Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F43.0
- Who leads care
- A psychiatrist, joined by a psychotherapist when needed
- Format
- Video consultation from home or the office, follow-ups online
- Duration
- First appointment 40–60 minutes, monitoring for 2–6 weeks
- Anonymity
- Medical confidentiality under the Kazakhstan Code “On Public Health”; full name not required
- When it's urgent
- Thoughts of death, confusion, danger to life — call 103 or 112
- Outcome
- A clear plan: sleep, workload, symptom control and warning signs of deterioration
What you should know
Why can't a person simply “pull themselves together” after a car crash, a sudden loss, an assault or a severe conflict at work? Because in the first hours and days the brain runs in threat mode: the alarm system is switched on, a surge of stress hormones keeps the body tense, sleep breaks down, and memory replays the event over and over again. This is not weakness of character but predictable physiology. The doctor's job is to determine whether the reaction is within the normal range and how to help it run its course without turning into a prolonged disorder.
Clinical guidelines on acute stress agree on the essentials: in the first weeks a person needs safety, restored sleep, simple information about what is happening, and monitoring. This is exactly what works well online. Someone living on the Left Bank who, after a long day at a ministry, is in no mood to cross the whole city against the winter wind needs nothing more than a laptop and a closed door. A video appointment takes 40–60 minutes, and a follow-up contact is scheduled a few days later to see how things are changing.
Symptoms of an acute stress reaction
- a sense that things are unreal, emotional numbness, feeling “as if in a dream”
- intrusive memories of the event, vivid images flashing up as you fall asleep
- insomnia, frequent waking and nightmares in the first nights after the event
- a pounding heart, trembling, sweating, a lump in the throat for no obvious reason
- outbursts of irritability, tearfulness, abrupt mood swings
- avoiding places, people and conversations that remind you of what happened
- difficulty concentrating at work, muddled thinking, everything slipping out of your hands
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 stress gets “stuck”: the mechanisms
Acute stress activates the hypothalamic–pituitary–adrenal axis: cortisol and adrenaline levels rise, and the body prepares to run or defend itself. Normally the system returns to balance within a few days. But if a person is not sleeping, remains in an unsafe environment or suffers new blows, the alarm signal does not switch off. The memory of the event is stored without the context “this is already behind me,” and the brain keeps reacting as though the threat were still close by.
The risk of a prolonged course is higher in people who have experienced trauma before, live with depression or an anxiety disorder, lack support, or try to “drown out” their state with alcohol. External conditions matter too: short daylight hours and a long winter disrupt circadian rhythms, while the demanding schedule of civil service work leaves no time for recovery. That is why the doctor looks not only at the symptoms but also at the person's sleep, workload and surroundings.
How an online appointment for acute stress works
Before the consultation, find a quiet place where no one can overhear you and check your internet connection and camera. You can join from your car in a parking lot in Yesil district or from a meeting room at the office. The doctor will ask what happened, how you are sleeping and eating, how you are coping with work, and whether you have any thoughts of death. If needed, they will use questions from standardized rating scales. At the end you will receive an explanation of what is going on, recommendations on sleep and workload, a monitoring plan and the date of your next contact.
Online care cannot replace in-person help if a person has been physically injured, is confused, cannot take care of themselves, or their life is at risk — in such cases call 103 or 112. If medication is needed, the decision to prescribe it and issue a prescription is made in line with the legislation of the Republic of Kazakhstan and may require an in-person examination. The doctor will tell you honestly when it is time for an in-person visit or hospital care.
How we help
Psychoeducation
The doctor explains how the stress response works, which symptoms are to be expected and how long they usually last. Understanding the mechanism reduces the fear of “going crazy” and lowers anxiety. The person receives simple criteria: what counts as normal, and what is a reason to contact the doctor earlier than scheduled or to call for emergency help.
Restoring sleep and daily rhythm
Sleep is the main resource for recovery after stress. The doctor helps set up a routine: a fixed wake-up time, light in the morning, and limiting caffeine and screens in the evening. In winter, when it gets dark early, it is especially important to get out into daylight, even for a short walk. For severe insomnia, temporary medication support is discussed.
Brief psychotherapy
When symptoms are pronounced, a psychotherapist joins the care. Evidence-based methods include trauma-focused cognitive behavioral therapy and stabilization techniques. They can be delivered online: the person learns to cope with intrusive memories, gradually returns to situations they have been avoiding, and regains a sense of control.
Medication support
Medication is not the first-line treatment for acute stress, but it is sometimes needed: for severe insomnia, marked anxiety or depressive symptoms. Antidepressants, sleep aids or anti-anxiety medications may be used — only as prescribed by a doctor, as a short course and with monitoring. Decisions about prescriptions follow the rules of the Republic of Kazakhstan.
Myths and facts
MythStress just has to be endured; doctors aren't needed
FactMost people do recover on their own, but in some the reaction drags on and develops into PTSD or depression. An early consultation helps you understand which group you are in and allows timely intervention if recovery is not going according to plan.
MythThe best cure for stress is to have a drink and forget
FactAlcohol relieves tension for a short while, but it worsens sleep, prevents memory from “processing” the event and increases anxiety the next day. Regular drinking after a trauma is one of the risk factors for a prolonged disorder and for addiction.
MythYou should talk through what happened in detail right away
FactGuidelines do not recommend forcing people to “talk through” a trauma in the first days. Safety, sleep and support matter more. If a person wants to talk, that is helpful, but there is no need to force yourself. Work with traumatic memories is best done with a psychotherapist.
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 Astana
| 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
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
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 acute stress different from PTSD?
An acute reaction develops immediately after the event and usually passes within a few days or weeks. PTSD is diagnosed when symptoms last longer than a month and interfere with daily life: intrusive memories, avoidance, constant hypervigilance. An online doctor will assess which stage you are at and tell you what to do next.
When should I see a psychiatrist rather than wait?
If your sleep has not recovered after a week, if you cannot work, are avoiding familiar places, have started drinking more, or have begun to feel that life is not worth living. If you have suicidal thoughts or your life is in danger, call 103 or 112 immediately — do not wait for an appointment.
Can I have a consultation during my lunch break?
Yes. An appointment takes 40–60 minutes, and you can join from a private office or your car. Many patients working in offices on the Left Bank choose exactly this format so they don't have to ask for time off or spend time on the road. What matters is that no one can overhear you and the connection is stable.
Will my employer be told about the consultation?
No. Information about your visit is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” It can be disclosed only in cases expressly provided for by law. You do not have to give your full name at the first consultation if you do not need official documents.
Will I be prescribed medication online?
The doctor may recommend a class of medication if it is genuinely needed. Prescribing and issuing a prescription depend on Kazakhstan's legislation and the requirements for an initial examination, so an in-person visit is sometimes necessary. A reputable clinic will never promise a prescription “in five minutes.”
How many consultations are usually needed?
Most often, a first appointment plus one to three follow-up sessions over a month is enough to track progress. If symptoms persist, the doctor will suggest a course of psychotherapy or broaden the assessment. At Psychiatry Online, follow-up contacts take place online at a time that suits you.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. 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
