Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F45
- Who leads care
- A psychiatrist and a psychotherapist, together with a general practitioner when needed
- Format
- Video consultations, review of test results, online psychotherapy
- Duration
- First appointment 50–60 minutes; a course of therapy usually takes 8–16 sessions
- Confidentiality
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it is urgent
- Acute chest pain, shortness of breath, or loss of consciousness — call 103 or 112
- Outcome
- Symptoms ease, their link to stress becomes clear, and there are fewer unnecessary tests
What you should know
Psychosomatic does not mean “it’s all in your head” or that symptoms are imaginary. Pain, nausea, palpitations, and a lump in the throat are real and tangible. The mechanism lies in the stress system’s direct influence on how organs work: through the autonomic nervous system, hormones, muscle tension, and pain perception. With chronic stress and anxiety, these mechanisms are constantly active, and physical symptoms become persistent even when the organs are healthy.
A typical patient story is many tests with different specialists, normal results, and a feeling that no one can help. At Psychiatry Online, a psychiatrist and psychotherapist work over video and look at the whole picture: what has already been ruled out, which tests are really needed, and how the symptoms relate to lifestyle and stress. This is convenient with a packed work schedule: there is no need to travel yet again to a clinic on the other bank.
Signs and Symptoms of a Psychosomatic Disorder
- physical symptoms that are not explained by test results
- abdominal pain, back pain, or headaches that get worse under stress
- digestive problems: nausea, bloating, irregular bowel movements
- palpitations, a lump in the throat, or a feeling of breathlessness with no underlying disease
- dizziness, weakness, and chronic fatigue with no apparent cause
- numerous visits to doctors of different specialties
- flare-ups linked to work, conflicts, lack of sleep, and anxiety
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 Psychosomatic Disorders
The modern model describes psychosomatic conditions in terms of the interaction between brain and body. Chronic stress keeps the autonomic nervous system and the hormonal stress system constantly activated, which affects the functioning of the gut, heart, muscles, and immune system. At the same time, the processing of signals from the body changes: the brain begins to notice and amplify sensations that previously went unnoticed — this is called central sensitization.
Symptoms are maintained by anxiety, focusing attention on the body, avoiding activity, and a cycle of repeat tests. The demanding schedules of the civil service and offices, constant deadlines, and a sedentary lifestyle increase muscle tension and disrupt sleep. A long winter, wind, and short days cut down on time outdoors and physical activity. Importantly, a psychosomatic condition does not rule out organic disease, so this is checked in parallel.
How an Online Consultation for Psychosomatic Symptoms Works
At the first video consultation, the doctor asks in detail about your symptoms, how they began and how they relate to stress, sleep, workload, and mood, and reviews the results of tests you have already had. Prepare discharge summaries, test results, and specialists’ reports — this helps avoid duplicating tests and shows what has already been ruled out. Questionnaires are used to assess anxiety, depression, and physical symptoms. At the end, you receive a clear explanation and a treatment plan.
A physical examination and instrumental diagnostics cannot be done online. If some symptoms have not yet been investigated, the doctor will refer you to a general practitioner or the relevant specialist in person — ruling out an organic cause is essential. For acute chest pain, shortness of breath, loss of consciousness, or bleeding, call 103 or 112. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law.
How we help
Explaining the mechanism
Understanding how stress and anxiety cause real physical symptoms in itself reduces fear and the focus on the body. The doctor explains the brain-body connection using your own symptoms as examples, without dismissing them. Research shows that a good explanation makes subsequent treatment more effective and reduces the number of unnecessary visits.
Cognitive behavioral therapy
CBT for somatoform disorders helps you work with catastrophic interpretations of sensations, attention to the body, and avoidance of activity. The patient gradually returns to activities they have been avoiding and learns to respond to symptoms differently. The method has a strong evidence base for functional pain and irritable bowel syndrome.
Medication
For severe anxiety, depression, or chronic pain, clinical guidelines recommend certain classes of antidepressants that affect both mood and pain perception. The class of medication and the length of treatment are decided by the psychiatrist, taking into account other health conditions and any treatment already prescribed by other doctors.
Routine, exercise, and relaxation
Regular physical activity, sleep, and relaxation techniques reduce the activation of the stress system. At Psychiatry Online, the specialist puts together a realistic plan: for example, stretching breaks if you sit at a desk all day in an office in the Yesil district, a pool or gym in winter, and breathing exercises before bed. This complements psychotherapy and speeds up recovery.
Myths and facts
MythPsychosomatic means the symptoms are made up
FactSymptoms in psychosomatic disorders are real and tangible. They are caused by real physiological processes — the activity of the autonomic nervous system, hormones, and muscles. The only difference is that the cause lies in regulation, not in organ damage.
MythIf the tests are normal, there’s nothing to treat
FactNormal tests rule out a number of organic diseases, but they do not explain the symptoms. Psychosomatic disorders require treatment, and with the right approach, symptoms ease significantly.
MythAll illnesses come from nerves
FactThis is an exaggeration. Many diseases are organic in nature and require treatment by the relevant specialists. Stress can affect the course of a disease but does not replace medical diagnosis. That is why organic causes must always be ruled out.
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
How can I tell that my symptoms are psychosomatic?
The signs are symptoms that are not explained by test results, get worse with stress and anxiety, and shift from one part of the body to another. The final determination is made by a doctor after ruling out organic causes and assessing your psychological state.
Do I need more tests?
Only those that are truly necessary. The psychiatrist reviews the tests you have already had and, if needed, recommends any that are missing. Repeat tests without a clear reason usually do not help and can increase anxiety and the focus on the body.
Which doctor treats psychosomatic disorders?
A psychiatrist and psychotherapist work with the psychological mechanisms behind the symptoms, while a general practitioner and the relevant specialists rule out organic causes. Coordination between them gives the best results. An online consultation helps put this plan together.
How long does treatment take?
A CBT course usually takes 8–16 sessions, and the first improvements are often noticeable within a few weeks. If medication is prescribed, it is taken for several months. The timeline depends on how long you have had symptoms and on any accompanying anxiety or depression.
Will sedatives help?
Sedatives can temporarily reduce tension, but they do not treat a psychosomatic disorder. The foundation of treatment is psychotherapy and, when needed, medications with proven effectiveness, chosen by the doctor after diagnosis.
Is it confidential?
Yes. Information about your consultation is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” 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
