications in this class restore the balance of neurotransmitters. The effect develops gradually: the first changes appear after 1–2 weeks, the full effect after 4–6 weeks. The psychiatrist chooses a medication based on the symptoms, co-existing illnesses and age. Antidepressants must not be stopped abruptly: they are tapered gradually according to the doctor's plan, otherwise discontinuation syndrome and relapse are possible.
Psychotherapy
Cognitive behavioral therapy, interpersonal therapy and behavioral activation are recognized as effective treatments for depression in NICE guidelines. In mild depression, psychotherapy can be used without medication; in moderate and severe depression, it is combined with medication. A course usually includes 12–20 sessions, and an online format is available.
Treating sleep and daily routine
Sleep problems are both a symptom of depression and a factor that keeps it going. The doctor gives advice on sleep hygiene, daily routine and physical activity and, if needed, prescribes short-term medication to normalize sleep. Regular moderate exercise has been shown to improve mood and complements the main treatment.
Maintenance treatment and prevention
After recovery from an episode, treatment continues for at least 6 months, and longer after repeated episodes. The patient learns to recognize early signs of deterioration. Follow-up with the psychiatrist can continue online so that the course is not interrupted by business trips or a busy schedule. Scheduled visits gradually become less frequent. This reduces the risk of relapse.
Myths and facts
MythDepression will pass on its own — you just need to pull yourself together
FactMild episodes sometimes resolve spontaneously, but without treatment depression often drags on for months, recurs and raises the risk of suicide. Willpower cannot restore disrupted regulation — medical help is needed.
MythAntidepressants change your personality and are addictive
FactAntidepressants do not change your character or cause euphoria. They return a person to their usual self. There is no addiction in the clinical sense, but stopping abruptly can cause unpleasant symptoms, so the course is ended gradually.
MythIf there's a reason to be sad, it isn't depression
FactGrief and a reaction to a difficult event are normal experiences. But if the state lasts for weeks, interferes with life and comes with insomnia, hopelessness or thoughts of death, it is a reason to see a doctor, even when the cause is clear.
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 Zhezkazgan
| 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
Narcology 24 in Zhezkazgan: 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 — 104 Pushkina St., Zhezkazgan and 149 Alashakhana Ave., Zhezkazgan. 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 if I have depression and not just fatigue?
Fatigue goes away after rest, but depression does not. If low mood, loss of interest, sleep and appetite problems and difficulty concentrating persist for two weeks or longer, it is worth seeing a psychiatrist. An online consultation in Zhezkazgan can help assess your condition without a visit to the clinic.
How long does depression treatment take?
The acute phase — until improvement — usually lasts 6–12 weeks. It is followed by continuation treatment for at least 6 months to consolidate the result. After repeated episodes, the doctor may recommend longer maintenance treatment. The specific plan depends on the severity and your medical history.
Can depression be treated without pills?
In mild depression, psychotherapy, a healthy routine and physical activity can form the basis of treatment. For moderate and severe forms, guidelines recommend combining psychotherapy with medication. The psychiatrist will explain which option suits your case and take your preferences into account.
Can I drink alcohol during depression treatment?
No. Alcohol itself worsens depression, disrupts sleep and does not mix well with most psychotropic medications. If you find it hard to give up alcohol, tell your doctor: at Narcology 24 you can get help from an addiction specialist and a psychiatrist at the same time.
What should I do if a loved one talks about death?
Take it seriously, calmly ask about their thoughts and plans, do not leave the person alone, and remove dangerous objects and medications. If there is a plan or an attempt has been made, call 103 or 112. If there is no immediate danger, book them in with a psychiatrist as soon as possible.
Does depression treatment at home work?
Yes, if there are no signs that call for hospital admission. A psychiatrist home visit in Zhezkazgan is convenient in severe apathy, when the person cannot leave home. The doctor carries out an examination and prescribes treatment, and further follow-up can take place online.
Where do doctors visit in Zhezkazgan and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 104 Pushkina St., Zhezkazgan and 149 Alashakhana Ave., Zhezkazgan. Phone in Zhezkazgan: +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
