Many of us have experienced times when we felt down or blue. Sometimes it’s for no apparent reason, and sometimes it’s because something difficult or painful has occurred in our lives.

For most of us, these feelings last only a day or two and are a totally natural part of living our lives. However, in some cases the feelings become intense and do not last for days but weeks, or even longer. In those cases, a person may be experiencing major depression.

Major depression occurs in about 15 million Americans every year. It is the second-leading cause of disability for young- and middle-aged adults. Many people are now familiar with the symptoms. Persistent sadness and hopelessness. Frequent crying spells. Increased irritability. Weight loss and poor concentration. Excessive guilt. Preoccupation with death and dying. Thoughts of suicide.

I remember when I began to fully appreciate the long road faced by those struggling with depression. My first full-time job as a psychologist was in a day treatment program which served people transitioning out of the hospital back to their homes.

One of the first people I treated was Sheryl, a middle-aged woman with major depression. It wasn’t entirely clear what triggered her depression. She had started some medicine that sometimes has a side effect of causing depression. A few years earlier she had been divorced, and she was in a new relationship. Her self-esteem was only fair. Yet, it didn’t all quite fall together to her or to me.

After a few weeks in the day treatment program Sheryl was somewhat better, but she wasn’t really her old self – at least from what she told me. Nonetheless, she left the program and started seeing a counselor once a week. About six months later, I heard that she was back in the hospital. She had tried to take her own life. My heart sank.

A few weeks later I saw her outside the hospital at a picnic table. I stopped to ask what had happened. We talked for a half-hour as she told her story, how she tried to take her own life, what she had done in recent treatment and how she was finally beginning to feel like her old self.

I asked what advice she would offer to people in the midst of a major depressive episode, something that might help others through the darkest days.

“Someone needs to give you hope,” she said. “When you are down, you can’t generate your own hope. People will tell you it’s going to get better, and you will tell them it isn’t true. You’ll argue. But that is exactly what you need to hear. Even though you can’t say it at the moment, part of you believes them.”

It was only with hindsight that Sheryl could talk about these things. Her point was that when we help people with depression, we need to do the right thing. Offer them hope. Listen to how they are feeling. And, we need to do the right thing even when the depressed person cannot acknowledge its benefit.

People with depression often resist treatment or support. They will tell you it won’t help, or that they have tried everything. Sometimes a friend or loved one needs to hold onto hope when the person with depression cannot.

And there is good reason for people to have hope, even when they are suffering from depression.

Why? Because for a majority of individuals, treatment works. Seeking professional help is the key, and once treatment has begun, medications or therapy may be suggested. Most research points to a combination of the two as the most effective approach to getting better, but each person is different.

Since major depression impacts roughly one in five people during a lifetime, we all will have the opportunity to help someone make it through a difficult time. Don’t be afraid to reach out. Encourage people to stay hopeful and to seek out care from their family doctor or mental health care provider. It could make all the difference.

Psychologist Dr. David Prescott is the director of psychology services and clinical research at The Acadia Hospital. He writes a monthly column as part of Acadia’s Because Your Mental Health Matters Campaign. For more information about accessing treatment for depression, call 211 or visit www.211maine.org.