Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F60.3
- Who leads care
- A psychiatrist and a psychotherapist working as a team
- Format
- Video consultations and weekly online psychotherapy sessions
- Duration
- First appointment 50–60 minutes, therapy from 6 months
- Anonymity
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it's urgent
- Suicidal thoughts or self-harm — call 103, 112 or 150
- Outcome
- Fewer crises, more stable relationships and skills for managing emotions
What you should know
Why, in borderline personality disorder, do emotions “go off the scale” over small things, and why do relationships swing between idealization and disappointment? Research shows that people with this condition have heightened emotional sensitivity and return to baseline more slowly after an emotional surge. If their feelings were often dismissed in childhood, emotion regulation skills never fully developed. The result is intense pain, impulsive actions and a sense of emptiness. This is not a “bad character” but a condition that responds well to treatment.
International guidelines put psychotherapy first — dialectical behavior therapy, mentalization-based therapy and schema therapy. Medication is used for co-occurring symptoms rather than as the core of treatment. The online format works well here: regular sessions are not disrupted by travel, and in a moment of crisis you can reach a doctor from home. For someone who lives in Yesil district and works until late in the evening, this is often the only way to keep up the weekly rhythm of therapy.
Symptoms of borderline personality disorder
- an intense fear that loved ones will leave, and desperate efforts to prevent it
- relationships that swing from admiration of a person to total disappointment
- an unstable sense of self: who I am, what I want, what I believe in
- impulsive spending, binge eating, reckless driving, bouts of substance use
- sharp mood swings over hours rather than weeks
- a chronic feeling of emptiness and boredom that is hard to put into words
- outbursts of anger followed by shame and self-blame
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 borderline personality disorder develops
The modern biosocial model explains the disorder as the interaction of two factors. The first is an innate heightened emotional reactivity: the person feels things more intensely and for longer. The second is an environment in which the child's emotions were ignored, ridiculed or punished. In such an environment, skills for recognizing and regulating feelings do not develop, and in adult life emotion “takes over” behavior before reasoning has a chance to kick in.
Traumatic experiences, unstable attachments and heredity also play a role. The condition is often accompanied by depression, anxiety disorders, eating disorders and addictions, so the doctor assesses the whole picture. External pressures — a long winter, isolation during short daylight hours, conflict at work — are not causes, but they can intensify crises. This is taken into account when drawing up the plan.
How online treatment works
The first consultation takes place by video: the doctor asks about your mood, relationships, impulsive actions, sleep, alcohol use and thoughts of self-harm. Prepare a list of questions and, if you have them, previous discharge summaries. Join from a room where no one can overhear you. Then a plan is agreed: how often you will see the psychotherapist, check-ins with the psychiatrist, and what to do in a crisis between sessions.
The online format is not suitable if there is an immediate threat to life, self-harm requires medical attention, or the person is severely intoxicated. In that case call 103 or 112; for teenagers and young people, the 150 helpline is available. A severe crisis may require a short hospital stay. Medication is prescribed in accordance with the rules of the Republic of Kazakhstan.
How we help
Dialectical behavior therapy
DBT is one of the most thoroughly studied treatments for borderline personality disorder. It teaches four groups of skills: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Sessions can be held online in individual and group formats; regularity and homework between sessions are essential.
Mentalization-based therapy
This method helps you understand your own and other people's mental states: what am I feeling, and why did the other person act that way? As this ability grows, conflicts and impulsive reactions decrease. Sessions take place by video, and many patients say it is easier to talk about painful things at home than in an unfamiliar clinic office.
Schema therapy
Schema therapy works with deep-seated beliefs about oneself and others formed in childhood: “I'll be abandoned,” “I'm bad,” “I'm not allowed to be angry.” The psychotherapist helps you recognize these schemas in current situations and build new ways of responding. The course is usually long, but it produces lasting changes in relationships, self-esteem and reactions to stress.
Medication support
Guidelines do not recommend treating the disorder itself with pills, but for co-occurring depression, anxiety or sleep problems the psychiatrist may prescribe medication from the relevant classes. The decision is made after assessing the risks and in accordance with Kazakhstan's rules. It is important to avoid drugs with a risk of dependence and to review their benefit regularly.
Myths and facts
MythBorderline personality disorder can't be treated
FactThis is an outdated view. Long-term studies show that in most patients symptoms ease over time, especially with psychotherapy. Many no longer meet the diagnostic criteria after a few years.
MythThey're just manipulating people
FactBehind behavior that looks manipulative there is usually intense pain and fear rather than cold calculation. The person simply doesn't know another way to cope with what they feel. Therapy teaches them to express their needs directly.
MythIt's the same as bipolar disorder
FactIn bipolar disorder, mood episodes last days and weeks. In borderline personality disorder, mood swings happen over hours and are tied to relationships. Sometimes the two conditions co-occur, which is why an accurate assessment by a psychiatrist is 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
| Urgent online psychiatrist consultation | 18 000 ₸ |
| Consultation for relatives | 15 000 ₸ |
| Psychiatrist home visit | 45 000 ₸ |
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
Can the diagnosis be made online?
A psychiatrist can conduct a full diagnostic interview by video using the structured criteria of the ICD and DSM. One or two sessions are usually needed. If additional tests are required to rule out other conditions, the doctor will tell you what needs to be done in person. A diagnosis is never made on the basis of a single test.
What should I do in a crisis between sessions?
You will have a crisis plan: which skills to use, whom to call and when to contact the clinic. At Psychiatry Online you can reach the psychiatrist on duty 24/7. If your life is in danger or you have already harmed yourself, call 103 or 112; young people can also call the 150 helpline.
How long does treatment take?
Psychotherapy for borderline personality disorder is planned over months: noticeable changes usually appear after 6–12 months of regular work. Sessions are weekly, sometimes more frequent at the start. The online format helps you avoid missing sessions even during a blizzard or on business trips.
Do I need to take medication?
Not always. The main treatment is psychotherapy. Medication is considered if there is co-occurring depression, marked anxiety or insomnia. Prescribing depends on the assessment and on Kazakhstan's legislation. The doctor will discuss the benefits and risks and will not prescribe medication “just in case.”
Can family members be involved in treatment?
Yes, and it often helps. There are separate sessions for family and partners that explain what is happening, how to respond to outbursts and how to offer support without burning out. Information about your treatment is shared with loved ones only with your consent.
How is confidentiality protected?
Information about your visit is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” Your employer does not receive it. Join from a place where no one can overhear you and use headphones. You do not have to give your full name at the first appointment if you do not need documents.
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