Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F34.1
- Who provides care
- A psychiatrist and a psychotherapist; a general practitioner or endocrinologist consultation if needed
- Format
- Video consultations and online psychotherapy sessions; in-person visits for lab tests and examination when indicated
- Duration
- Initial appointment about 50 minutes; a course of treatment usually lasts from several months to a year or longer
- Confidentiality
- Medical confidentiality under the laws of the Republic of Kazakhstan; consultations are never disclosed to your workplace or school
- When it is urgent
- Sudden deterioration, thoughts of death or self-harm — call 103, 112 or the 150 helpline
- Outcome
- Better mood and energy, renewed interest in life, and skills to prevent relapses
What you should know
Dysthymia is coded F34.1 in ICD-10 and belongs to the chronic mood (affective) disorders; in DSM-5 a closely related condition is called persistent depressive disorder. It is characterized by constant low mood, poor self-esteem, fatigue and pessimism, which people often mistake for their own personality. Because it starts gradually and its symptoms are moderate, the disorder often goes undiagnosed and untreated for years.
At Psychiatry Online, dysthymia is treated mainly through video consultations with a psychiatrist and a psychotherapist. The online format suits this condition well: there are usually no severe acute symptoms, while psychotherapy and follow-up require regularity that is easier to maintain without travel. An online psychiatrist consultation in Zhezkazgan helps distinguish dysthymia from a depressive episode, bipolar disorder and physical causes of low mood.
Signs and Symptoms of Dysthymia
- low mood on most days for two years or longer
- constant tiredness and lack of energy even after adequate rest
- low self-esteem and a sense of personal inadequacy
- a pessimistic outlook on the future and feelings of hopelessness
- difficulty concentrating and making decisions
- changes in sleep and appetite — either decreased or increased
- a feeling that low mood is part of your character rather than a condition
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 Dysthymia
Dysthymia develops when several factors combine. A hereditary predisposition to mood disorders, features of neurotransmitter regulation and personality traits — such as a tendency toward self-criticism and heightened sensitivity to failure — all play a role. The risk is higher in people with chronic physical illnesses and in those who have already had anxiety disorders or episodes of depression.
External factors include prolonged stress, adverse childhood experiences, long-running conflicts, social isolation and chronic overload. Low mood can be sustained by alcohol misuse, as well as by thyroid dysfunction and other endocrine disorders. That is why it is important to rule out physical causes of the symptoms before making a diagnosis.
How Online Treatment for Dysthymia Works
The first video appointment is a detailed conversation: the doctor asks how long the symptoms have lasted, how they affect your work and relationships, whether there have been depressive or hypomanic episodes, and about any other medical conditions. Standardized depression rating scales are used. You will need a device with a camera, a stable internet connection and a private room. Prepare a list of the medications you take and, if available, recent blood test results in advance.
Lab tests and a physical examination, which are needed to rule out anemia, thyroid dysfunction and other physical causes, cannot be done online — they are carried out 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 thoughts of death appear or your condition suddenly gets worse, you need in-person help; call 103 or 112.
How we help
Psychotherapy
Evidence-based approaches include cognitive behavioral therapy, interpersonal psychotherapy and the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), which was developed specifically for chronic depression. Therapy addresses persistent negative beliefs, avoidance patterns and difficulties in relationships. Psychotherapy is delivered online, usually weekly, over a course of several months.
Medication
When indicated, the doctor may recommend antidepressants; their effect is assessed after several weeks of treatment. According to clinical guidelines, combining psychotherapy and medication for chronic mood disorders is often more effective than either method alone. Choosing, stopping or switching a medication is done only by the doctor.
Behavioral Activation
This method aims to gradually bring back meaningful and enjoyable activities that the person has given up because of low mood. An activity plan is drawn up, and the link between actions and mood is tracked. Behavioral activation works well online: assignments are done at home and the results are discussed during the video session.
Lifestyle Changes
A regular sleep schedule, moderate physical activity, limiting alcohol and maintaining social contacts complement the main treatment. These measures do not replace therapy, but they make it more effective and reduce the risk of setbacks. The doctor helps you choose realistic steps that take your current energy level and workload into account.
Myths and facts
MythDysthymia is just a bad personality
FactDysthymia is a diagnosable disorder with established criteria in ICD-10 and ICD-11. Because the symptoms last so long, people come to see them as part of who they are, yet with treatment mood and energy are restored in many cases.
MythIf it is not severe depression, it does not need treatment
FactThe chronic course of dysthymia lowers quality of life and the ability to work, and raises the risk of a major depressive episode developing on top of it. International guidelines call for active treatment rather than simply waiting for things to improve.
MythOnline psychotherapy is less effective than in-person therapy
FactResearch shows that video sessions and face-to-face meetings are comparably effective for depressive and anxiety disorders, provided the sessions are structured and regular. The key conditions are a private setting and a stable connection.
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 Zhezkazgan
| 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 Zhezkazgan: same-day video appointments and two branches for in-person visits — 65 Esenberlina St., office 30, Zhezkazgan and 81 Gagarina St., office 20, Zhezkazgan. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Ulytau Region, starting online is usually easiest.
Confidential and private
An online appointment in Zhezkazgan 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 dysthymia different from depression?
In a major depressive episode, the symptoms are more severe and last at least two weeks. Dysthymia is milder but chronic — two years or longer. Sometimes a depressive episode develops on top of dysthymia; this combination is called double depression and is treated with both conditions in mind.
Can dysthymia be treated entirely online?
Most of the work — the diagnostic interview, psychotherapy and monitoring of progress — is done by video call. In person, you will need lab tests to rule out physical causes, as well as an examination if the rules for prescribing certain medications require it. The doctor will explain which steps are needed in your case.
How long does treatment take?
The first changes with psychotherapy and medication are usually noticed after a few weeks, and a lasting result develops over months. Because the disorder is chronic, a maintenance phase is recommended after improvement to reduce the risk of symptoms returning.
Are antidepressants needed for dysthymia?
Not always. In mild cases, treatment often starts with psychotherapy; if the course is more severe or the effect is insufficient, medication support is discussed. The decision is made by the doctor together with the patient, weighing the benefits, possible side effects and the person’s preferences.
What should I do if I have thoughts of death?
This is a reason to seek help immediately, without waiting for a scheduled appointment. Call 103 or 112; the 150 helpline is available for children and young people. Once the condition has stabilized, treatment continues with a psychiatrist, in person if necessary.
How is confidentiality protected?
An online psychiatrist consultation in Zhezkazgan takes place over a secure channel, and information about the patient is protected by medical confidentiality. It may be disclosed only in cases expressly provided for by the laws of the Republic of Kazakhstan. Your contact with Psychiatry Online is not reported to your employer or school.
Where can I be seen in Zhezkazgan?
Online — from anywhere in the city or region. In person — at two branches: 65 Esenberlina St., office 30, Zhezkazgan and 81 Gagarina St., office 20, Zhezkazgan. 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