States With the Highest Rates of Depression

Depression is the leading cause of disability worldwide, according to the National Alliance on Mental Illness (NAMI). Those who suffer from it are at much greater risk for things like metabolic and cardiovascular disease, and the global economy loses $1 trillion in lost productivity every year to anxiety and depression disorders alone. Substance abuse is more prevalent among people with depression, as is suicide. Young people, who are more than twice as likely to drop out of school when they suffer from depression, are especially vulnerable.

That was all bad enough before the COVID-19 pandemic created economic and social conditions that were ripe for a quieter but equally crushing medical crisis to emerge—in mental health. That crisis has arrived in the form of a dramatic nationwide spike in cases of depression and anxiety since the arrival of the virus—and it's not hard to understand why. Many who were struggling before the pandemic, and even many who weren't, were pushed toward depression by months of stress, isolation, loss of control, change, instability, and uncertainty—all of which played out against a backdrop of frightening social unrest.

Rates of depression, however, vary considerably from one state to the next. Here, Stacker examines the prevalence of depression in every state in America and then breaks down those findings by key demographics like sex, race, and income.

To determine the states with the highest rates of depression, Stacker used data from the Centers for Disease Control and Prevention (CDC)'s Behavioral Risk Factor Surveillance System. All 50 states and Washington D.C. are ranked based on the share of the sampled population that reported a depression diagnosis in 2019, with one exception: 2018 data was used for New Jersey due to the unavailability of 2019 data for this state. The national median for diagnosed depression rates is 19.9%.

It's important to note that the findings exclude the time of the pandemic and do not represent the dramatic uptick in cases—particularly in major depressive episodes—that many states are reporting.

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#51. New Jersey
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#51. New Jersey

- Population diagnosed with depression: 11.8% (40.7% below national median)
- Breakdown by sex: 8% rate for men; 15.2% rate for women
- Breakdown by race: 13.7% rate for White population; 10.4% rate for Black population; 11.4% rate for Hispanic or Latino population
- Breakdown by household income: 19.8% rate for $15,000-$24,999 earners; 17.9% rate for $25,000-$34,999 earners; % rate for $35,000-$49,999 earners; 8.8% rate for $50,000+ earners

New Jersey consistently ranks at or near the very top of the list in terms of states with the lowest rates of depression. That fact confounds experts who study the issue, according to the Bridgewater Courier News, because New Jersey tends to rank poorly in terms of access to mental health care. Generally, the level of access to care closely correlates with depression rates.

#50. Hawaii

- Population diagnosed with depression: 12.8% (35.7% below national median)
- Breakdown by sex: 10% rate for men; 15.5% rate for women
- Breakdown by race: 16.9% rate for White population; 20.4% rate for Hispanic or Latino population; 7.6% for Asian population
- Breakdown by household income: 17.5% rate for $15,000-$24,999 earners; 13.6% rate for $25,000-$34,999 earners; 13.6% rate for $35,000-$49,999 earners; 10.2% rate for $50,000+ earners

Like New Jersey, Hawaii occupies a perennial home at or near the bottom of the list in terms of depression rates. In another correlation with New Jersey, Hawaii's rankings are striking considering that the state is also known for its low access to care.

#49. Connecticut

- Population diagnosed with depression: 14.4% (27.6% below national median)
- Breakdown by sex: 10.8% rate for men; 17.8% rate for women
- Breakdown by race: 16% rate for White population; 8.7% rate for Black population; 12% rate for Hispanic or Latino population
- Breakdown by household income: 21.1% rate for $15,000-$24,999 earners; 15.9% rate for $25,000-$34,999 earners; 13% rate for $35,000-$49,999 earners; 11.6% rate for $50,000+ earners

Reflecting a nationwide trend, Connecticut is facing especially tough challenges in meeting the growing demand for adolescent mental health care. Between 2019 and 2020, Connecticut lost significant ground in a ranking that measures youth access to treatment for mental health issues, including major depressive episodes.

