Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F42
- Who leads care
- A psychiatrist and a CBT psychotherapist
- Format
- Video consultations, CBT sessions, exposure exercises at home
- Duration
- First appointment 50–60 minutes; a CBT course usually takes 12–20 sessions
- Confidentiality
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it is urgent
- Suicidal thoughts, or completely refusing to eat or leave home — call 103, 112, or 150
- Outcome
- Obsessions weaken, rituals take less time, and life opens up again
What you should know
OCD is not a “love of order” or pedantry. In the disorder, intrusive thoughts cause intense anxiety, disgust, or a feeling that something is “not right,” and the person feels they must perform an action to relieve it: check again, wash their hands, count, or repeat a phrase in their head. The relief is short-lived, and rituals gradually take up more and more time. An important feature: the person usually understands that their thoughts are excessive but cannot stop them.
Many people hide OCD for years out of shame, especially when the obsessions involve themes that seem frightening or unacceptable. Such thoughts are a symptom of the disorder, not a reflection of a person’s desires or character. At Psychiatry Online, diagnosis and treatment take place over video and anonymously, which often makes it easier to talk about symptoms for the first time. The format also suits exposure therapy: exercises can be done at home, on the left or right bank, right where the rituals actually happen.
Signs and Symptoms of OCD
- intrusive thoughts about contamination, dirt, or illness that are hard to shake off
- repeatedly checking doors, the stove, the iron, or documents
- washing hands or cleaning until it feels “just right,” rather than clean
- intrusive, frightening thoughts or images that go against your values
- a need for symmetry, order, or a specific number of repetitions
- mental rituals: counting, praying, or repeating phrases to relieve anxiety
- avoiding places and objects that trigger obsessions
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 OCD
OCD is linked to dysfunction in the neural circuits that connect the frontal cortex with subcortical structures and are responsible for assessing threat and shifting from one thought to another. Heredity also plays a role. The cognitive model explains why obsessions become entrenched: a person attaches excessive importance to ordinary unpleasant thoughts (“if I thought it, it must be dangerous”), tries to suppress them, and they come back stronger.
The key maintaining mechanism is compulsions. A ritual reduces anxiety for a short time, and the brain learns that it was the ritual that prevented disaster. In this way, the “obsession — anxiety — ritual — relief” cycle grows stronger. Flare-ups often coincide with periods of stress: intense reporting periods in the civil service and offices, moving house, or the birth of a child. A long winter, when people spend more time at home, can create more opportunities for rituals.
How Online Treatment for OCD Works
At the first video consultation, the doctor asks about intrusive thoughts and rituals, how much time they take, and what you avoid. A standardized OCD severity scale is used to track progress. You can describe your symptoms in general terms if that is easier: the specialist knows that the content of obsessions can be frightening. Have headphones ready and find a place where you cannot be overheard. Exposure exercises are then carried out over video right in your home.
A neurological examination cannot be done online: if OCD appeared suddenly or comes with other neurological symptoms, the doctor will refer you for an in-person examination. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law and the requirements for an initial in-person examination. If you feel desperate or have suicidal thoughts, call 103, 112, or the 150 helpline.
How we help
Exposure and response prevention
According to international guidelines, ERP is the gold standard of psychotherapy for OCD. You gradually face situations that trigger obsessions and learn not to perform the ritual. The mechanism is habituation: anxiety rises at first and then falls on its own, without the ritual. The brain learns that no disaster happens, and the obsession loses its power.
Cognitive therapy
This involves working on the beliefs that keep OCD going: an inflated sense of responsibility, overestimating the importance of thoughts, and a need for complete certainty. You learn to treat intrusive thoughts as mental “noise” rather than a danger signal. This component is especially helpful for obsessions without visible rituals.
Medication
Clinical guidelines recommend antidepressants from certain classes as first-line medications for OCD, often combined with ERP. In OCD, the effect usually develops more slowly than in depression — it takes several weeks or months. The class of medication is decided by the psychiatrist, and medication is tapered off gradually.
Working with the family
Loved ones often unintentionally keep OCD going: they offer reassurance, take part in rituals, and help with avoidance. At Psychiatry Online, the specialist explains to the family how the disorder works and helps them adopt a stance that is supportive but does not reinforce symptoms. This makes treatment more effective and noticeably reduces tension in relationships.
Myths and facts
MythOCD is just a love of order
FactPedantry brings satisfaction, whereas OCD brings suffering. In the disorder, obsessions cause intense anxiety, and rituals take up a lot of time and get in the way of life. It is a medical condition described in ICD-10.
MythIf I have thoughts like these, I must be a bad person
FactIntrusive thoughts are a symptom of the disorder. They cause horror precisely because they go against a person’s values. People with OCD are not inclined to act on what they obsessively think about — on the contrary, they try as hard as they can to avoid it.
MythOCD can’t be treated
FactOCD is a chronic disorder, but it responds well to treatment. ERP and medication help most patients significantly reduce their symptoms and return to a full life.
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
An online appointment in Astana is first of all about privacy: no clinic visit, no waiting room. A private room and headphones are enough. Data is stored in a secure system with restricted access and does not enter any state registry without legal grounds.
Questions and answers
Can exposure therapy be done online?
Yes. Research shows that ERP delivered by video is effective for OCD. The online format even has an advantage: the exercises take place at home, where rituals most often occur, and the specialist sees the real situation and can support you in the moment.
How long does OCD treatment take?
A course of CBT with ERP usually takes 12–20 sessions, and the first changes are noticeable within a few weeks. Medication for OCD is taken for a long time — often a year or more after improvement. The exact timeline depends on the severity of symptoms and how regularly you do the exercises.
Do I have to take medication?
For mild to moderate OCD, ERP is often enough. For severe OCD or OCD combined with depression, combined treatment is recommended. The decision is made together with your doctor after diagnosis and a severity assessment using a rating scale.
How can I talk about thoughts I’m ashamed of?
Doctors who work with OCD know that obsessions can be about any topic, including frightening and unacceptable ones. You can start in general terms. The specialist will not judge you: these thoughts are a symptom, not who you are, and talking about them is the first step toward treatment.
How often are sessions needed?
CBT with ERP is usually held once a week, sometimes more often at the start. Between sessions, you do the exercises on your own. The online format means you do not miss sessions, even if you work in the Yesil district and live in Saryarka.
Is it anonymous?
Yes. Information about your consultation 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
