Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F41.0
- Who carries it out
- a psychiatrist handles diagnosis and medication; a psychotherapist provides CBT for panic disorder
- Format
- in-person appointments at the clinic, online consultations, and a psychiatrist home visit if fear makes it impossible to go out
- Duration
- a noticeable reduction in attacks usually within 1–3 months; the full course takes several months
- Confidentiality
- medical confidentiality, anonymous treatment with no psychiatric registry entry
- When it is urgent
- a first attack with chest pain, loss of consciousness, or shortness of breath at rest: call 103 or 112
- Outcome
- attacks become rare or stop, and the person drives, works, and travels again
What to know
For people in Almaty, the first panic attack often happens in the car: a traffic jam on Al-Farabi Avenue, heat, cars all around, and suddenly the heart starts pounding, there isn't enough air, the hands go numb, and terror sets in. The person calls an ambulance or drives to the emergency department, where they do an ECG and say the heart is fine. A week later, the attack happens again in the metro, on an escalator in a shopping mall, or in a high-rise elevator. Gradually, the person stops driving around the city, avoids trips to the mountains, and becomes afraid of being alone.
Panic disorder (F41.0 under ICD-10) consists of recurring panic attacks that come without any real danger, along with fear of the next attack. An attack itself usually lasts 10–30 minutes and is not life-threatening, although it feels like a catastrophe. Important: a first episode with chest pain, especially in someone over 40 with risk factors, is a reason to call 103 and rule out a heart attack. Once the heart has been checked, treating panic disorder is the job of a psychiatrist and a psychotherapist.
Symptoms of Panic Attacks
- a sudden attack of fear with a pounding heart, peaking within a few minutes
- a feeling of not getting enough air, a lump in the throat, pressure in the chest
- dizziness, trembling, numbness in the hands, waves of heat or chills
- fear of dying, losing control, or going crazy during the attack
- avoiding traffic jams, the metro, elevators, shopping malls, and trips out of town
- constant anxiety while waiting for the next attack, even at home
- repeated ambulance calls and medical tests that find no illness
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
Why Panic Attacks Happen
A panic attack is a false alarm of the fight-or-flight system. The body reacts to a safe situation as if life were in danger: a surge of adrenaline, rapid breathing, a pounding heart. Predisposing factors include heredity, heightened sensitivity to bodily sensations, prolonged stress, lack of sleep, and overwork. Common triggers are coffee and energy drinks, hangovers, stopping sedatives, and a recent illness. The first attack often happens against a background of exhaustion.
What entrenches the disorder is not the attack itself but what happens afterward. The person starts listening to their heart, avoiding places where they felt bad, carrying pills, and not going out alone. Avoidance brings relief but narrows life: first you can't drive on the Eastern Bypass, then you can't go to the mountains, then to the office. Treatment aims to break this cycle, not just to stop an individual attack.
How Panic Attacks Are Treated
First, physical causes are ruled out: an ECG, blood tests, thyroid hormones, and, if needed, a cardiologist consultation. If you already have test results, you can send them online in advance. At the appointment, the psychiatrist goes through the attacks in detail: where they happen, how often, what precedes them, and what the person does. The doctor then explains how panic works and draws up a plan. The first-line treatment according to NICE is CBT; for frequent attacks or at the patient's preference, medication is added. Follow-ups take place every 2–4 weeks and are convenient by video.
Do not diagnose yourself with panic disorder without tests if the attacks first appeared after age 40, come with chest pain on exertion, loss of consciousness, or neurological symptoms. In that case, call 103 first and rule out a heart or neurological cause. Taking tranquilizers on your own, bought at a pharmacy or obtained from friends, is dangerous: dependence develops quickly. If you have suicidal thoughts, call 103 or 112 immediately.
How we help
Explaining how panic works
Understanding what happens in the body during an attack already reduces fear. The doctor explains why a pounding heart and breathlessness are not dangerous, and why the feeling “I'm about to die” is a symptom, not reality. This is not a way of brushing the problem aside but the basis of all further treatment: once a person understands the mechanism, it is easier for them to ride out an attack rather than fight it.
CBT for panic disorder
This method has the strongest evidence base. The psychotherapist teaches breathing techniques and ways of working with catastrophic thoughts, and then, together with the patient, gradually brings back avoided situations: car trips, elevators, traffic jams, the mountains. A course usually takes 12–16 sessions. CBT itself is described in detail on a separate page; what matters here is that it is combined with treatment by a psychiatrist.
Medication treatment
For frequent attacks, coexisting depression, or at the patient's preference, the psychiatrist selects medication. The mainstay is certain classes of antidepressants that reduce the frequency of attacks; the effect develops over several weeks. Anxiolytics are sometimes prescribed for a short course and strictly as directed. All of this happens only after an examination, with no self-adjustment of doses.
An action plan for attacks
Together with the patient, a Akalam psychiatrist draws up a specific plan: what to do in the car, at the office, or on the street, how to breathe, when to call the doctor, and when to call 103. Relatives are told how to help: don't panic along with the person, don't call an ambulance for every attack once the heart has been checked, and don't encourage avoidance.
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
MythYou can die during a panic attack
FactA panic attack itself is not life-threatening, although that is exactly how it feels. This is why it is important to rule out heart and other physical causes once: after that, panic disorder can be treated calmly.
MythYou should always carry a pill with you
FactThe habit of keeping a pill at hand sustains fear and often leads to dependence on tranquilizers. Treatment is built on skills, and medication, if needed, is taken according to the doctor's plan.
MythIf you avoid traffic jams and the metro, there will be no attacks
FactAvoidance temporarily reduces anxiety but expands the list of “dangerous” places. Within a few months, the person is afraid of more and more. Treatment helps you return to a normal life rather than narrow it.
Prices: Panic attack treatment
| Panic attack 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 a panic attack from a heart attack?
It is hard to tell by sensations alone, so a first episode with chest pain, especially after 40 and with risk factors, is a reason to call 103 and get an ECG. A panic attack usually peaks within a few minutes, passes in 10–30 minutes, and comes with fear. If your heart has already been checked and the attacks keep recurring, it is time to see a psychiatrist.
What should I do during an attack?
Sit down or stop; if you are driving, pull over to the side of the road. Breathe slowly: a short inhale, a long exhale. Remind yourself that this is panic and it will pass. Don't flee the situation if it is safe to stay. It is best to practice specific techniques with your doctor in advance. If you have any doubts about your heart, call 103.
How long does panic attack treatment take?
The first changes are usually noticeable within a few weeks, and attacks become less frequent within 1–3 months. CBT takes 12–16 sessions, and medication is continued for several months after improvement. The timeline depends on how long the attacks have been going on and how many situations the person already avoids.
Can panic attacks be treated without pills?
Yes. According to NICE guidelines, CBT is the first-line treatment and is often sufficient. Medication is considered for frequent and severe attacks, coexisting depression, or when psychotherapy is not available. The decision is made together with your doctor, and you have a choice.
Can I fly or travel to the mountains if I have panic attacks?
During treatment, gradually returning to such situations is part of the therapy, but it is better to do this according to a plan rather than forcing yourself. A Akalam doctor will suggest where to start. While medication is being adjusted, if it causes drowsiness, it is better not to drive or take on difficult mountain roads.
Can teenagers or students have panic attacks?
Yes, the first attacks often appear between the ages of 18 and 25 — for example, before exams or after moving to Almaty to study. Teenagers are seen with their parents involved. If a young person is in crisis and thinking about suicide, call 112; the 150 helpline is available for children and young people.
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