When it comes to the economy, the term “depression” can have more than one meaning and consequence.

Depression with a capital “D” is a sustained economic recession in which a nation’s Gross National Product is falling; a period marked by low production and sales, and a high rate of business failures and unemployment.

Though the local and U.S. economies continue to struggle, we’re not there, yet.

But depression with a lower-case “d” – the kind that leaves sufferers feeling sad, empty and hopeless – is a frequent side effect of unemployment, particularly long-term joblessness.

With an unemployment rate that remains stubbornly high, those in the local mental health community, such as the counselors at Coastal Horizons Center, Inc., in Wilmington, are seeing more people suffering from mental health problems related to or exacerbated by being out of work for an extended time.

In some cases, alcohol and other substance abuse complicates the issue, making it harder for clients to find work and setting up a vicious cycle that keeps individuals from realizing their potential.

It can happen to anyone, said Pamela Morrison, New Hanover program director for outpatient treatment services at Coastal Horizons Center.

“When men and women find themselves in situations of chronic unemployment, that increases their risk for depression,” Morrison said. “Loss of housing and loss of income can result in increased substance abuse and depression.”

Unemployment numbers have remained consistent in the Wilmington region this year. The rate in New Hanover County for July was 10.1 percent of the labor force, compared to 9.7 percent in January.

In Brunswick County, the unemployment rate was 10.4 percent in July, lower than the 12.3 percent figure from January. Pender County’s unemployment rate was 12.0 percent in July, compared to 11.1 percent in January.

The statewide unemployment rate was 10.4 percent in August, up slightly from the 10.1 percent unemployment rate in August 2010.

Numerous studies have shown that the unemployed population is more likely to become depressed or suffer other forms of mental illness. One survey conducted in 2009 by Mental Health America and the National Alliance on Mental Illness found that unemployed individuals are four times as likely as those with jobs to report “symptoms consistent with severe mental illness.”

The study also found that Americans who experienced involuntary changes in their employment status, such as pay cuts or reduced hours, are twice as likely to have those symptoms, even though they are employed full-time.

Complicating the problem is the lack of health insurance for many who have lost their jobs, Morrison said.

“When people lose their employment they also lose their health insurance, then they may lose the insurance that covers the mental health services that they desperately need,” she said.

Coastal Horizons, a non-profit organization, does accept clients without health insurance. Many private mental health providers also won’t accept clients who don’t have health insurance.

For someone who has worked many years in the same job or occupation, sudden or long-term unemployment can trigger feelings of depression, Morrison said.

“In our culture and our society, a lot of peoples’ identity is very much tied to how they earn a living and when they lose their employment, for a lot of people, that is an identity crisis,” Morrison said.

Coastal Horizons also has offices in Brunswick and Pender counties. In the Wilmington office, 2010 and the first nine months of 2011 have been very busy, Morrison said. The Wilmington office has about 500 active clients.

“We have seen more people seeking help for mental health and substance abuse, especially in the past six months to a year,” she said.

Unemployment statistics do not count people who have given up searching for a job.

“We definitely have people who just feel so hopeless about the employment situation, and the depression plays into that. It just feeds that sense of hopelessness and despair,” Morrison said.

For some, alcohol and other substance abuse seems like a temporary answer, she said.

“Substance abuse makes it harder for them to find employment. The depression makes it harder for them to get out of bed and get motivated,” Morrison said. “Better coping skills would be to seek treatment for the depression, whether that’s to get help though doctors or (free) natural community support.”

Faith-based groups are one example, along with peer support groups of others with depression.

Working with organizations that can help a person find a job can also help, Morrison said.

“Friends, family support and doing something active to help manage the depression can help,” she said. “People may turn to drugs and alcohol. That does not solve the problem in any way. It only makes it worse.”

The important thing to remember, Morrison said, is that treatment is available and individuals “should not give up hope.”

“Treatment helps encourage people to seek help for their depression and substance abuse,” she said. “Treatment is available and it does work.”

Major depression is a serious medical illness affecting 15 million American adults, or approximately 5 to 8 percent of the adult population in a given year, whether they are unemployed or not, according to NAMI.

Depression is also treatable. Treatment such as antidepressants and talk therapy is effective over 80 percent of the time, NAMI officials said.

But fewer than half of those confronting depression seek treatment, regardless of economic or employment status, mental health advocates said.

Depression is a timely topic. Mental Illness Awareness Week is October 2-8, with October 4 set aside as a “National Day of Prayer for Mental Illness Recovery and Understanding.” National Depression Screening Day is October 6. For more information, call Coastal Horizons at (910) 343-0145.