Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F32
- Who carries it out
- a psychiatrist makes the diagnosis and prescribes treatment; a psychotherapist provides psychotherapy
- Format
- in-person appointments in Almaty, psychiatrist home visits for severe conditions, online follow-up; inpatient care when indicated
- Duration
- response to an antidepressant takes 2–6 weeks; after improvement, maintenance therapy continues for at least 6 months
- Confidentiality
- medical confidentiality, anonymous treatment with no registration at the state psychoneurological dispensary
- When it is urgent
- suicidal thoughts, refusal of food and water, or complete immobility: call 103 or 112
- Outcome
- restored sleep, energy, interest, and ability to work; a plan to prevent future episodes
What to know
In an Almaty psychiatrist's practice, depression follows a recognizable seasonal pattern: from November to February, when smog settles over the city and the sun barely breaks through the gray haze over the bowl between the mountains, noticeably more people seek help. They don't complain of “sadness” but of waking up exhausted, being unable to make themselves go to the office, no longer answering friends, and lying in the evening with their phone, drained of energy. Many are sure it's just big-city fatigue and will pass after a vacation. Sometimes that's true, but if the state lasts for weeks, it is a reason to see a doctor.
Under ICD-10, depression is a depressive episode (F32) or recurrent depressive disorder (F33) of mild, moderate, or severe degree. It is not a character weakness or laziness. Treatment is chosen according to severity: for a mild episode, NICE guidelines often recommend starting with psychotherapy and routine changes; for moderate and severe episodes, with a combination of antidepressants and psychotherapy. If a person talks about death, stops eating and drinking, or doesn't get out of bed, this is a severe condition that needs urgent help; if there is a threat to life, call 103 or 112.
Signs of Depression That Warrant Seeing a Psychiatrist
- low mood for most of the day, nearly every day, for more than two weeks
- loss of interest in things that used to bring joy: friends, hobbies, the mountains, trips
- constant fatigue, with even simple tasks requiring enormous effort
- early waking at 4–5 a.m. with heavy thoughts about yourself and the future
- changes in appetite and weight without dieting or any obvious illness
- feelings of guilt and worthlessness, thoughts like “everyone would be better off without me”
- trouble concentrating, with everything falling apart at work
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 Depression and Why You Can't Just “Pull Yourself Together”
Depression arises from a combination of biology, stress, and circumstances: a hereditary predisposition, differences in neurotransmitter function, hormonal changes after childbirth or with age, chronic illnesses, and certain medications. Against this background, stress becomes the trigger: divorce, job loss, moving, or a loved one's illness. In Almaty, we often see depression after prolonged overwork in IT specialists and managers, and in students who have come from the regions and ended up on their own.
Willpower does not help here, because depression impairs the very ability to feel pleasure and find energy. Advice like “go to the mountains” or “take up sports” is useful as part of treatment, but it does not replace it. It is also important that depression is sometimes masked by other problems: alcohol “to relax,” insomnia, back and stomach pain, irritability. The doctor will work out what is primary and rule out hypothyroidism, anemia, and other physical causes.
How a Psychiatrist Treats Depression
The first step is a psychiatric consultation: in person, at home, or online. The doctor asks about symptoms, how long they have lasted, and previous episodes, and checks whether there have been periods of unusually elevated mood so as not to miss bipolar disorder. Tests are ordered if needed. The doctor then explains the diagnosis and proposes a plan. If antidepressants are prescribed, there is a follow-up in 2–4 weeks to check the effect, side effects, and sleep. A psychotherapist joins in at the same time. You can send discharge summaries and your medication list online in advance.
Outpatient treatment is not suitable if there are active suicidal thoughts with a plan, if the person refuses food and water, if delusions of guilt or voices have appeared, or if depression is combined with heavy binge drinking. These cases require inpatient care, and if there is a threat to life, call 103 or 112. Never start or abruptly stop antidepressants on your own: this increases the risk of deterioration and discontinuation syndrome.