#48. California
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#48. California

- Population diagnosed with depression: 14.6% (26.6% below national median)
- Breakdown by sex: 10.6% rate for men; 18.6% rate for women
- Breakdown by race: 19.6% rate for White population; 12.1% rate for Black population; 13.1% rate for Hispanic or Latino population; 6.1% for Asian population; 14.7% rate for Native American or Alaska Native population
- Breakdown by household income: 16.8% rate for $15,000-$24,999 earners; 16.1% rate for $25,000-$34,999 earners; 14.1% rate for $35,000-$49,999 earners; 13.4% rate for $50,000+ earners

California traces its mental health legislation history to the 1957 Short-Doyle Act, which funded depression counseling at the municipal level. Today, that tradition continues in the form of the nonprofit California Mental Health and Spirituality Initiative, a county-level, faith-based approach to combating depression.

#47. New York

- Population diagnosed with depression: 15.3% (23.1% below national median)
- Breakdown by sex: 11.5% rate for men; 18.8% rate for women
- Breakdown by race: 17.6% rate for White population; 12.6% rate for Black population; 14.7% rate for Hispanic or Latino population; 5.1% for Asian population
- Breakdown by household income: 20% rate for $15,000-$24,999 earners; 16.5% rate for $25,000-$34,999 earners; 13.7% rate for $35,000-$49,999 earners; 13.1% rate for $50,000+ earners

About one in four New Yorkers struggling with depression receive both counseling and medication, while much smaller percentages receive counseling or medication only. A full 62% receive neither.

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#46. Maryland

- Population diagnosed with depression: 15.8% (20.6% below national median)
- Breakdown by sex: 12.1% rate for men; 19.2% rate for women
- Breakdown by race: 19.2% rate for White population; 13% rate for Black population; 11.8% rate for Hispanic or Latino population; 5.2% for Asian population; 22.1% rate for Native American or Alaska Native population
- Breakdown by household income: 19% rate for $15,000-$24,999 earners; 16.5% rate for $25,000-$34,999 earners; 17.8% rate for $35,000-$49,999 earners; 13.1% rate for $50,000+ earners

Less than 57% of Marylanders with depression and other mental illnesses receive treatment of any kind—whether through private providers and public systems. More than 43% of those who need treatment in the state receive no care at all. In a testament to mental health in America as a whole, even Maryland's numbers are good enough for a spot among the top 15 states in the country in terms of access to care.

#44. Iowa (tie)

- Population diagnosed with depression: 16.2% (18.6% below national median)
- Breakdown by sex: 11.4% rate for men; 20.9% rate for women
- Breakdown by race: 16.4% rate for White population; 10.6% rate for Black population; 14% rate for Hispanic or Latino population
- Breakdown by household income: 22.6% rate for $15,000-$24,999 earners; 17.7% rate for $25,000-$34,999 earners; 17.7% rate for $35,000-$49,999 earners; 13.1% rate for $50,000+ earners

The first sparsely populated, non-coastal state on the list is Iowa, home to roughly 3.1 million people. Less than half of all Iowans suffering from any mental illness, including major depression, receive treatment—48.5%, to be exact.

#44. Nebraska (tie)

- Population diagnosed with depression: 16.2% (18.6% below national median)
- Breakdown by sex: 10.6% rate for men; 21.7% rate for women
- Breakdown by race: 17.3% rate for White population; 12.2% rate for Black population; 10.5% rate for Hispanic or Latino population; 18.9% rate for Native American or Alaska Native population
- Breakdown by household income: 23.2% rate for $15,000-$24,999 earners; 18.3% rate for $25,000-$34,999 earners; 17.2% rate for $35,000-$49,999 earners; 12.7% rate for $50,000+ earners

Nebraska is dealing with a troubling rise in youth suicide across several counties. Experts trace the increase—which is occurring even as adult rates are dropping—to a rise in adolescent depression spurred by the coronavirus crisis. This is true despite a strong record of youth suicide prevention efforts in the state spearheaded by the Nebraska State Suicide Prevention Coalition.

