Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F31
- Who provides care
- a psychiatrist (a medical doctor) handles diagnosis and medication treatment; a psychotherapist helps with daily routine, early warning signs, and relationships
- Format
- in-person appointments in Almaty, online follow-up, a psychiatrist home visit during a relapse, and inpatient care for a severe phase
- Duration
- an acute phase takes weeks to months to stabilize; maintenance treatment usually lasts for years
- Confidentiality
- medical confidentiality and anonymous treatment with no registration with the state psychoneurological dispensary (PND) registry
- When it is urgent
- mania with dangerous behavior, delusions, hearing voices, or suicidal thoughts: call 103 or 112
- Outcome
- fewer and milder relapses, stable sleep and mood, and a clear action plan for the patient and family
What to know
In the practice of an Almaty psychiatrist, bipolar disorder often goes unrecognized for a long time. A person comes in with depression and is prescribed an antidepressant, and a few weeks later they are suddenly sleeping three hours a night, launching five projects at once, taking out a car loan, writing code all night, or driving around the city. Relatives say, "He's become a different person." Or the opposite happens: for years the family believed their son simply had an "explosive temper" and lazy spells, and only after a serious episode involving a fight, debts, or a car accident does anyone ask about a diagnosis.
Bipolar affective disorder (F31 under ICD-10) is a chronic condition in which episodes of depression alternate with episodes of mania or hypomania, with periods of stable mood possible in between. It is not just the "mood swings" everyone has. Treatment is long-term and requires regular follow-up, but many people with bipolar disorder work, study, and raise children. Acute mania with dangerous behavior, psychotic symptoms, or suicidal thoughts during a depressive phase are reasons to call 103 or 112 and to be treated in a hospital.
Signs That May Point to Bipolar Disorder
- periods of depression alternate with weeks of unusually high energy and mood
- during a "high" you sleep 3–4 hours a night and don't feel tired
- rapid speech, a flood of ideas, and many new plans at the same time
- impulsive spending, loans, risky trips, or reckless decisions
- irritability and a short temper that you didn't have before
- an antidepressant brought not relief but sudden agitation and insomnia
- relatives have had similar episodes or have died by suicide
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
What Causes Bipolar Disorder and What Triggers Relapses
Bipolar disorder has a strong biological basis: heredity plays a major role, and close relatives of a person with bipolar disorder are at higher risk. First episodes usually appear between ages 15 and 30, often during university years or early in a career. That is exactly why we often see a first episode in students who have moved to Almaty to study or in young professionals starting their first demanding job. The cause is not upbringing or character.
Relapses are triggered by specific things, and it is important to know them. Lack of sleep is one of the main triggers: late-night deadlines, flights, time zone changes, working nights with overseas clients. Others include alcohol and psychoactive substances, stopping medication on your own, severe stress, and childbirth. Relapses are more common in spring and autumn. Knowing your triggers is the foundation of prevention, and this is taught as part of treatment.
How Bipolar Disorder Is Treated
Diagnosis begins with a detailed conversation about every episode in your life, not just the current one: when the highs and lows happened, how you slept, and what was going on. Input from relatives is very helpful, because a person in hypomania often does not notice the changes. The psychiatrist rules out physical causes and the effects of substances. Treatment is then selected, and lab tests are ordered to monitor safety. After that come regular appointments, some of them online, with tracking of mood and sleep.
Treating acute mania at home is not safe if the person has not slept for several days, is spending large sums of money, is driving at high speed, is aggressive, or is saying strange things. This is a reason for hospital treatment; if there is any danger, call 103 or 112. A depressive phase with suicidal thoughts is also an emergency. Involuntary hospitalization of an adult is possible only on the grounds set out in the law of the Republic of Kazakhstan and by a court decision.
