Gloom, reluctance, malaise - depression is a disease. You are not alone with it. How to deal with it, whether and when to go to a psychologist, how to find one - on the Day for Fighting with Depression we ask a psychologist dr Agata Rudnik, the director of the Academic Psychological Support Centre at the University of Gdańsk.

- Elżbieta Michalak-Witkowska: What do the latest statistics say about depression? Is the number of mental disorders still growing dramatically? Or is there any light at the end of the tunnel?

- Dr Agata Rudnik: The prognoses are not very optimistic. The World Health Organisation predicts that within the next few years depression will be the most common illness. Currently, in the world, the number of sufferers is over 350 million and in Europe nearly 85 million. Officially, about 1.5 million people in Poland suffer from it, which is three times the number of inhabitants of Gdańsk! Some patients, although experiencing symptoms, do not report to a specialist and do not obtain a diagnosis. It is estimated that up to 10 % of Polish women and men struggle with depression. It is diagnosed twice as often in women than in men, and people aged 20-40 years old most often come to doctors' offices with its symptoms. We already know, and the research confirms this, that the pandemic has exacerbated the problem. Taking into account the political, social and economic situation in the world, the enormous pressure under which we live, I am afraid that the WHO's forecasts may come true.

- What are the main symptoms of depression and how do you distinguish them from exhaustion or blue devils?

- Depression is not sadness, it is definitely something more. Sadness is an emotion, a signal that we have lost something important for us. It makes us stop and think about what really matters to us, it makes us reflect and each of us experiences it with more or less intensity. Meanwhile, depression consists of a whole range of symptoms, not only lowered mood but also, among others, lack of energy and motivation, feeling of hopelessness, being worthless, anxiety, isolation from other people, lack of hope, problems with making decisions, inability to experience pleasure. According to the American Psychiatric Association's classification, these symptoms must last for at least two weeks to be diagnosed. Let's remember that depression has different faces and can occur at different levels of severity. Moreover, it is a fatal disease and suicide is one of the leading causes of death among teenagers.

Depression is accompanied by many myths and stereotypes. One of them is the conviction that people struggling with depression do not smile, while it is not uncommon for this smile to be a mask, allowing us to function in everyday life. Another myth is that it is not a disease, but just laziness and it is enough to say 'get a grip, go for a walk' and everything will return to normal. It won't if the person doesn't get the right help. The fact that taking care of mental health is still a taboo subject, because 'I have to cope', but what does 'cope' really mean? Seeking the help of a psychotherapist is not a sign of weakness, but of great strength and the fact that we are fighting for ourselves. It is worth talking about it and emphasising it because the statistics indicating that depression is diagnosed more often in women partly stems from the fact that men seek help less frequently.

- How to support ill people? Is a psychologist always a good decision?

- What we can do for a person who is beginning to experience symptoms of illness is to notice that something bad is happening. Talking and showing interest is great support. Here it is important to remember that it is not our job to take on the role of therapist. Let's not take on too much, because we can quickly burn ourselves out, and then we will no longer be able to help in any way, we simply won't have the strength to do so. Professional help is needed here, but it is worthwhile for us to support our loved ones in the therapeutic process, including, for example, helping them to find appropriate contacts, and providing a sense of security and an atmosphere of trust.

- Please tell us how to find the right psychologist for oneself? Sometimes people ask their friends for a contact, ask for a recommendation, but I don't think that's the right way. Is the search for a psychologist already the first stage of therapy?

- Therapy is a process, unfortunately, there is no magic spell that will make the troublesome symptoms of depression disappear at the touch of a wand. Before we start the process, it's worth considering what we really expect, what we'd like to achieve, what may be the most difficult for us. This is an important stage and a lot of work to be done.

Finding the right professional is indeed a challenge. I avoid recommending any particular person because this is a very individual issue. Some people may find it great to work with a particular psychologist, while others may not. Certainly, one way is to read opinions on Internet platforms and forums. Let's find out in which stream the psychotherapy is conducted, read more about it, to consider whether it will work best in our case. More and more centres offer a short, free consultation, which allows you to get an initial idea.

- How can you tell if you have found the right psychotherapist?

- First of all, we must feel comfortable and safe. During psychotherapy, the person working with us should treat us with respect, listen to us carefully, respond to our needs and answer our questions. It is worth asking ourselves questions: am I accepted unconditionally? Can I express myself freely? What should worry us is promising rapid improvement without much effort, and coming up with far-reaching conclusions that we don't agree with at all.

- When we last spoke about the AKWP, we brought up the subject of queues and long waiting times to see a psychologist. Has anything changed since then in terms of access to psychotherapeutic help?

The queues are still long, but we must remember that there is no regionalisation. When you receive a referral for psychotherapy (and here it's worth knowing that it can also be written by a family doctor, not just a psychiatrist), check the available appointments in different places. Even if you have to wait several months in one clinic, it may turn out that there is a vacancy for another week.

Do not be afraid of online therapy. At the beginning of the pandemic, many people decided to stop the therapeutic process because they were afraid that a conversation via skype or other platforms would not replace the one in real life. Meanwhile, research shows that virtual collaboration with a therapist can be just as effective. I've heard many times from patients that, even though they weren't convinced at the beginning, they forgot during the first meeting that they weren't talking to the therapist face to face. Some people also said that they felt safer in their own chair and that it was easier for them to open up.

- Psychotherapist versus psychiatrist? What are the differences?

- The main difference is the type of help they can provide. A psychiatrist is a doctor and has completed a specialisation, and can write prescriptions, issue sick leave and referrals to a hospital. In their work, they diagnose and treat mental disorders. However, not every psychiatrist or psychologist can conduct psychotherapy. Here, it is necessary to have completed a specialist school and to be certified as a psychotherapist.

- Where else, apart from psychologists' offices, can people with depression look for help?

- In principle, various initiatives throughout Poland support our mental health. If we experience difficult situations, we can always go to a crisis intervention centre, often such places operate round the clock. There are also helplines and even internet chat rooms that work well with children and young people. Thanks to the fact that today there is more and more talk about mental health, we have more and more opportunities to get support when we feel that it is really difficult. This gives us hope.

- Thank you for the interview