#43. Arizona
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#43. Arizona

- Population diagnosed with depression: 16.8% (15.6% below national median)
- Breakdown by sex: 12.5% rate for men; 21% rate for women
- Breakdown by race: 19.3% rate for White population; 11.5% rate for Black population; 13.6% rate for Hispanic or Latino population; 15.9% rate for Native American or Alaska Native population
- Breakdown by household income: 22.1% rate for $15,000-$24,999 earners; 17.3% rate for $25,000-$34,999 earners; 14.7% rate for $35,000-$49,999 earners; 14.2% rate for $50,000+ earners

As in so many states, instances of depression—ranging from episodes lasting a few days to near-daily affliction—have increased sharply in Arizona since the onset of the pandemic. About 5.6 million adults in the state reported experiencing symptoms of depression since the beginning of the crisis.

#41. Georgia (tie)

- Population diagnosed with depression: 17% (14.6% below national median)
- Breakdown by sex: 12.3% rate for men; 21.4% rate for women
- Breakdown by race: 21.3% rate for White population; 11.8% rate for Black population; 12.1% rate for Hispanic or Latino population
- Breakdown by household income: 24.6% rate for $15,000-$24,999 earners; 22.4% rate for $25,000-$34,999 earners; 16.8% rate for $35,000-$49,999 earners; 13% rate for $50,000+ earners

In October, Georgia marked the 10th anniversary of a major settlement that the state made with the U.S. Justice Department requiring it to restructure how it provides care to people with mental illnesses and developmental disabilities. According to the Georgia Recorder, mental health experts in the state seem to agree that while work remains to be done, access to care and care itself has improved dramatically in Georgia over the last decade since the new rules went into effect.

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#41. Virginia (tie)

- Population diagnosed with depression: 17% (14.6% below national median)
- Breakdown by sex: 12.5% rate for men; 21.2% rate for women
- Breakdown by race: 19.8% rate for White population; 13.2% rate for Black population; 11.8% rate for Hispanic or Latino population
- Breakdown by household income: 24.3% rate for $15,000-$24,999 earners; 20.8% rate for $25,000-$34,999 earners; 20.5% rate for $35,000-$49,999 earners; 13.8% rate for $50,000+ earners

The steep rise in depression caused by the stress of 2020 has had particularly tragic consequences in Virginia. The state has witnessed a huge increase in drug overdose fatalities, making this "the worst year on record by far," according to the Virginia Mercury.

#39. Colorado (tie)
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#39. Colorado (tie)

- Population diagnosed with depression: 17.2% (13.6% below national median)
- Breakdown by sex: 13.6% rate for men; 20.7% rate for women
- Breakdown by race: 18.4% rate for White population; 21.1% rate for Black population; 12.9% rate for Hispanic or Latino population; 18.1% rate for Native American or Alaska Native population
- Breakdown by household income: 22% rate for $15,000-$24,999 earners; 20.5% rate for $25,000-$34,999 earners; 19.2% rate for $35,000-$49,999 earners; 14.5% rate for $50,000+ earners

More than one veteran commits suicide every week in Colorado, as reported by The Colorado Springs Gazette. Due to an inexact and complex web of contributing factors, veteran suicide rates are strikingly higher in Colorado than in the country as a whole, even though military veteran suicide is a nationwide epidemic.

#39. Texas (tie)

- Population diagnosed with depression: 17.2% (13.6% below national median)
- Breakdown by sex: 12.1% rate for men; 22.2% rate for women
- Breakdown by race: 21.2% rate for White population; 16.5% rate for Black population; 13.6% rate for Hispanic or Latino population
- Breakdown by household income: 21.7% rate for $15,000-$24,999 earners; 17.1% rate for $25,000-$34,999 earners; 18.6% rate for $35,000-$49,999 earners; 14% rate for $50,000+ earners

Nationwide, Latinos are suffering from depression and other mental health issues triggered by the pandemic in numbers that are disproportionate to the population as a whole—and that's more evident in Texas than just about anywhere else in America. The places hardest hit by the virus, like El Paso, tend to have large Hispanic populations. That dynamic, along with the stress and anxiety of managing mental and physical health crises on both sides of the border, has made depression far more common in Texas' many Latino enclaves in 2020.

