Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F40.1
- Who leads care
- A psychiatrist and a CBT psychotherapist
- Format
- Video consultations, CBT sessions, behavioral experiments
- Duration
- First appointment 50 minutes; a CBT course usually takes 12–16 sessions
- Confidentiality
- Medical confidentiality; you can start without turning on your camera
- When it is urgent
- Despair or isolation with suicidal thoughts — call 103, 112, or 150
- Outcome
- Fear of judgment fades, and socializing, presentations, and career growth return
What you should know
Social anxiety is more than shyness. A shy person may feel awkward in a new group but copes. In social anxiety disorder, the fear of negative evaluation is so strong that a person worries for weeks in advance about an upcoming presentation, avoids meetings, phone calls, and office parties, and after a conversation keeps replaying what they said wrong. The body reacts with blushing, trembling, and sweating, and this in turn becomes a reason for new fear.
Many people go years without seeking help, because the appointment with a doctor is itself a social situation. The online format lowers this barrier: at Psychiatry Online, you start treatment from home, you do not have to turn on your camera right away, and you can choose a convenient time. This is especially important for people who work in government agencies and offices, where public speaking and meetings are part of the job and avoidance directly holds back their career and growth.
Signs and Symptoms of Social Anxiety
- intense fear of public speaking, meetings, presentations, and questions in front of others
- fear of seeming stupid, awkward, or boring in conversation
- blushing, trembling, sweating, or a shaky voice in front of others
- avoiding phone calls, office parties, meeting new people, and new teams
- worrying for a long time before an event and replaying the conversation afterward
- difficulty eating, writing, or working while someone is watching
- using alcohol to “loosen up” before socializing
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 Social Anxiety
Social anxiety disorder usually begins in adolescence and is linked to a combination of temperament (behavioral inhibition), heredity, and experience — criticism, bullying, or presentations that went badly. The cognitive model explains why the fear persists: in a social situation, attention turns inward, to one’s own sensations and an image of how one looks from the outside, and the person judges how they come across by their anxiety rather than by other people’s reactions.
Social anxiety is maintained by avoidance and “safety behaviors”: memorized phrases, avoiding eye contact, and trying to end a conversation quickly. These prevent the person from discovering that no disaster happens. A work environment with frequent meetings, public reporting, and a strict hierarchy, typical of the civil service and large offices, can intensify the fear of judgment. A long winter, when there are fewer reasons to meet up, encourages isolation.
How Online Treatment for Social Anxiety Works
At the first video consultation, the doctor asks which situations cause fear, how long this has been going on, what you do to reduce it, and how it affects your work and relationships. Social anxiety rating scales are used. If turning on your camera is hard, you can start with audio only — this is normal and does not get in the way of treatment. Have headphones ready and find a place where you cannot be overheard. The online appointment itself gradually becomes the first step of exposure.
Many situations can be practiced online, but some behavioral experiments take place in real life: talking to a colleague, asking a shop assistant a question, or speaking up in a meeting. These are assignments between sessions, not a reason for an in-person visit. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law. If isolation is accompanied by suicidal thoughts, call 103, 112, or the 150 helpline.
How we help
Cognitive therapy for social anxiety
International guidelines name individual CBT as the first-line treatment. The specialist helps you see how self-focus and safety behaviors keep the fear going. Using video feedback, you compare how you feel you look with how you actually look. The difference is often considerable and reduces anxiety.
Behavioral experiments
Instead of arguing with anxious predictions, you test them through experience. For example, you ask a question in a meeting without a prepared phrase and see what actually happens. Experiments are planned gradually, from easy to hard, and discussed at the next session to consolidate the new experience.
Medication
For severe social anxiety, clinical guidelines recommend antidepressants from certain classes, especially when psychotherapy is unavailable or not sufficient. For situational symptoms, such as before a presentation, the doctor may discuss other options. The class of medication and the length of treatment are decided by the psychiatrist.
Attention and communication skills
Attention training helps you shift focus from yourself to the other person and the task at hand, which reduces anxiety. If needed, the specialist practices with you how to start a conversation, give a presentation, and answer questions. At Psychiatry Online, exercises are tailored to your real situation: a report to management, a job interview, or a new team.
Myths and facts
MythIt’s just shyness — it will pass on its own
FactShyness does not get in the way of life, whereas social anxiety leads to avoidance and reduces quality of life and career opportunities. Without treatment, it often persists for years and may be accompanied by depression.
MythEveryone will notice how nervous I am
FactResearch shows that people with social anxiety overestimate how visible their nervousness is. Others see much less than it seems from the inside and usually judge more kindly.
MythYou just need to force yourself to socialize more
FactWithout shifting your focus of attention and dropping safety behaviors, socializing “through gritted teeth” often only confirms the fear. Gradual exposure with a specialist’s support and a review of each experience is more effective.
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
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 is social anxiety different from introversion?
An introvert prefers quiet socializing and recharges alone but does not feel an intense fear of being judged. In social anxiety disorder, a person wants to connect with others but is afraid and avoids it. It is a disorder that can be treated, whereas introversion is a personality trait.
Can social anxiety be treated online if I’m afraid even of video calls?
Yes. You can start with audio or chat and then gradually turn on your camera. This is already part of therapy. Many patients say that the online format helped them seek help for the first time after avoiding it for years out of fear of an in-person visit.
How long does treatment take?
A CBT course usually takes 12–16 sessions, and the first changes are noticeable within a few weeks. Medication, if needed, is continued for several months after improvement to lower the risk of symptoms returning. The doctor will clarify the timeline after diagnosis.
Does alcohol help with anxiety?
Alcohol temporarily reduces anxiety, but it does not treat it and prevents you from gaining new experience. Over time, there is a risk of dependence, and anxiety the next day is often worse. If you notice that you drink before socializing, it is worth discussing with your doctor.
How often are sessions needed?
Usually once a week. Between sessions, you carry out behavioral experiments in real life: at work in the Yesil district, at a store in Baikonur, or when meeting friends. The online format means you do not miss sessions because of the weather or your schedule.
Is it confidential?
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
