(USA TODAY) -- With the economy in the doldrums, Kenneth Kott expected he might be laid off from his job as a project manager. He never expected the depression that followed.

"Sleep and alcohol are the only escapes for me," says Kott, 62, of Birmingham, Mich., who was laid off in January after 17 years at a high-tech company. "The smartest thing I've done is start seeing a therapist for depression."

For many employees rattled by financial worries and job insecurities, the economic downturn is packing an emotional wallop. Many are grappling with depression, substance abuse, anxiety disorders, suicidal thoughts and marital woes.

Demand for substance-abuse treatment in many states is up. And mental-health experts report spikes in complaints about anxiety, depression or other emotional problems related to personal financial concerns. New Mexico, which posted the largest jobless rate increase from a year ago, saw the number of suicides in 2001 reach an all-time high.

Chicago-based ComPsych experienced a 35% jump in calls from workers citing financial issues as a source of stress. Overall calls to the employee assistance provider are up 10% this year. Use of antidepressants grew 12.8% in 2001, according to St. Louis-based pharmacy benefit manager Express Scripts.

Professionals in Transition Support Group, which holds support meetings for unemployed workers in Winston-Salem and Greensboro, N.C., has seen the number of visitors coming per session leap to an average of 51 today from 15 in 2001.

"We are currently beyond capacity," says Damian Birkel, who founded the non-profit support agency. "I was out of work two times, and both times I hit bottom. There is so much unmet need."

A layoff meant financial worries and relationship strain for Ted and Christina Stoever of Reno. They had just bought their dream house when Christina, 31, quit her job last year to stay home with their son, Jackson, who is now 2 years old. Just a few weeks later, Ted was laid off from his job as a national sales manager at an outdoor clothing store.

His company let him continue working until he found a new job, so the couple were able to keep their home. But the financial ambiguity took its toll. She wanted Ted to wait for a job with comparable pay and in the same state, while he felt it was important to find employment fast.

"The blow was extensive to our day-to-day living and, in all divine honesty, to our marriage," Christina says.

Ted, 33, spent nights awake in bed wondering whether he should take a lower-paying job. "As the breadwinner for the family, there is a tremendous sense of responsibility to provide," says Ted, now a director of marketing and business development. "If you can't pay the mortgage, you have no shelter. If you can't buy groceries, you will go hungry. These notions will drive you crazy when you picture your child going without."

Workers fear repercussions

Deeper signs of stress:

* Substance abuse. Nearly 25 states reported an increase in requests for drug and alcohol treatment, according to a survey this year by the National Center on Addiction and Substance Abuse at Columbia University. That increase is attributed to the aftermath of Sept. 11, the recession and mounting unemployment.

The problem is often hidden because employees who need help fail to seek it. More than one in five insured employees believe they would face negative consequences at work, such as losing out on a promotion, if they sought alcohol or drug addition treatment, according to a survey by Minneapolis-based treatment center Hazelden Foundation.

* Depression. According to a 2001 survey by the National Mental Health Association, there is a strong connection between depression and diminished economic circumstances, such as unemployment.

There were 180 million prescriptions for antidepressants dispensed in 2001, according to IMS Health, a Plymouth Meeting, Pa., provider of information services to the pharmaceutical and health care industries. That's up from 163 million in 2000. About 115 million prescriptions were dispensed through July of this year.

Nearly 30% of husbands who have experienced unemployment experienced significant mental-health problems compared with 16% of those who maintained stable employment, according to research from the University of Western Ontario in Canada.

Among women, almost 36% who had a job loss reported mental-health issues compared with about 23% of women who remained employed. The study also found panic and anxiety disorders increased.

"It can trigger a biochemical imbalance, a clinical state of depression," says Mark Gorkin, a Washington, D.C., therapist. "Exercising or talking it out's not going to do it."

Interphase International, a security and investigative services provider in Morgan Hill, Calif., says companies over the past 18 months have been bringing them in to provide security when layoffs are announced. The reason: Employers worry job cuts may send workers over the edge.

* Suicide. The greater the duration of unemployment, the greater the suicide rate, according to an analysis of U.S. Public Health Service data published in the journal Sociological Focus. It found that the unemployment increases seen during the lean economic times of the 1980s are associated with at least 900 additional deaths from suicide.

Roughly 15% of people suffering from severe depression commit suicide.

Some mental-health experts already see worrisome signs.

"As far as the economy goes, when people are broke, it makes everything harder," says Molly McCoy Brack at the Agora University of New Mexico Crisis Center, which has seen the number of suicide calls quadruple over last year. The state saw unemployment reach a four-year high this year.

Financial problems also influence families and relationships.

Todd Lang felt it. The 26-year-old New York public relations account executive was without full-time work for 13 months. It was hard staying in touch, he says, because there was little reason to call family and friends when he had no employment news.

The emotional strain of what he was going through, he says, took a toll.

"Relationships with family, friends and girlfriend were all strained," he says. "You start to question every decision you've made in life. It seemed like it was never ending."

A study by the Centers for Disease Control and Prevention found marriages tend to last longer under several conditions, including low levels of male unemployment.

Even employees who say they handle stress well admit that joblessness and financial turmoil can cause real emotional angst.

"I don't tend to get stressed very easily, but I got very frustrated," says Jennifer Schneider, 25, in Bloomington, Minn., an account coordinator at communications firm Weber Shandwick, who was without full-time work for about two years. "I felt hopeless."

Employed feel stress, too

Even those who haven't lost a job or aren't facing the prospect of a job loss are feeling pressure these days: Seven out of 10 employees say they feel a great deal or a moderate amount of stress in their jobs, according to a poll by Gallup/UBS. Only one in 10 say they feel no stress at all.

Mental-health problems can strike unemployed or underemployed workers who have a family history of depression or anxiety, but that's not always the case.

Prolonged stress and major life changes can be enough of a catalyst to trigger clinical diagnoses. Unlike a down mood, depression typically lasts for at least two weeks. Signs include irritability, sleep changes, weight loss or weight gain.

It's not just an issue that strikes men, who traditionally carried the burden of providing for their families' economic security.

"Women have given up more for their jobs in some ways. They may have delayed child-bearing," says Carl Greiner, a professor of psychiatry at the University of Nebraska Medical Center in Omaha. A layoff may leave them wondering whether "the sacrifice was worth it."

Bounding back can take months, even years, mental-health experts say. Even a new paycheck may not curb the anxiety.

More than workers affected

Joanne McCall remembers being laid off for eight months in 1993. She was let go from a job in radio broadcasting and now runs her own book publicity company, McCall Public Relations, in Portland, Ore.

"It took a number of years to really get over it," says McCall, 43. "It's such a blow to your self-esteem and who you are, and it takes a long time to repair that. It's like a grief process. . . . Your work is like family, and all of a sudden you feel cut off and ostracized. It's huge. There's a period of loss."

The impact touches more than employees. According to the National Mental Health Association, depression costs the economy nearly $44 billion annually in absenteeism, lost productivity and direct treatment costs.

For unemployed workers like Kott, part of the strain is not knowing what the future will bring. His therapist is helping him prepare for the rejections and challenges of job interviews, but it's hard.

He's drawing on the savings from his retirement fund sooner than expected and, after 10 months, feels no closer to finding another job.

"My friends are growing weary of my tales of woe. My family tries to help by calling me with morale-boosting," Kott says.

"All the self-confidence I had developed during my career has vanished."

Copyright 2002 USA TODAY, a division of Gannett Co. Inc.