Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F32
- Who leads the session
- a psychiatrist, working together with a psychotherapist when needed
- Format
- video consultations, with contact with the doctor between them on agreed-upon issues
- Duration
- 40–60-minute appointments, follow-ups every 2–4 weeks; a course typically lasts 6 to 12 months
- Anonymity
- you can start without giving your surname; medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System”
- When it is urgent
- suicidal thoughts or an intention to harm yourself—call 103 or 112; young people can call the 150 helpline
- Outcome
- remission: restored mood, sleep, energy, ability to work, and interest in life
What you should know
Depression is not just a bad mood or a weakness of character; it is a disorder in which the systems that regulate emotions, sleep, energy, and motivation function differently. Under ICD-10, a diagnosis of a depressive episode requires at least two weeks of persistently low mood, loss of interest, or increased fatigue combined with other symptoms: sleep and appetite disturbances, difficulty concentrating, feelings of guilt, and thoughts of death. Severity determines the choice of treatment.
Why does online treatment work? The key elements of depression treatment—clinical assessment, psychotherapy, and monitoring of medication—are based on conversation and regular appointments. The video format removes the main barrier: with depression, people often lack the energy to travel. For a government employee with irregular hours or a resident of the Baikonur district facing a winter trip across the whole city in freezing wind, it is easier to start treatment from home.
Signs of Depression That Mean You Should See a Doctor
- your mood has been low most of the day, nearly every day, for at least two weeks
- you have lost interest in and pleasure from things you used to enjoy
- you feel constantly tired, and even simple tasks take enormous effort
- your sleep is disrupted: waking too early or, conversely, feeling sleepy during the day
- it is hard to concentrate, make decisions, read, or work
- you have developed feelings of guilt or worthlessness and thoughts that you are a failure
- you have thoughts of death or feel that you do not want to live
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 Depression Develops
The modern model of depression is biopsychosocial. Genetic predisposition determines vulnerability, while an episode is most often triggered by stressful events: loss, conflict, or overload. At the biological level, chronic stress disrupts the regulation of the hormonal stress system, reduces neuroplasticity in brain regions responsible for emotion and memory, and throws circadian rhythms off balance. That is why depression affects not only mood but also sleep, appetite, and energy.
The psychological component consists of persistent negative thinking patterns: a tendency to overgeneralize failures, blame oneself, and expect the worst. These patterns keep depression going even after the stress has passed. There are also physical causes: thyroid disease, anemia, chronic illnesses, and medication side effects. A shortage of daylight during the long winter also affects body rhythms and mood. That is why diagnosis always includes looking for such factors.
How Online Depression Treatment Works
At the first appointment, the psychiatrist assesses your symptoms, the severity of the episode, whether you have had previous episodes—including episodes of elevated mood—and the risks. You complete depression rating scales, and the doctor recommends lab tests to rule out physical causes. Then you discuss the plan: psychotherapy, medication by drug class, and daily routine. To prepare, find a quiet place and write down your complaints, your questions, and a list of your medications. Follow-up appointments are shorter and take place every 2–4 weeks.
Online treatment is not appropriate for severe depression with refusal to eat or drink, psychotic symptoms, or a high suicide risk—these require an in-person examination and sometimes inpatient care. Prescribing prescription medications depends on Kazakhstan law and the requirement for an initial in-person examination. If you have suicidal thoughts, call 103 or 112; teenagers and young people can call the 150 helpline.
How we help
Psychotherapy
For mild to moderate depression, clinical guidelines recommend psychotherapy as a first-line treatment. The best-studied approaches are cognitive behavioral therapy, behavioral activation, and interpersonal therapy. They target the mechanisms that keep depression going: negative thoughts, avoidance, and the loss of rewarding activities. Research confirms that the online format is comparable in effectiveness to in-person therapy.
Medication
For moderate to severe depression, and when psychotherapy alone is not effective enough, antidepressants are prescribed. Most often these are selective serotonin reuptake inhibitors (SSRIs) and related drug classes. The choice depends on your symptom profile and tolerability. The effect develops over several weeks, so it is important not to stop taking the medication too early.
Combined treatment
For moderate to severe depression, combining medication with psychotherapy is usually more effective than either approach alone and lowers the risk of relapse. At Psychiatry Online, the psychiatrist and psychotherapist work as one team: medication reduces the severity of symptoms and gives you energy, while psychotherapy helps change the factors that keep depression going.
Routine and behavioral measures
Regular sleep, morning light, physical activity, and a structured day are evidence-based additions to the main treatment. They are not a substitute for therapy but a way to enhance its effect. The doctor helps you build a realistic plan that fits your work schedule and the season—for example, morning walks along the Yesil River embankment or indoor exercise on freezing days.
Myths and facts
MythDepression will go away on its own—you just need to pull yourself together
FactDepression is a disorder with biological mechanisms, and willpower cannot eliminate them. Without treatment, an episode can last for months, and the risk of repeat episodes grows. Timely treatment shortens its duration.
MythAntidepressants change your personality
FactAntidepressants do not change your personality—they reduce the symptoms that prevent you from being yourself. Many patients say that after treatment they felt like their old selves again. Side effects are discussed with the doctor and managed.
MythOnline psychotherapy doesn’t work for depression
FactResearch shows that video-based therapy for depression is comparable in effectiveness to in-person therapy. What matters is the regularity of sessions and the quality of the therapeutic relationship, not where you happen to be.
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 “Online depression treatment” 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 can I tell whether it’s depression or just fatigue?
Fatigue goes away after rest; depression does not. The key signs are low mood and loss of interest lasting more than two weeks, sleep and appetite disturbances, difficulty concentrating, and feelings of guilt. A consultation with a psychiatrist, which also rules out physical causes, will help assess your condition accurately.
How long does depression treatment take?
The first changes are usually noticeable after 2–4 weeks, and the full effect after 6–8 weeks. Once remission is achieved, treatment is continued for several more months to prevent relapse. With repeat episodes, maintenance treatment may last longer.
Can depression be treated without pills?
For mild depression, often yes: psychotherapy and behavioral measures may be enough. For moderate to severe depression, clinical guidelines usually recommend combining psychotherapy with medication. The decision is made together with your doctor, taking into account your preferences and the risks.
Can I get treatment online if I work in government service?
Yes. The anonymous online format lets you start treatment without visiting a clinic and without explanations at work. Appointments can be scheduled early in the morning or in the evening. Medical confidentiality is protected by Kazakhstan law, and information is not shared with your employer.
What should I do if I have suicidal thoughts?
Do not stay alone with them. If you have an intention or a plan, call 103 or 112 immediately; teenagers and young people can call the 150 helpline. If you have the thoughts but no intention, be sure to tell your doctor: this is a reason for an urgent consultation and a review of your plan.
Does Psychiatry Online help with recurrent episodes?
Yes. With recurrent depression, it is important not only to resolve the current episode but also to build a prevention plan: maintenance treatment, monitoring for early warning signs, and psychotherapy aimed at preventing relapse. Ongoing online care makes it possible to do this without interruptions.
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
