Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F41.0
- Who provides it
- A psychiatrist makes the diagnosis and prescribes treatment; a psychotherapist provides CBT
- Format
- In-person appointments in Almaty and Astana, online CBT and follow-up; a home visit if the person is afraid to go out
- Duration
- A CBT course of 10–16 sessions, fewer attacks after 4–8 weeks, maintenance treatment for 6 months or longer
- Confidentiality
- Anonymous, medical confidentiality, no entry in the state dispensary registry
- When it is urgent
- Chest pain, shortness of breath or fainting for the first time, especially in people over 40 — call 103 immediately
- Outcome
- Attacks become rarer and milder or stop, the fear of the next attack fades, and freedom of movement returns
What to know
Many of my patients first come to us after calling an ambulance several times. The attack starts suddenly: the heart pounds, there is not enough air, the hands go numb, and it feels as if a heart attack, fainting or losing one’s mind is about to happen. After 10–20 minutes everything passes, the ambulance doctors say the heart is fine, and the person is left confused and afraid. That is a panic attack. In itself, this state is not life-threatening, but living with it is very hard.
When attacks keep coming back and the person starts to fear the next one and avoids the metro, public transport, shops and trips, we are talking about panic disorder. It can and should be treated, and the outlook is usually good. Below I explain how we tell panic apart from heart disease, what to do during an attack, which treatments work best, and how long it takes. For constant background anxiety without attacks, see the page on anxiety disorder.
Signs of Panic Attacks
- a sudden attack of intense fear that peaks within a few minutes
- a racing heart, a feeling that your heart is about to stop
- shortness of breath, a lump in the throat, a sense of choking and tightness
- dizziness, trembling, sweating, numbness in the hands and lips
- a sense that things are unreal, fear of going crazy or dying
- constantly waiting for the next attack between episodes
- avoiding public transport, crowds, trips, and places where an attack has happened
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 the body’s false alarm: the system responsible for the “fight or flight” response goes off without any real threat. The first attack often happens against a background of exhaustion, lack of sleep, stress, illness, too much caffeine, or after drinking alcohol or using other substances. The person is frightened by the physical sensations, their attention to them grows, and soon the heartbeat itself is perceived as a danger signal. This is how a vicious circle of fear forms.
Before talking about panic disorder, heart rhythm disorders, thyroid disease, asthma, hypoglycemia and medication side effects must be ruled out. That is why the psychiatrist orders an ECG, blood tests and sometimes 24-hour Holter monitoring. Panic attacks also occur in other conditions: depression, post-traumatic stress disorder, and alcohol withdrawal. This matters for choosing the right treatment.
How Panic Attacks Are Treated
The first step is a psychiatrist consultation. The doctor asks in detail about the attacks: when they started, how often they occur, what triggers them, and what you do to prevent them. An ECG and blood tests are ordered. Then the doctor explains how panic works — this alone reduces fear. Next comes CBT: we learn to understand physical sensations and to give up avoidance and safety behaviors. If attacks are frequent, the doctor adds medication. Follow-up sessions can be held online.
During an attack, it is important to remember: a panic attack does not kill. But if chest pain, shortness of breath or fainting occurs for the first time, especially in a person over 40, or someone with high blood pressure or heart disease, call 103 first — a heart problem must be ruled out. If panic comes together with suicidal thoughts or severe depression, call 103 or 112 and discuss inpatient care with your doctor.
How we help
Psychoeducation
First, the doctor explains what happens in the body during an attack: why the pulse speeds up, where the dizziness and numbness come from, and why it feels as if there is not enough air. Once the person understands the mechanism, the sensations stop seeming like a deadly threat. This is the foundation for all further work. It is also useful for relatives to know how to behave during an attack: calmly, without panic, and without calling an ambulance every time.
Cognitive behavioral therapy
CBT is the first-line treatment recommended by NICE and the APA. The psychotherapist helps change catastrophic thoughts about physical sensations and gradually give up avoidance and safety behaviors — always carrying pills or water, checking your pulse. Interoceptive exposure is used: safely bringing on sensations similar to panic so that the brain stops fearing them. A course consists of 10–16 sessions.
Medication
For frequent and severe attacks, the psychiatrist prescribes antidepressants, which reduce how often attacks occur when taken regularly. The effect builds up over several weeks. Tranquilizers are sometimes used as a short course at the start of treatment, only as prescribed by a doctor, because of the risk of dependence. Medication is combined with CBT: this reduces the risk of attacks returning after medication is stopped.
Self-help skills
The Akalam psychotherapist teaches techniques that help you ride out an attack: slow breathing with a longer exhale, grounding through the senses, and learning not to fight the sensations but to observe them. Sleep, limiting caffeine and energy drinks, and avoiding alcohol also matter. These skills do not replace treatment, but they give a sense of control.
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 or go crazy from a panic attack
FactA panic attack is very unpleasant, but in itself it is not life-threatening and does not turn into psychosis. The racing heart and shortness of breath are the nervous system’s reaction to a false threat. However, if chest pain occurs for the first time, a heart problem must be ruled out by calling 103.
MythYou should wait out attacks at home and not go out until they pass
FactAvoidance brings relief only at first; then it narrows your life and reinforces fear. Treatment is built on gradually returning to the situations the person avoids. This is done step by step, together with a psychotherapist.
MythPanic is always a sign of heart disease
FactMost people with panic attacks have a healthy heart, as an ECG and tests confirm. That is exactly why it is important to get checked once and then treat the panic, rather than endlessly going from one cardiologist to another.
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
What should I do during an attack?
Remind yourself that this is a panic attack and it will pass in a few minutes. Breathe slowly, making the exhale longer than the inhale. Focus on what you see and hear around you. Do not flee the situation if it is safe to stay. If chest pain appears for the first time or is very different from your usual attacks, call 103.
Can panic attacks be cured completely?
For many people, after a course of CBT and, if needed, medication, the attacks stop or become rare and mild. Sometimes they return under severe stress, but by then the person knows how to cope with them. An honest doctor cannot promise “forever,” but the outlook is usually good.
Will over-the-counter sedatives help?
Herbal sedatives may slightly reduce tension, but they do not treat panic disorder. Prescription tranquilizers taken without a doctor’s supervision carry a risk of dependence. It is better to discuss full treatment with a psychiatrist — CBT and, if needed, suitable medication.
I’m afraid to leave the house. How can I see a doctor?
You can start with an online consultation with a psychiatrist or psychotherapist: it is a first step without travel or crowds. In Almaty and Astana, a Akalam doctor can visit you at home. Then, as part of CBT, you will gradually return to traveling and going outside, together with your psychotherapist.
Are panic attacks linked to alcohol?
Yes, quite often. Alcohol temporarily reduces anxiety, but during withdrawal the nervous system becomes overexcited and attacks become more frequent. Panic attacks can also follow energy drinks or other substances. Tell your doctor the truth about your use: this helps choose safe treatment.
How is panic disorder different from anxiety disorder?
In panic disorder, the main features are sudden attacks of intense fear and the fear of them recurring. In generalized anxiety disorder, it is constant background worry about many things without sudden attacks. Sometimes the two occur together. A psychiatrist will help tell them apart and choose treatment.
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