How we help
Mood Stabilizers
The foundation of bipolar disorder treatment is mood-stabilizing medication. These drugs reduce the frequency and severity of both manic and depressive episodes. Some of them require regular monitoring of blood levels and of kidney and thyroid function. The psychiatrist chooses the medication based on which episodes predominate, any coexisting conditions, and plans for pregnancy. Stopping medication on your own is one of the main causes of relapse.
Other Medication Groups
Certain antipsychotics are also used for mania, mixed states, and relapse prevention. In bipolar disorder, antidepressants are used with caution and only together with a mood stabilizer, because on their own they can trigger a switch into mania. All medications are taken only as prescribed by a doctor, with regular monitoring of their effect and side effects.
Psychoeducation and Daily Routine
NICE guidelines emphasize the role of psychoeducation: the patient and family learn how to recognize early signs of a relapse, why regular sleep matters, and how to keep a mood diary. A stable sleep-wake schedule is one of the most effective preventive measures. A psychotherapist helps organize daily routine, work, and relationships.
Family Work and a Crisis Plan
A Akalam psychiatrist works with the patient and loved ones to draw up a written plan: which signs signal a worsening, whom to call, what to do with bank cards and the car during a high, when to request a doctor's home visit, and when to call 103. A plan made during a calm period helps everyone act quickly and without conflict.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythBipolar disorder is just sharp mood swings
FactOrdinary mood swings last hours and are linked to events. In bipolar disorder, episodes last days and weeks, change sleep, energy, behavior, and thinking, and meet ICD-10 criteria. That is why the diagnosis is made by a psychiatrist after an examination.
MythPeople feel good during mania, so why treat it?
FactHypomania can feel like a surge of energy, but mania often leads to debts, conflicts, and accidents, and it is usually followed by severe depression. Treatment protects against the consequences of both phases.
MythOnce you feel better, you can stop the medication
FactA stable mood is the result of treatment, not a reason to stop it. Stopping mood stabilizers on your own is a common cause of a new episode. Any change to the treatment plan should be made only together with your doctor.
Prices: Bipolar disorder treatment
| Bipolar disorder treatment | 25 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
How is bipolar disorder different from depression?
With depression, there are only lows. With bipolar disorder, the person has also had periods of highs: less sleep without fatigue, lots of energy, plans, and spending. People often do not see these as a problem. That is why the psychiatrist asks in detail about your whole history and, if possible, talks with relatives. The choice of treatment depends on it.
Will I need treatment for life?
Bipolar disorder is a chronic condition, and maintenance treatment usually continues for years to prevent new episodes. However, the regimen, dosing, and frequency of visits change over time. Many people with bipolar disorder go years without a relapse. Decisions to scale back treatment are made only together with a psychiatrist.
Can I get pregnant if I have bipolar disorder?
Yes, but pregnancy should be planned in advance with your psychiatrist: some mood stabilizers are not recommended during pregnancy, and the risk of relapse rises after childbirth. The doctor will help choose a safer regimen and put together a monitoring plan. Do not stop your medication on your own when you find out you are pregnant; call your doctor right away.
What should relatives do when mania begins?
Don't argue or mock; speak calmly. If possible, limit access to bank cards and the car, as agreed in the plan. Contact the psychiatrist as early as possible and request a home visit if the person agrees. For dangerous behavior, aggression, or delusions, call 103 or 112. Relatives cannot take a person to the hospital by force.
Can I work and study with bipolar disorder?
Yes. Many Akalam patients work in IT and business or study at university. It is important to take certain things into account: avoid constant night shifts and flights without keeping your routine under control, and let your doctor know about exams and deadlines. The psychiatrist will help choose a regimen that interferes with work as little as possible.
Does online follow-up help with bipolar disorder?
Yes, online monitoring is convenient during the maintenance stage: the doctor reviews your mood and sleep diary and how well you tolerate the medication. However, blood tests are done in person, and signs of a relapse call for an in-person examination or a psychiatrist home visit. Acute mania cannot be treated online.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy