Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- Who leads the session
- a psychiatrist, working together with a psychotherapist when needed
- Format
- video consultations, with seasonal follow-up and preventive appointments in the fall
- Duration
- initial appointment 40–60 minutes; treatment covers the fall and winter, with prevention every year
- Anonymity
- consultations without your surname; medical confidentiality under Kazakhstan law
- When it is urgent
- suicidal thoughts or an urge to harm yourself—call 103 or 112; young people can call the 150 helpline
- Outcome
- relief from the current episode and a personal prevention plan for next winter
What you should know
Why does mood get worse in winter? The main mechanism behind seasonal depression is the shortening of daylight hours. Light reaching the retina in the morning synchronizes the body’s internal clock, controls melatonin production, and affects the serotonin system. When there is little light, these rhythms shift, melatonin is produced for longer, and people who are vulnerable develop a depressive episode. Classification systems describe this as a seasonal pattern of recurrent depression.
In a city with a sharply continental climate, this factor matters especially: the long winter, frost, strong winds, and short daylight hours limit the time people spend outdoors. Many leave for work at government agencies and offices in Yesil and Nura in the dark and come home in the dark, getting a bare minimum of natural light. An online consultation lets you start treatment in time without adding yet another trip in the dark and without putting off help until spring.
Signs of Seasonal Depression
- low mood and energy come back every year in the fall or winter
- in spring and summer, you return to normal without treatment
- you feel very sleepy and sleep longer than usual, but without feeling rested
- you have an increased appetite, crave sweets and starchy foods, and gain weight
- it is hard to get up in the morning, especially when it is still dark outside
- you lose interest in socializing and feel like “hibernating”
- your productivity drops, and by the end of winter you start to feel that nothing makes sense
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 Seasonal Depression Happens
Circadian rhythms play a key role. When there is not enough morning light, the body clock shifts relative to actual time, and the body behaves as if it were living in a different time zone. This affects sleep, energy, and mood. In addition, serotonin system activity decreases and melatonin production lasts longer. Genetic predisposition determines who develops depression from these changes and who experiences only mild sluggishness.
The farther north the region and the shorter the winter day, the more common seasonal deterioration becomes. In a freezing, windy winter, people move less, go outside less often, and cut back on social contact—all of which intensifies the episode. It is important to distinguish seasonal depression from other causes of winter fatigue, such as vitamin D deficiency, anemia, and hypothyroidism, so the doctor recommends the necessary lab tests.
How Seasonal Depression Is Treated Online
The psychiatrist asks how many years the episodes have been recurring, when they start and end, how they manifest, and whether there have been periods of elevated mood in summer. This matters: in bipolar disorder, light therapy and antidepressants require special caution. You complete depression and seasonality scales, and lab tests are recommended. The doctor then explains how to do light therapy correctly at home and draws up a plan that fits your work schedule.
Lab tests and an eye examination—which is needed before starting light therapy if you have eye disease—cannot be done online. Prescribing prescription medications depends on Kazakhstan law and the requirement for an initial in-person examination. If the depression is severe and accompanied by suicidal thoughts or refusal to eat, in-person care is required; if there is a threat to life, call 103 or 112.
How we help
Light therapy
This is the first-line treatment for seasonal depression. A special bright white light lamp of a specific intensity is used, with sessions in the morning shortly after waking up. The mechanism is shifting circadian rhythms and suppressing excess melatonin production. The doctor will advise you on the lamp specifications, the best timing and session length, and contraindications. The effect is usually noticeable within the first few weeks.
Psychotherapy
Cognitive behavioral therapy adapted for seasonal depression addresses negative thoughts about winter and reduced activity. Patients plan enjoyable and active pursuits for the dark season and learn to resist “hibernation.” Research shows that this kind of therapy can lower the risk of episodes returning in subsequent winters.
Medication
For moderate to severe seasonal depression, or when light therapy is not effective enough, antidepressants are prescribed. For people with regular severe episodes, preventive treatment started in the fall, before symptoms appear, may be an option. The choice of drug class and timing are discussed with the doctor, taking into account your history of episodes and tolerability.
Routine, light, and movement
A consistent wake-up time, walks during daylight hours even when it is overcast, a workspace near a window, and physical activity are evidence-based additions to treatment. The doctor helps you adapt them to local conditions—for example, using your lunch break for a walk along the embankment or through indoor spaces when the wind outside is strong.
Myths and facts
MythEveryone gets the winter blues—it’s not an illness
FactA mild dip in energy in winter is indeed common. But if every year the deterioration reaches the level of depression—with loss of interest, impaired ability to function, and a sense that nothing makes sense—it is a disorder that responds well to treatment.
MythTaking vitamin D is enough
FactVitamin D deficiency can increase fatigue, and it is worth checking and correcting. However, the main mechanism of seasonal depression is related to light and circadian rhythms, and the strongest evidence base is for light therapy, psychotherapy, and antidepressants.
MythLight therapy is just a bright lamp—any one will do
FactFor a therapeutic effect, the light intensity, spectrum, distance, and session timing all matter. Ordinary lamps do not provide the required intensity. In addition, the method has contraindications, so it is best to start it after consulting a doctor.
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 can I tell seasonal depression from ordinary winter fatigue?
The key signs are regularity and severity. If for several years in a row you develop a state of low mood, loss of interest, sleepiness, and reduced productivity in the fall or winter, and it all goes away in spring, that is a reason to consult a psychiatrist.
When should treatment start if the depression comes back every year?
Ideally in advance—at the beginning of fall, before the first symptoms appear. Preventive light therapy, routine adjustments, and, when indicated, preventive medication help soften or prevent an episode. A Psychiatry Online doctor can schedule a preventive appointment for September.
Can light therapy be done at home?
Yes, light therapy is usually done at home with a special lamp. The online doctor will explain which specifications matter, what time of day to do it, and how long a session lasts, and will assess any contraindications. If you have eye disease or bipolar disorder, an additional evaluation is needed before you start.
Does a trip somewhere warm and sunny help?
A temporary change of climate with longer daylight hours can improve how you feel, but the symptoms usually return once you are back. This confirms the role of light in the mechanism of the disorder. A trip can be a useful addition, but it does not replace systematic treatment.
Is the online format suitable for seasonal depression?
It is one of the best options. When you leave for work in the dark and come home in the dark, with frost and wind outside, one more trip to a clinic is a serious barrier. A video appointment from home lets you start treatment on time and not miss follow-up appointments.
Can seasonal depression happen in summer?
Yes, there is also a summer variant: the deterioration falls in summer and is more often accompanied by insomnia, reduced appetite, and anxiety. It is less common. The doctor will clarify the nature of your seasonal pattern and choose an approach accordingly, because the mechanisms and treatment of the summer variant are different.
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