Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F48.0
- Who leads care
- A psychiatrist; a primary care doctor or neurologist in person when indicated
- Format
- Video consultation, online review of test results, follow-up sessions
- Duration
- First appointment 40–60 minutes, recovery over 1–3 months
- Anonymity
- Medical confidentiality under Kazakhstan law, nothing shared with employers
- When it's urgent
- Thoughts of death, sudden weakness, fainting — call 103 or 112
- Outcome
- A clear cause of the fatigue and a step-by-step recovery plan
What you should know
Why do neither weekends nor a vacation help, and why is there no energy even first thing in the morning? In asthenia, the balance between load and recovery is disrupted: the nervous system works at its limit for a long time, sleep stops being deep, and reserves have no time to replenish. What develops is “irritable weakness” — a person tires quickly and at the same time reacts sharply to noise, light and minor setbacks. It is important to understand that asthenia is a syndrome, and different causes can lie behind it.
Clinical guidelines require physical illnesses and depression to be ruled out first, since treatment depends on it. An online consultation is a convenient first step here. A doctor at Psychiatry Online takes a history, helps you put together a list of tests and interprets the results. People who work in offices until dark and then head home across a windswept bridge to the Right Bank don't have to spend yet another evening on a trip to the doctor.
Signs of asthenic syndrome
- tiredness in the morning that does not go away after sleep or a weekend
- getting tired quickly from your usual mental work
- irritability, tearfulness, sharp reactions to small things
- heightened sensitivity to noise, bright light and loud voices
- difficulty concentrating, losing the thread of conversation, worsening memory
- shallow sleep, trouble falling asleep despite feeling exhausted
- headaches, heaviness in the body, a pounding heart with little exertion
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.
What causes asthenia
The most common causes are prolonged stress and overwork without proper recovery, as well as past infections. After a severe viral illness, asthenia can persist for weeks. The mechanism involves changes in how the stress system works, inflammatory processes and disturbed sleep. It is important to remember that severe fatigue often masks depression and anxiety disorders, which require treatment of their own.
Physical causes — anemia, thyroid dysfunction, vitamin deficiencies, diabetes, cardiovascular disease and sleep apnea — must be ruled out. External conditions also play a role: the long winter, strong winds and short daylight hours disrupt circadian rhythms, and a lack of sunlight lowers activity levels. The demanding schedule of civil service and office work with no breaks turns temporary tiredness into chronic exhaustion.
How an online appointment for asthenia works
By video, the doctor asks when the symptoms began and about your sleep and work routine, past illnesses, mood, medications and alcohol use. Questionnaires are used to assess depression and anxiety. Have any existing test results and medical reports ready. As a result you receive a list of the tests you need, recommendations on your routine and, if necessary, a treatment plan. At the follow-up session, the doctor goes through the test results with you.
Tests, a physical examination, an ECG and other investigations cannot be done online — they are carried out in person. If the fatigue comes with weight loss, fever, shortness of breath, fainting or chest pain, you need to see a primary care doctor in person without delay, and for acute symptoms call 103 or 112. Medication is prescribed in accordance with Kazakhstan's legislation and may require an in-person examination.
How we help
Finding the cause
The first step is to rule out physical illness: a complete blood count, iron levels, thyroid function, blood glucose and other tests as indicated. At the same time, mental health is assessed: depression, anxiety, burnout. Without this, treatment risks being merely symptomatic and ineffective, so the doctor is in no hurry to prescribe.
Routine and paced activity
Recovery is built on balance: fixed times for going to bed and getting up, short breaks every 60–90 minutes of work, and a gradual increase in physical activity. In winter it is important to catch the daylight — a lunchtime walk along the riverside embankment does more good than an extra cup of coffee. The load is increased slowly so as not to trigger another slump.
Psychotherapy
Cognitive behavioral therapy helps build a realistic workload, reduce self-criticism and health anxiety, and break the habit of working “until you drop.” Sessions are held online and fit easily into the working day. The method is especially useful when asthenia is linked to stress, burnout and perfectionism.
Medication support
If the asthenia is caused by depression or an anxiety disorder, the doctor considers medication from the relevant classes. When the cause is physical, treatment is prescribed by the appropriate specialist. Guidelines do not support “pick-me-up” remedies when the cause has not been established. Prescribing follows Kazakhstan's rules.
Myths and facts
MythAsthenia is just laziness
FactAsthenic syndrome has a physiological basis and clear signs. The person wants to be active but cannot, and effort only leads to further exhaustion. Blame only makes things worse.
MythA good night's sleep is all you need
FactIn asthenia, sleep often becomes shallow and unrefreshing. In addition, anemia, thyroid disease or depression may lie behind the fatigue. Without finding the cause, rest helps only partially.
MythCoffee and energy drinks will help
FactStimulants give a short-lived boost but disrupt sleep and increase irritability and anxiety. In the end, the exhaustion builds up. Recovery requires a proper routine, treating the cause and sometimes psychotherapy.
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
An online consultation for “Asthenic syndrome and chronic fatigue” is available to people across Astana and Akmola Region 24/7 — from home, work or while travelling. For an in-person visit, Psychiatry Online in Astana has two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Doctor home visits: 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 asthenia different from depression?
In asthenia, fatigue and irritable weakness come first, while interest in life is usually preserved. In depression, mood and the ability to enjoy things decline, and feelings of guilt and hopelessness appear. The two conditions can co-occur, so a psychiatrist's assessment is needed.
Which tests should I take before the consultation?
Most often — a complete blood count, iron levels, thyroid hormones, blood glucose, and vitamin D and B12 as indicated. The doctor will determine the exact list after talking with you. If you already have test results, upload them before the video appointment — this will save time.
How long does recovery take?
Once the cause is addressed and the routine is followed, noticeable improvement usually comes within 4–8 weeks, and full recovery within 2–3 months. After severe infections, the period may be longer. Follow-up online sessions help adjust the plan.
Can I work with asthenic syndrome?
In most cases yes, but with an adjusted routine: breaks, limits on overtime and a reasonable workload. Sometimes the doctor recommends temporarily reducing the load. Sick leave is handled under Kazakhstan's rules and may require an in-person examination.
What if nothing helps?
If there is no improvement after 2–3 months, the doctor widens the investigation and reviews the diagnosis: sleep apnea, autoimmune diseases and hidden depression are ruled out. A consultation with a neurologist or endocrinologist may be needed. The online doctor will help you map out the next steps.
How do I book an appointment and keep it confidential?
Simply submit a request on the website or call: at Psychiatry Online, consultations are available 24/7. Information about your visit is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System” and is not passed on to your employer.
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
