Being in debt, broke, and unemployed can lead to depression but the converse is also true: Depression can precipitate financial meltdown.

There is the issue of lost wages. People who are depressed take off more time from work. In fact, according to a 2008 study reported in the American Journal of Psychiatry mental illness costs America $193.2 billion in lost earnings per year. Estimates are that between six and 10 percent of American adults has a mental illness in any given year. Of those, over a million have a depressive disorder. In a SAMHSA (Substance Abuse and Mental Health Services Administration) 2004 National Survey, an estimated 8 percent of adults aged 18 or older (approximately 17.1 million adults) had experienced at least one major depressive episode during the past year.

Holding down a job while you are in the throes of the symptoms of major depression can be very difficult for some people—although there are people who find functioning at work far easier than functioning at home. Job loss or unemployment is not uncommon in those with depression.

If you have a depressive disorder and have lost your job or are unemployed, ask your therapist to help you find a pre-employment or employment program suitable for people who have limitations due to disabilities such as depression. Don’t give up—there are actually jobs out there that can act as healthy stopgaps until you can return to career-oriented employment.

If you are on Medicaid they have available a work employment program called WEP that can help you become job-ready by doing an internship at various city or state agencies. This may even lead to part- or full-time employment if you are doing well. It is important to remember that you find a work environment that isn’t unduly stressful in order to prevent the possibility of relapse.

You may also want to consider applying for SSI (Social Security Income) or SSD (Social Security Disability). It may be a lengthy process and you may need an attorney to help navigate the system, but if you meet the eligibility requirements then you can receive payments not only from when the application is accepted but backdated to when your disability began. If you happen to be living in a congregate care situation (such as a group home), and you are awarded SSI or SSD your rate will actually increase to cover room and board. You will also receive a monthly stipend, after all expenses are deducted.

Also, people who struggle with a depressive disorder are more likely to find managing their bills and finances overwhelming. If feelings of despair and feelings that nothing matters prevail, why pay the bills? This can lead to credit problems, utility shutdowns, eviction, job loss, fines, and even jail. Thought exact statistics aren’t available, I see these problems frequently in patients with major depression, especially if they don’t take their medications as prescribed and don’t go to their therapy appointments.

You can also apply for emergency medication assistance — most, if not all, pharmaceutical companies have patient assistance programs. You or your therapist should call the toll-free number of the manufacturer of the medication you take and ask for their patient assistance programs. They may supply you with free medication for a significant period of time. As a temporary measure you can ask your prescribing doctor for samples of the medication you are taking. Also, be sure to ask if there is a generic alternative to your prescription — that can really cut your co-pay costs (if you are paying by insurance).

If you have enough money to pay your bills but are finding the process overwhelming, have a friend or advisor help you set up an automated payment program with your bank and the companies that bill you regularly. This can be a big load of worry off your mind.

If you need intensive support with managing your money and other daily activities you can ask your therapist to apply for an (ICM) intensive case manager though city or state agencies. There are different levels of case manager and you may need someone for fewer hours a week.

The main goal is to take responsibility for your recovery from depression which includes: taking your medication regularly as directed, going to therapy as scheduled and following your therapist’s recommendations, and so on. The end goal is to reintegrate into family, community and the workforce at a level that respects the limits of your disability.