Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F31
- Who leads care
- A psychiatrist, together with a psychotherapist when needed
- Format
- Video consultation, follow-up appointments, mood diary, chat with your doctor
- Duration
- First appointment 50–60 minutes, follow-ups 25–30 minutes
- Confidentiality
- Medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System”
- When it is urgent
- Mania with dangerous behavior, psychotic symptoms, or suicidal thoughts — call 103 or 112
- Outcome
- Stable mood, a clear plan to prevent new episodes, fewer hospital admissions
What you should know
Bipolar disorder is not just “mood swings.” It is a disorder of mood regulation in which a person spends weeks or months in a state far removed from their usual self. Clinical guidelines distinguish bipolar I disorder, with at least one manic episode, from bipolar II disorder, in which hypomanic episodes are combined with severe depressions. The distinction matters: it shapes the choice of medication classes and the outlook, so the diagnosis is made from the history of all episodes, not from a single visit.
At Psychiatry Online, patients with bipolar disorder are looked after by psychiatrists who work over video and build long-term follow-up: a mood diary, regular check-up appointments, and an action plan for the first signs of a new phase. For people living on the right or left bank of the city, this means no more crossing town in the wind and the dark after work: the appointment takes place from home or from a meeting room at the office, and important changes are recorded straight away rather than a month later.
Signs and Symptoms of Bipolar Disorder
- periods of elevated mood with a reduced need for sleep and no feeling of tiredness
- rapid, pressured speech and racing thoughts, making it hard to stay on one topic
- unusual self-confidence, risky spending, and impulsive decisions
- depressive episodes with loss of interest and energy and a sense of slowing down
- shifts between phases that family members notice before the person does
- seasonal flare-ups, for example worsening in late fall and winter
- a poor response to antidepressants, or a sudden “high” soon after starting them
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 Bipolar Disorder
Bipolar disorder is one of the conditions with a strong hereditary component: the risk is noticeably higher in first-degree relatives. The mechanism involves disrupted regulation of neurotransmitter systems and of circadian rhythms — the internal clock that governs sleep, energy, and mood. That is why disrupted sleep is often not a consequence but a trigger of a new phase: a few sleepless nights can set off hypomania in a person who is predisposed to it.
External triggers include stress, overwork, alcohol and other psychoactive substances, and abrupt changes in light exposure. A long winter with short days and the sudden “jump” in daylight in spring can affect the seasonal pattern of episodes, which is taken into account when drawing up a prevention plan. The demanding schedules of civil service jobs and offices, with crunch periods and late-night reporting, are a separate risk: clinical guidelines explicitly name a stable sleep routine as one of the components of bipolar disorder treatment.
How an Online Appointment for Bipolar Disorder Works
At the first video consultation, the psychiatrist takes a detailed history: when episodes occurred, how long they lasted, how you slept, and what helped. It is useful to write down the dates of relapses and the names of medications you have taken in advance, and to invite someone close to you — they often remember hypomanic periods more accurately. You will need a stable internet connection, headphones, and a room where you cannot be overheard. At the end, the doctor gives a preliminary diagnosis and discusses the treatment plan and the schedule of follow-up appointments.
Laboratory monitoring cannot be done online: some mood stabilizers require regular blood tests, which are done in person at a laboratory. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law and the requirements for an initial in-person examination. Severe mania, psychotic symptoms, refusing food and sleep, or thoughts of suicide require in-person care or hospital admission — call 103 or 112; your doctor will also help with a referral.
How we help
Mood stabilizer treatment
According to international guidelines, the foundation of bipolar disorder treatment is mood-stabilizing medication, sometimes combined with atypical antipsychotics. Its purpose is not only to end the current episode but also to lower the risk of the next one. The specific medications are chosen by the doctor based on the type of bipolar disorder, other health conditions, and tolerability, and doses and regimens are discussed only during the appointment.
Psychoeducation
Research shows that patients who understand their illness are hospitalized less often. Sessions cover the early warning signs of episodes, the role of sleep and alcohol, and the danger of stopping treatment on your own. Psychoeducation is especially helpful for families: loved ones learn to notice the start of hypomania and tell the doctor in time, without turning it into control and conflict.
Rhythm-focused psychotherapy
Interpersonal and social rhythm therapy is based on the idea that a stable daily routine protects against new episodes. Together with a psychotherapist, you even out the times you get up, go to bed, eat, and work. For people with demanding office schedules, this is a practical tool: it teaches you to plan crunch periods and flights without sacrificing sleep, and to notice when your rhythm is starting to break down.
Mood diary and monitoring
A brief daily rating of mood, sleep, and energy makes it possible to spot a phase before it fully develops. The doctor reviews the entries at follow-up appointments and adjusts the plan. At Psychiatry Online, the diary is discussed over video, and if your ratings change sharply you can message your doctor without waiting for the next scheduled visit.
Myths and facts
MythBipolar disorder is just a difficult personality
FactBipolar disorder is an ICD-10 diagnosis with clear criteria for how long and how severe episodes must be. It is not a personality trait or simply being “emotional”: without treatment, episodes usually recur, and the gaps between them can become shorter.
MythIf I feel fine now, I can stop my medication
FactRemission is the result of treatment, not a reason to stop it. Clinical guidelines warn that abruptly stopping mood stabilizers on your own raises the risk of a rapid relapse. Any change to your regimen should be made only together with your doctor.
MythAn online psychiatrist can’t manage such a serious disorder
FactMost of the work in bipolar disorder — conversation, reviewing episodes, adjusting treatment, and monitoring — translates well to video. Lab tests and emergencies remain in person, and the doctor will tell you honestly when they are needed.
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
Psychiatry Online in Astana: same-day video appointments and two branches for in-person visits — 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Astana and Akmola 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 bipolar disorder different from ordinary depression?
In bipolar disorder, in addition to depression, there are periods of elevated mood — mania or hypomania. This changes treatment: antidepressants without a mood stabilizer can trigger a switch into mania. That is why the doctor will always ask about periods when you slept little and felt unusually active and confident.
Can the diagnosis be made online?
The diagnosis is based on clinical criteria: the history of episodes, their duration, and symptoms. This information is gathered through conversation, so a video appointment is suitable for diagnosis. Sometimes the doctor recommends additional tests, such as blood work, to rule out physical causes of mood changes.
How often are follow-up appointments needed?
While treatment is being adjusted, usually once every one to two weeks; later, once you are stable, once a month or less often. The frequency is set by your doctor. The online format makes it easy to fit an appointment into your working day, even if your office is in the Yesil district and you live on the other bank.
What should I do if a loved one is manic and refuses help?
If there is a threat to life or dangerous behavior, call 103 or 112. Otherwise, you can book a consultation yourself: the psychiatrist will advise you on how to talk to the person and what steps are possible. Involuntary care is provided only in accordance with the procedure set out in Kazakhstan law.
Can I work and live a normal life with bipolar disorder?
Yes. With the right treatment and a stable routine, many people with bipolar disorder work, study, and raise families. What matters is noticing the early signs of a new phase in time and not skipping follow-ups. The goal of treatment is not only to end an episode but also to preserve your usual quality of life.
Will my employer find out about my diagnosis?
No. Information about your visit is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” At Psychiatry Online, you can seek help anonymously, and information may be disclosed only in cases expressly provided for by law.
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
