Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F41.0
- Who provides care
- A psychiatrist and a psychotherapist; a general practitioner or cardiologist if needed
- Format
- Video consultations and online CBT sessions; ECG and lab tests in person on referral
- Duration
- Initial appointment about 60 minutes; a CBT course usually takes 10–16 sessions
- Confidentiality
- Medical confidentiality under the laws of the Republic of Kazakhstan, secure communication channel
- When it is urgent
- First-time chest pain, shortness of breath, fainting, weakness in the arms or legs — call 103 or 112
- Outcome
- Fewer and milder attacks, less fear of them, and a return to your usual activities
What you should know
Panic disorder is coded F41.0 in ICD-10. It is based on recurrent unexpected panic attacks followed by persistent worry about new attacks or changes in behavior, such as avoiding places where an attack has already happened. Isolated panic attacks can also occur in other conditions — phobias, post-traumatic stress disorder, depression — so a single attack does not in itself mean a person has panic disorder.
At Psychiatry Online, panic attacks are treated by psychiatrists and psychotherapists via video call. The online format is convenient for people who avoid travel and public places for fear of an attack: treatment can start from home. A video appointment with a psychiatrist in Lisakovsk helps you understand what exactly happens during the attacks, which tests are needed to rule out physical causes and which treatment method suits your specific case.
What a Panic Attack Feels Like: Signs and Symptoms
- sudden intense fear or a sense of impending doom
- a racing or pounding heart, a feeling that the heart is skipping beats
- shortness of breath, a choking sensation or a lump in the throat
- dizziness, trembling, sweating, hot flashes or chills
- numbness or tingling in the hands, a sense that things are unreal
- fear of losing control, going crazy or dying during an attack
- avoiding public transport, shops and other places for fear of another attack
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.
Causes of Panic Attacks
Panic disorder is linked to heightened sensitivity to bodily sensations and a tendency to interpret them as dangerous. A normal bodily reaction — a faster pulse or breathing — is perceived as a sign of threat, which intensifies fear and physical arousal. This creates a vicious circle. A hereditary predisposition and the way the systems that regulate the response to danger function also play a role.
The first attack often occurs against a background of prolonged stress, lack of sleep, exhaustion, after an illness or major life changes. Attacks can be triggered by caffeine, nicotine, alcohol and alcohol withdrawal, stimulants and certain medications. Similar symptoms can be caused by heart rhythm disorders, hyperthyroidism, hypoglycemia and asthma, so it is important to rule out physical causes before making a diagnosis.
How Online Treatment for Panic Attacks Works
During the video appointment, the doctor asks in detail about the first and subsequent attacks, how long they lasted, the physical symptoms, the situations in which they occur, and about sleep and your use of caffeine, alcohol and medications. The extent of avoidance is assessed. It helps to write down a few recent episodes in advance and have the results of any previous tests ready. You will need a device with a camera, a stable internet connection and a private room.
An ECG, blood pressure measurement, lab tests and the examination needed to rule out heart, endocrine and lung causes cannot be done online — this is done in person. Whether prescription medications can be prescribed depends on the legislation of the Republic of Kazakhstan and the requirement for an initial examination. If the symptoms have appeared for the first time, especially chest pain, shortness of breath or fainting, an emergency must be ruled out first: call 103 or 112.
How we help
Cognitive Behavioral Therapy
CBT is the first-line treatment for panic disorder. Patients learn how an attack works, learn to interpret bodily sensations in a new way, and gradually stop avoiding situations. A course of 10–16 sessions is delivered online and includes homework, a panic diary and exercises between sessions.
Interoceptive Exposure
This is part of CBT in which, under a psychotherapist’s guidance, sensations similar to the symptoms of an attack — such as rapid breathing or dizziness — are safely brought on. Repetition reduces the fear of these sensations. The exercises are chosen individually, taking your health into account, and can be done during a video session.
Medication
For severe and frequent attacks, or when psychotherapy is not effective enough, the doctor may recommend antidepressants used for the long-term treatment of panic disorder. Sedatives that carry a risk of dependence are used sparingly. Choosing a medication, monitoring tolerability and stopping it is done only by the doctor.
Overcoming Avoidance
Gradual exposure to situations the person has started to avoid — public transport, shops, trips — restores freedom of movement. A step-by-step plan is drawn up with the psychotherapist, and the results are discussed during video sessions. This reduces the risk of developing agoraphobia, consolidates the effect of treatment and lowers the likelihood of relapse.
Myths and facts
MythYou can die from a panic attack
FactA panic attack is extremely unpleasant, but in itself it is not life-threatening for a healthy person and passes within minutes. However, first-time chest pain or shortness of breath requires ruling out a physical cause, which is why an initial medical assessment matters.
MythOnly a sedative in your pocket will help
FactThe habit of always carrying a sedative keeps the fear of an attack going and can lead to dependence. CBT is considered the first-line treatment because it removes the mechanism behind the attacks rather than just relieving symptoms.
MythAvoiding situations means fewer attacks
FactAvoidance brings short-term relief, but over time it narrows the range of places you can go and intensifies fear. Gradually returning to avoided situations under a psychotherapist’s guidance is a key part of treatment.
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 Lisakovsk
| 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 Lisakovsk: same-day video appointments and two branches for in-person visits — 189 Abaya St., Lisakovsk and 142 Mira St., Lisakovsk. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Kostanay Region, starting online is usually easiest.
Confidential and private
An online appointment in Lisakovsk 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 a panic attack from a heart attack?
You cannot do this on your own, especially during the first episode. If you have chest pain, shortness of breath, weakness or fainting, call 103 or 112. Once physical causes have been ruled out in person, recurrent attacks with a typical pattern are treated by a psychiatrist and a psychotherapist.
What should I do during an attack?
It helps to remind yourself that the attack will pass within a few minutes, to slow down your breathing, to focus on objects around you and not to try to run away. A specific action plan is drawn up with the psychotherapist. If the symptoms are unusual for you or keep getting worse, call an ambulance.
Can panic attacks be treated entirely online?
CBT, follow-up and treatment adjustments are successfully carried out by video call. In person, you will only need an initial examination to rule out physical causes and, in some cases, an examination for prescribing medication. After that, the course can continue remotely.
How long does treatment last?
With regular CBT, a noticeable reduction in attacks usually comes within 2–4 months. If medication is used, it is generally continued for several months after improvement. The timeframe depends on how long the disorder has lasted and how severe the avoidance is.
Will the attacks come back after treatment?
There is a risk of relapse, especially during periods of severe stress. The skills learned in CBT allow you to recognize the start of a problem quickly and cope with it. If symptoms return, you can book a maintenance video consultation at Psychiatry Online without a long wait.
Is an online consultation anonymous?
A video appointment with a psychiatrist in Lisakovsk takes place over a secure channel, and information about the patient is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” Disclosure is allowed only in cases expressly provided for by law. You can give just the name you would like to be called.
Where can I be seen in Lisakovsk?
Online — from anywhere in the city or region. In person — at two branches: 189 Abaya St., Lisakovsk and 142 Mira St., Lisakovsk. 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
