Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F32
- Who you see
- a psychiatrist and a psychotherapist
- Format
- video consultations, online psychotherapy and messenger contact
- Duration
- first consultation 50–60 minutes; a course usually lasts at least 6 months
- Anonymity
- treatment is confidential; your data is protected by medical confidentiality
- When it is urgent
- suicidal thoughts, severe agitation, refusing food — call 103 or 112
- Outcome
- less anxiety and restored sleep, mood and energy
What you should know
Anxious depression feels different from “classic” depression. Instead of apathy and slowness, the main features are worry, an inability to relax, thoughts going round in circles and physical tension. A person is exhausted yet cannot stop: at night they cannot sleep because of anxiety, and during the day they have no energy. Such people often spend years treating their heart, stomach or headaches without suspecting that behind the symptoms lies depression with a pronounced anxiety component.
Online treatment is especially well suited to anxious depression, because travel, queues and unfamiliar offices make anxiety worse in themselves. You message us on WhatsApp, connect from a calm place — an apartment in Bostandyk district or a house in Talgar — and talk to the doctor without extra stress. A Psychiatry Online psychiatrist works out which is currently predominant and chooses treatment that addresses both the anxiety and the depression, not just one of them.
Signs of anxious depression
- low mood combined with constant worry and a sense that something bad is coming
- it is hard to sit still; you feel inner trembling, as if your nerves are on edge
- falling asleep is difficult because of thoughts you cannot switch off
- physical symptoms: palpitations, a lump in the throat, muscle tension, nausea
- irritability and outbursts of anger that were not typical for you before
- fear for the health of loved ones, your job or the future, even though there seems to be no reason
- tests by a cardiologist and a gastroenterologist find no serious cause
If at least two points apply and the state lasts longer than two weeks, it is worth seeing a specialist. Phone consultation is free. If life is at risk, call 112 or 103.
Why anxiety and depression go hand in hand
Anxiety and depression share biological mechanisms: disturbances in the serotonin and norepinephrine systems and chronic activation of the body’s stress system. That is why they often occur together, and each makes the other worse. Long-lasting anxiety is exhausting and leads to depression, while depression makes a person vulnerable to anxious thoughts. International research shows that marked anxiety in depression affects the choice of treatment and calls for closer monitoring.
Triggering factors include chronic stress, work overload, financial uncertainty, conflicts and illness in loved ones. The pace of a big city, the constant rush, the noise and traffic on Almaty’s roads keep background anxiety going, while a lack of sleep and rest prevents recovery. Caffeine, energy drinks and alcohol, which people often use to “keep going” or “unwind,” actually intensify anxiety symptoms.
How online treatment works
You message us on WhatsApp → receive a link → the doctor on a video call asks about your mood, anxiety, sleep and physical symptoms and how they relate to events in your life. It helps to gather results of tests from other doctors in advance — ECG, blood work, ultrasound — so they do not have to be repeated. The psychiatrist may suggest anxiety and depression rating scales to assess severity. Then together you choose a plan and agree on follow-up appointments.
If your physical symptoms have not been investigated, the doctor will recommend ruling out physical causes in person: thyroid disease, heart conditions and anemia. Some medications used for anxiety require special caution and are prescribed in line with Kazakhstan law. Severe agitation, suicidal thoughts or refusing food require in-person help — call 103 or 112.
How we help
Comprehensive assessment
The psychiatrist determines what is predominant — anxiety or depression — and how both relate to your life circumstances. It is important to rule out bipolar disorder, in which anxious agitation can be part of a mixed state. The choice of treatment depends on an accurate assessment, so the first appointment lasts longer than usual and is as thorough as possible.
Medication
Anxious depression is usually treated with antidepressants that act on both mood and anxiety. At the start of treatment anxiety sometimes increases temporarily, and the doctor explains in advance how to cope with this. Medications for quick anxiety relief are used cautiously and only for short periods because of the risk of dependence.
Psychotherapy for anxiety
Cognitive behavioral therapy helps you recognize anxious thoughts, stop going over them again and again, and gradually return to situations you have started avoiding. A Psychiatry Online psychotherapist teaches relaxation techniques and ways of working with physical tension that you can use right there in a traffic jam or before an important meeting at work.
Working on sleep and stimulants
The doctor helps you build a sleep routine, cut down on caffeine and energy drinks and stop using alcohol as a way to relax. These changes may not look impressive, but they often noticeably reduce anxiety within the first few weeks and help medication and psychotherapy work better and faster. The steps are agreed to fit your schedule.
Myths and facts
MythAnxiety is just your personality, there is nothing to treat
FactAnxiousness as a personality trait and anxious depression are different things. If anxiety keeps you from sleeping and working and comes with low mood, it is a medical condition that responds well to treatment.
MythSedatives will solve the problem
FactSedatives can temporarily relieve tension, but they do not treat depression and cause dependence with long-term use. The foundation of treatment is antidepressants and psychotherapy selected by a doctor.
MythIf my heart is pounding, it must be a heart problem
FactPalpitations are a common symptom of anxiety. It is important to have your heart checked, but if the cardiologist has found no serious changes, it is worth seeing a psychiatrist. Anxiety symptoms are real and physically felt, even though their cause is not in the heart.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Almaty
| Online psychiatrist consultation (50–60 min) | 15 000 ₸ |
| Follow-up online consultation | 12 000 ₸ |
| One month of online psychiatric care | 60 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
Psychiatry Online in Almaty: same-day video appointments and two branches for in-person visits — 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Almaty and Almaty Region, starting online is usually easiest.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
How is anxious depression different from an anxiety disorder?
In an anxiety disorder the main problem is anxiety, while mood may remain normal. In anxious depression there are all the signs of depression — low mood, loss of interest, fatigue — plus marked anxiety. Telling them apart matters because the choice of treatment depends on it.
Why can anxiety get worse at the start of treatment?
Some antidepressants cause a temporary increase in restlessness in the first few days. This usually passes within one to two weeks. The doctor warns you about this in advance and explains how to cope. If the restlessness becomes severe, message your doctor rather than stopping the medication yourself.
Can anxious depression be treated with psychotherapy alone?
In mild cases, yes — psychotherapy can be the main treatment. In moderate and severe cases, a combination with medication is usually recommended. The decision is made together with the doctor, taking into account how severe the symptoms are and how they affect your daily life.
Does the online format help if I feel anxious talking on video?
Yes, many people find it easier to start with an audio call or messages and turn the camera on later. Being able to talk from home, without a trip across Almaty or waiting in a hallway, reduces anxiety in itself. The doctor will adapt to a pace that suits you.
How long does treatment take?
The first improvements are often noticeable after two to six weeks, but a full course usually lasts six months or longer. It is important not to stop treatment at the first signs of improvement, to reduce the risk of symptoms returning. A plan for finishing treatment is discussed with the doctor in advance.
What should I do if I have a severe anxiety attack at night?
Use the techniques your doctor taught you: slow breathing, grounding and shifting your attention. You can contact the on-duty psychiatrist via the 24-hour line. If you have suicidal thoughts or feel that you cannot cope, call 103 or 112.
Where can I be seen in Almaty?
Online — from anywhere in the city or region. In person — at two branches: 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online 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) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
