Clinical or major depression is not just a bad day. It is a common and serious mental health issue whose effect on people cannot be minimized. It goes on and on, all day, every day; at least for several weeks, often for months or even longer. All of a person’s “get up and go” gets up and leaves. People with major depression have serious problems motivating themselves, even minor things like brushing their teeth or taking a shower can feel like climbing a mountain. Sleep and appetite are often disturbed; people stop being interested in things they ordinarily like to do, isolate themselves, and even have trouble feeling enjoyment or excitement. It can be hard to concentrate, and memory can go downhill. Libido, or sex drive, drops off. In more extreme cases, people can feel like life is no longer worth living, can wish they would just die, or even have thoughts about killing themselves. The greatest danger is that some of these people may actually attempt or succeed in killing themselves. Major depression must be taken seriously.

If you suspect that someone you know or love has major depression, you may feel like you don’t know how to help them. In fact, there are many things that you can do, but it’s also important to realize that there may be limitations as well.

The most important thing that you can do is stay connected. Depressed people often isolate themselves, not because they no longer like their friends or relatives, but because it feels too difficult for them to be around people, or because they feel so badly about themselves. So just calling, texting, going over and spending time with them, telling them how much you care for them can mean a lot. Even if they have stopped reaching out to you, don’t stop reaching out to them.

Try to let them talk about how they feel without judging or trying to fix it for them. Although there are probably no words that you have that are powerful or magical enough that they would cure them of their depression, your presence and your words can be a great comfort. Remember though, if you try to tell them why things “really aren’t all that bad” or “think of everything you have going for you” you will be out of sync with how they feel and might wind up making them feel even more lonely and misunderstood–even though you are sincerely trying to help. It may seem counterproductive or paradoxical, but acknowledging how much pain they are in, how difficult things are for them, may be a comfort for them. One of the first things they teach you when you learn to be a therapist, is to empathize with people’s negative feelings and not to try to “cheer them up.”

Sometimes it’s not about words. Just a hug, or a hand on the shoulder can mean a lot to a depressed person. “I love you” may work better than a long speech.

If you can, get them moving. Take them out for a walk, or go somewhere that they enjoy. Exercise, fresh air and sunshine can go a long way. Try not to get frustrated if they refuse, though. Losing motivation is one of the central, if not the central, problems in depression. They may look healthy, like there is no reason why they can’t get up off the sofa and take a walk on the beach, but they may feel invisible emotional heavinesses that may make it psychologically impossible. But don’t give up either. “All right, but I’ll be back in a few days and we’ll go get a cup of coffee.”

It may feel wrong or very uncomfortable to ask if there having any thoughts about suicide or wishing that they would just die, but it’s really important to ask about this. I guarantee you are not putting any ideas in their head by bringing this up. And it might just save a life, the life of someone that you care about.

All of the above can be helpful, but it is very possible that by doing these things you can only make the person feel somewhat better, not really eliminate the problem. Major depression, if it has many of the above symptoms, can become a chemical, biological state, one that unfortunately often does not get cured by exercise, friendship, or love. If it’s been going on for long enough, if it’s more than mild in severity, it’s probably a good idea to suggest that they get some professional help. They could start with a therapist or someone who can prescribe medications (a psychiatrist or psychiatric nurse practitioner); a good professional will know whether therapy, medications, or both is the best course of action. The most important thing is to get the person across the threshold of someone’s consulting room.

This is all the more essential if they are having some level of suicidal thoughts. Therapists are used to assessing degrees of suicidality in a way that laypeople are not, so my recommendation is that you err on the side of caution. If you think there is even a 1% chance that your friend or loved one is going to try to kill themselves, your safest bet is to bring them to an emergency room and let a professional make the assessment. If you really think that they are acutely suicidal, and are refusing to get help, call 911. This may feel aggressive, maybe they’ll be angry at you, but in reality it is a noble act of love and friendship. The last thing anyone wants is to not act and then the unimaginable happens.

Your depressed friend or relative needs you. You can help mitigate their suffering, even if you cannot cure them. And you can certainly put them on the right track towards being well again.