Arkansas - This State ranks high on the list and rates as one that has a high rate of depression, especially among young people.
Indiana - A sluggish economy, high unemployment, and massive budget shortfalls contribute to the depression in this Rust Belt State.
Kentucky - Rates of depression and other mental-health problems are higher than the national average throughout the mountainous and sparsely settled region known as Appalachia. They are higher still in the coal-mining areas of central Appalachia, which includes most of eastern Kentucky. Unemployment and drug abuse escalate the problems of the people living in this region.
Michigan - Few states have been as battered by the economic downturn as Michigan. With unemployment as high as 20% in some counties, it’s not surprising that residents might be feeling distressed.
Mississippi - The poorest state in the U.S., Mississippi ranks at or near the bottom on many health measures, from obesity to heart disease. Mental health is no exception. The state has the highest rate of depression in the nation (14.8%), according to the Centers for Disease Control and Prevention (CDC), and it has the third-highest rate of frequent mental distress (13.5%)
Missouri - Missouri isn’t at the bottom of the barrel in any one measure of mental health, but it gets very low marks in several areas, including the rate of serious psychological distress (13%).
Fortunately for residents, the Show-Me State has had a proactive approach to preventing and treating mental-health problems. In 2008 it began a pilot program to integrate primary care and mental health care.
Nevada - For out-of-state visitors, Nevada often evokes images of gambling, partying, skiing, and other carefree diversions. For those who live there, the reality is often quite different. Nevada has high rates of mental distress, and, at last count, about 1 in 11 residents had experienced at least one episode of major depression in the previous year.
Oklahoma - Maybe it’s the flat, barren landscape and threat of severe weather; maybe it’s the high poverty rate (16%) and low rates of health-insurance coverage. For whatever reason, the Sooner State ranks in the bottom five of every category we considered. Even the official state rock song is depressing.
Tennessee - It may not be a coincidence that Memphis and Nashville are famous, respectively, for their blues and heartsick country music. By one measure, Tennessee is the unhappiest state in the union: Nearly 10% of residents have experienced an episode of major depression in the previous year.
Like Mississippi, Tennessee also has high rates of chronic diseases such as obesity and diabetes, the stress of which can worsen depression. As many as 70% of Tennesseans who see a primary care physician for obesity, diabetes, or hypertension meet the criteria for depression, anxiety, or other mental disorders, the state’s mental health commissioner has estimated.
West Virginia - The Mountain State is ranked last or next-to-last in every mental-health category on our list, including the average number of "mentally unhealthy" days residents have per month and the percentage of people who experience frequent mental distress (15%).
One reason may be that roughly two-thirds of West Virginians live in rural areas, where both steady jobs and access to mental health care can be hard to come by.