Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F31
- Who provides it
- A psychiatrist manages treatment; a psychotherapist joins for psychoeducation and family work
- Format
- In-person appointments in Almaty and Astana, home visits, online follow-up; inpatient care for severe mania or depression
- Duration
- Bringing an episode under control takes from several weeks to 2–3 months; maintenance treatment takes years
- Confidentiality
- Anonymous paid treatment, medical confidentiality, no entry in the state dispensary registry
- When it is urgent
- Severe mania with dangerous behavior, psychotic symptoms, suicidal thoughts — call 103 or 112 immediately
- Outcome
- Stable remission, fewer and milder episodes, and the ability to recognize early warning signs and act in time
What to know
Bipolar disorder is often not recognized right away. A person may be treated for depression for years, while the periods when they slept three hours a night, made grandiose plans, spent a lot of money and were unusually energetic were never considered part of an illness — on the contrary, relatives remember them as “the good times.” Yet it is precisely these highs that distinguish bipolar disorder from ordinary depression, and they determine which treatment will help and which may cause harm. That is why I always ask in detail about past episodes.
Bipolar disorder is a chronic condition, but it is possible to live a full life with it: to work, study and start a family. The key is properly selected maintenance therapy, an understanding of your own early warning signs, and a stable routine. On this page I explain how the diagnosis is made, how mania, hypomania and mixed states differ, which groups of medications are used, why psychoeducation is just as important as pills, and when inpatient care is necessary during an episode.
Signs That May Point to Bipolar Disorder
- periods of low mood alternate with periods of an unusual surge of energy
- during a high, the person sleeps little but does not feel tired for several days
- rapid speech, a flood of ideas, difficulty sitting still and finishing tasks
- risky spending, decisions or trips that the person later regrets
- irritability and conflicts that are unusual for this person
- depression keeps coming back, and antidepressants cause sharp agitation
- there is a family history of bipolar disorder, depression or 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 Is Known About the Causes of Bipolar Disorder
Bipolar disorder has a strong hereditary component: the risk is higher if parents, brothers or sisters have had it. However, what is inherited is a predisposition, not the illness itself. Episodes are set off by triggers: disrupted sleep, jet lag, severe stress, the postpartum period, alcohol and drug use, and sometimes taking antidepressants without a mood stabilizer. That is why a stable sleep schedule is an important part of treatment for people with this disorder.
There is bipolar I disorder, with full manic episodes, and bipolar II disorder, in which the highs are milder (hypomania) and depression predominates. There are also mixed states, in which agitation and despair occur at the same time — these are especially dangerous in terms of suicide risk. The psychiatrist also rules out other causes of elevated mood: thyroid disease, the effects of substances, and neurological conditions.
How Bipolar Disorder Is Treated
At the first consultation, the psychiatrist takes a detailed history: all episodes of depression and elevated mood, how long they lasted, sleep, use of medications and substances, and family history. An account from relatives helps a great deal. Tests are ordered, including thyroid, kidney and liver function and an ECG — this is necessary for choosing medication safely. The doctor then explains the diagnosis and proposes a treatment regimen and a follow-up schedule, including laboratory monitoring.
Outpatient treatment is not possible in severe mania, when the person does not sleep, does dangerous things and is not aware of their condition, or with psychotic symptoms or severe depression with suicidal thoughts. In these cases, inpatient care is needed, and if there is an immediate threat, call 103 or 112. Hospitalization is voluntary; without consent it is only possible by court order under the procedure established by the law of the Republic of Kazakhstan.
How we help
Mood stabilizers and other medications
The foundation of treatment is mood stabilizers. In mania and mixed states, they are combined with antipsychotics; in depression, medications are chosen that do not trigger a switch into mania. As a rule, antidepressants are not prescribed for bipolar disorder without a mood stabilizer. Many medications require regular blood test monitoring, so it is important to stick to the visit schedule. Everything is taken only as prescribed by a psychiatrist.
Psychoeducation
The patient and their family learn how the illness works, what its triggers and early warning signs are: sleeping less, speeding up of speech, unusual plans, irritability or, on the contrary, growing apathy. Together with the doctor, a personal action plan is drawn up: whom to call, when to increase monitoring, and how to protect finances during a high. According to international guidelines, psychoeducation reduces the frequency of relapses.
Routine and lifestyle
Regular sleep is the main protective factor. It is important to go to bed and get up at the same time, avoid night shifts and frequent flights across time zones, and, if possible, give up alcohol and any psychoactive substances. A mood diary and sleep-tracking apps help. The Akalam psychotherapist helps build a stable daily rhythm without turning life into a set of prohibitions.
Working with the family
Relatives are often the first to notice the start of an episode, but they do not know how to react: argue, try to persuade, or stay silent. Family sessions with the doctor help agree in advance on what to do at the first signs, how to talk without blame, and when to call the doctor or 103. This reduces tension at home and helps intervene earlier, before the episode fully develops.
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 just means frequent mood swings
FactOrdinary mood changes during the day are not bipolar disorder. It involves episodes lasting days, weeks or months that change sleep, energy, thinking and behavior. The diagnosis is made by a psychiatrist using clear criteria after a thorough assessment.
MythOnce remission has been reached, medication can be stopped
FactStopping maintenance therapy is one of the main causes of repeat episodes, and stopping certain mood stabilizers abruptly is especially dangerous. Only the doctor, together with the patient, decides to reduce the dose — gradually and under supervision.
MythPeople with bipolar disorder can’t work or have a family
FactMany people with bipolar disorder work, study and raise children successfully. This requires stable treatment, a routine, and an action plan for early warning signs. Pregnancy planning should be discussed with a psychiatrist in advance so that a safe treatment regimen can be chosen.
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 can bipolar disorder be told apart from depression?
The key difference is a history of elevated episodes: periods when the person slept little without feeling tired and was unusually active, talkative and impulsive. Patients themselves often do not see these as a problem, so the psychiatrist also asks relatives. The choice of treatment depends on getting the diagnosis right.
How many years do I need to take medication?
Bipolar disorder requires long-term maintenance treatment, often for many years. The duration depends on the number and severity of episodes, the response to therapy, and life circumstances. Decisions to reduce or stop medication are made together with the psychiatrist, gradually and taking the risk of relapse into account.
What should relatives do if mania is starting?
Do not argue or try to change the person’s mind. Calmly remind them of the agreements in the plan, suggest contacting the treating doctor, and if possible limit access to large sums of money. If the person has not slept for several days, is behaving dangerously, or hears voices, call 103 or 112.
Can follow-up be done online?
Yes, follow-up visits work well online when the condition is stable. However, tests for medication monitoring must be done regularly in person, and if an episode begins, the doctor may suggest an in-person appointment or a home visit. Akalam patients from different cities in Kazakhstan often combine both formats.
Is it dangerous to drink alcohol with bipolar disorder?
Alcohol disrupts sleep, triggers episodes, worsens depression and impulsivity, and does not mix well with many medications. People with bipolar disorder are more likely to run into problems with alcohol use. It is best to give up alcohol completely and discuss this topic openly with your doctor.
Is bipolar disorder inherited?
What is inherited is a predisposition, not the illness itself: children have a higher-than-average risk, but most children of people with bipolar disorder do not develop it. It is important to know the early warning signs and, if they appear in a teenager, to see a psychiatrist without delay.
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