How do you know if you should seek professional debt help?

For instance, at what point should you consider debt consolidation loans, credit counselors, and/or bankrupcy? This is given that I understand the responsible use of money, but live in a crappy economy and in one of the crappiest states for crappy economies in the U.S.A. Just looking for some advice from those who are experienced and/or knowlegable in this area. Thanks!

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