Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- Who conducts it
- a psychiatrist and a psychotherapist
- Format
- video consultations, online psychotherapy, and follow-up
- Duration
- first changes after several weeks; a course lasts months
- Anonymity
- confidential, under the rules of medical confidentiality
- When it's urgent
- suicidal thoughts, panic with physical symptoms of unclear origin — call 103 or 112
- Outcome
- reduced anxiety, improved mood, and relapse prevention
What you should know
Depression and anxiety are closely linked: according to clinical research, a substantial share of people with a depressive episode have pronounced anxiety symptoms. The DSM-5 classification provides the specifier “with anxious distress” for this, and ICD-11 has a qualifier for prominent anxiety symptoms in a depressive episode. Separately, ICD-10 includes mixed anxiety and depressive disorder for conditions in which neither syndrome reaches full severity.
Anxious depression is clinically significant: it usually runs a more severe course, is more often accompanied by insomnia and physical complaints, responds less well to standard treatment, and is associated with a higher risk of suicidal thoughts. That is why it is important not only to recognize depression but also to assess how severe the anxiety is. Online treatment for anxious depression in Zharkent lets you see your doctor more often and adjust treatment more quickly.
Signs of Anxious Depression
- depressed mood combined with constant inner tension
- restlessness — it is hard to sit still, and you feel the need to keep moving
- worry about the future and a sense that something bad will happen for no clear reason
- fear of losing control over yourself, your reactions, or the situation
- difficulty falling asleep because of a flood of anxious thoughts
- a racing heart, a lump in the throat, muscle tension, digestive problems
- irritability and an inability to tolerate uncertainty
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 Depression Occurs Together With Anxiety
Depression and anxiety disorders share biological mechanisms: disruptions in the serotonin, norepinephrine, and other neurotransmitter systems, an overactive stress-response axis, and inherited predisposition. That is why they often occur together or one after the other: prolonged anxiety is exhausting and leads to depression, while depression intensifies worry and a sense of helplessness.
Triggers include chronic stress, uncertainty, financial and work difficulties, illness in loved ones, and lack of sleep. Excessive caffeine and alcohol and abrupt discontinuation of sedatives can intensify the anxiety component. Psychological traits matter too: perfectionism, an excessive sense of responsibility, and difficulty expressing emotions. These factors are taken into account when the treatment plan is drawn up.
How Online Treatment Works
At the first video consultation, the psychiatrist assesses the severity of depressive and anxiety symptoms using standardized scales and asks about your history of episodes, panic attacks, use of alcohol and sedatives, and physical illnesses. The plan usually includes psychotherapy and, when indicated, medication. Before the appointment, it helps to note when the anxiety is worse, what intensifies it, and how your sleep changes. You need a stable connection and a private place.
Anxiety often shows up as physical symptoms — a racing heart, chest pain, shortness of breath. If such symptoms are new or getting worse, they require an in-person examination to rule out physical causes; for acute chest pain, call 103 or 112. For suicidal thoughts, also call 103 or 112, and young people can call 150. Prescribing prescription medications is governed by the laws of the Republic of Kazakhstan.
How we help
Cognitive behavioral therapy
CBT works on depressive and anxiety mechanisms at the same time: it teaches you to recognize catastrophizing thoughts, reduce avoidance, and gradually return to activity. Its effectiveness for combined depression and anxiety is supported by research, and the remote format is just as effective as in-person sessions. A course includes homework assignments and regular sessions.
Medication
Antidepressants with proven effects on both depression and anxiety are used. Anxiety sometimes increases temporarily at the start of treatment, so medication is introduced cautiously and with close monitoring. Medications with a sedative effect are used sparingly and only for short courses because of the risk of dependence. The specific choice is made by the doctor.
Self-regulation techniques
Breathing exercises, progressive muscle relaxation, and mindfulness practices help reduce physical tension and lower the intensity of anxiety. They are easy to learn during video sessions and to practice daily. They complement the main treatment but do not replace it when symptoms are pronounced. Practicing regularly matters more than practicing for long periods.
Follow-up and prevention
In anxious depression, it is especially important to assess progress and tolerability often, because the risk of stopping treatment too early is higher. Online treatment for anxious depression at Psychiatry Online includes regular contact with the doctor, an action plan for when things get worse, and gradual discontinuation of treatment after sustained remission.
Myths and facts
MythAnxiety in depression is just a personality trait
FactPronounced anxiety as part of depression is a clinical symptom that affects severity and prognosis. It can be treated, and taking it into account when choosing methods makes treatment more effective and safer.
MythSedatives will solve the problem
FactSedatives temporarily reduce anxiety but do not treat depression, and with long-term use they lead to dependence. The foundation of treatment is antidepressants and psychotherapy under a doctor's supervision.
MythIf your heart is pounding, it must be anxiety
FactPhysical symptoms are often linked to anxiety, but new chest pain, shortness of breath, or heart rhythm problems require an in-person examination to rule out physical illness. For acute chest pain, call 103 or 112.
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 Zharkent
| 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 Zharkent online or at one of two branches: 186 Yuldasheva St., Zharkent, 171 Golovatskogo St., office 38, Zharkent. 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 Zharkent 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 is anxious depression different from an anxiety disorder?
In an anxiety disorder, worry is the leading symptom and mood may remain intact. In anxious depression, low mood and loss of interest come to the fore, and anxiety intensifies them. The distinction determines the choice of treatment, which is why a psychiatrist's assessment is important.
Why can anxiety get worse at the start of treatment?
Some antidepressants cause a temporary increase in anxiety during the first days. The doctor takes this into account when choosing a regimen, gives advice, and monitors the patient more closely in the early period. Do not stop treatment on your own — tell your doctor how you are feeling.
Does online psychotherapy help with severe anxiety?
Yes, many people with anxiety feel calmer at home. CBT and self-regulation techniques can be learned effectively over video. For panic attacks, the psychotherapist helps you reduce avoidance and fear step by step. Online treatment for anxious depression in Zharkent is also available in the evening.
Can I drink coffee and alcohol with anxious depression?
Caffeine can increase anxiety and disrupt sleep. Alcohol relaxes you briefly but then intensifies both anxiety and depression, and it interacts with medications. It is usually recommended to limit caffeine and avoid alcohol during treatment.
How soon will I feel better?
Some self-regulation techniques bring relief within the first few days. The effects of medication and psychotherapy build up over several weeks. Giving your doctor regular feedback helps find the right approach faster.
Do I need a heart checkup if I have anxiety?
If physical symptoms are new, have become stronger, or have changed, it is sensible to have an in-person examination by a primary care physician or cardiologist. Treatment for anxious depression in Zharkent takes the results into account so that physical causes are ruled out and you can focus calmly on your mental health.
Where can I be seen in Zharkent?
Online — from anywhere in the city or region. In person — at two branches: 186 Yuldasheva St., Zharkent and 171 Golovatskogo St., office 38, Zharkent. 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