How we help
Antidepressants
The foundation of medication treatment for moderate and severe depression. There are several classes of drugs with different mechanisms and side-effect profiles; the doctor chooses taking into account age, illnesses, other medications, work, and pregnancy plans. The effect builds gradually, and in the first weeks there may be side effects that usually pass. They are not addictive in the sense used in addiction medicine, but they must be stopped gradually, following the doctor's plan.
Psychotherapy
Cognitive behavioral therapy (CBT) and interpersonal therapy are methods with a strong evidence base for depression, according to NICE and APA guidelines. They help people recognize automatic negative thoughts, regain activity, and work through conflicts. For mild depression, psychotherapy can be the main treatment; for more severe depression, it is combined with medication. The methods themselves are described in detail on the psychotherapy pages.
Adjusting routine and activity
Sleep, light, and movement are not just tips but part of the treatment protocol. The doctor will help you build a routine: a fixed wake-up time, daylight in the morning — especially in winter, when the city is covered in smog — and measured physical activity, such as walks on Kok-Tobe or in the First President's Park. You start small, with no demands to “run five kilometers.”
Maintenance therapy and prevention
After improvement, treatment continues for at least 6 months to reduce the risk of relapse; after repeated episodes, longer. Together with you, a Akalam psychiatrist draws up a plan: which early signs signal a deterioration, what to do, and when to call. Medication is only ever stopped gradually and in agreement with the doctor.
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
MythAntidepressants change your personality
FactA correctly chosen antidepressant does not make a person someone else; it restores their ability to feel and act. If you notice a sense of emotional blunting, that is a reason to discuss changing the regimen with your doctor.
MythDepression is just a bad mood
FactDepression is a disorder with specific ICD-10 criteria that affects sleep, appetite, thinking, and the body. A bad mood passes within days, while an untreated depressive episode can last for months.
MythOnce you start taking pills, you'll have to take them for life
FactAfter a single episode, most people take medication for 6–12 months and then gradually stop. Long-term therapy is needed when episodes recur frequently, and that decision is made together with the doctor.
Prices: Depression treatment
| Depression treatment | 20 000 ₸ |
| 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 can I tell whether it's depression and not just fatigue?
Fatigue goes away after rest and weekends. Depression persists even after a vacation and comes with loss of interest, disturbed sleep, feelings of guilt, and sometimes thoughts of death. If the state lasts longer than two weeks and gets in the way of work or study, it is worth consulting a psychiatrist. An online test can give you a hint, but it does not replace an examination.
How long does depression treatment take?
The first improvements on antidepressants usually become noticeable within 2–6 weeks, with full recovery taking several months. After that, treatment continues for at least six months to consolidate the result. Psychotherapy typically takes 12–20 sessions or more. The exact timeline depends on severity and on whether this is a first or a repeat episode.
Can depression be treated without pills?
For mild depression, often yes: psychotherapy, routine, and physical activity. For moderate and severe depression, NICE and WHO recommendations suggest combining medication and psychotherapy, because the result is more reliable that way. The decision is made together with your doctor, and you are free to discuss any option.
Can I drink alcohol during treatment?
It is not recommended. Alcohol itself worsens mood and sleep, reduces the effectiveness of antidepressants, and intensifies their side effects. If getting through an evening without alcohol is hard, tell your doctor: it is an important part of the picture, and it can be treated, with an addiction physician involved if needed.
What should I do if a loved one talks about death?
Take it seriously; do not argue or shame them. Ask directly whether they are thinking about suicide and whether they have a plan. Do not leave them alone, and remove dangerous objects and medications. If there is a real threat, call 103 or 112. If there is no immediate danger, arrange a consultation with a Akalam psychiatrist as soon as possible; a home visit is an option.
Does treatment help with depression after childbirth?
Yes. Postpartum depression is a common and well-studied condition. The psychiatrist chooses treatment with breastfeeding in mind: there are psychotherapeutic methods and medications that are compatible with nursing. The key is not to endure it but to seek help early, especially if you have disturbing thoughts about your baby.
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