#38. South Dakota

- Population diagnosed with depression: 17.3% (13.1% below national median)
- Breakdown by sex: 12.2% rate for men; 22.4% rate for women
- Breakdown by race: 17.4% rate for White population; 19.2% rate for Native American or Alaska Native population
- Breakdown by household income: 25.8% rate for $15,000-$24,999 earners; 25.2% rate for $25,000-$34,999 earners; 16.9% rate for $35,000-$49,999 earners; 12.4% rate for $50,000+ earners

In South Dakota, mental health services for conditions like depression are administered through the state's Division of Behavioral Health. The agency maintains partnerships with 11 community mental health centers located across the state.

#36. Alaska (tie)

- Population diagnosed with depression: 17.4% (12.6% below national median)
- Breakdown by sex: 12.1% rate for men; 23.3% rate for women
- Breakdown by race: 18.5% rate for White population; 15.4% rate for Native American or Alaska Native population
- Breakdown by household income: 19.4% rate for $15,000-$24,999 earners; 19.7% rate for $25,000-$34,999 earners; 16.6% rate for $35,000-$49,999 earners; 16.7% rate for $50,000+ earners

Alaska's remote northern location makes people there particularly vulnerable to a type of depression known as seasonal affective disorder (SAD), which affects just 1% of the population in the warmest, sunniest climates but 10% of those in the coldest, darkest environments. In 2020, the pandemic is hitting Alaska just as the state's infamously cold, dark winter months set in. On Dec. 21, Fairbanks will get just 3 hours and 42 minutes of sunlight all day—in Alaska's farthest northern reaches, it'll be dark for 67 days straight.

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#36. New Mexico (tie)
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#36. New Mexico (tie)

- Population diagnosed with depression: 17.4% (12.6% below national median)
- Breakdown by sex: 13.9% rate for men; 20.6% rate for women
- Breakdown by race: 18% rate for White population; 17.8% rate for Hispanic or Latino population; 12.2% rate for Native American or Alaska Native population
- Breakdown by household income: 22.2% rate for $15,000-$24,999 earners; 19.6% rate for $25,000-$34,999 earners; 15.7% rate for $35,000-$49,999 earners; 11.6% rate for $50,000+ earners

The New Mexico Crisis and Access Line is the state's front-line service for people in crisis due to depression and anxiety. The hotline has experienced a large increase in call volume since the onset of the pandemic, with about one in every five calling about suicidal thoughts or actions.

#34. Florida (tie)
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#34. Florida (tie)

- Population diagnosed with depression: 17.7% (11.1% below national median)
- Breakdown by sex: 13.1% rate for men; 22% rate for women
- Breakdown by race: 19.9% rate for White population; 11.7% rate for Black population; 15.7% rate for Hispanic or Latino population
- Breakdown by household income: 23.7% rate for $15,000-$24,999 earners; 19.9% rate for $25,000-$34,999 earners; 18.5% rate for $35,000-$49,999 earners; 12.9% rate for $50,000+ earners

Along with Maine, Florida has the highest percentage of seniors of any state in America—more than one in five Floridians are 65 or older. Nationwide, seniors with depression are far more likely to suffer in silence than the overall population—about two of three older depression sufferers won't seek help. Stigma is one of the primary reasons so many seniors keep their depression to themselves, as is the widespread belief that they'll be able to break free on their own.

#34. Nevada (tie)

- Population diagnosed with depression: 17.7% (11.1% below national median)
- Breakdown by sex: 12.5% rate for men; 22.8% rate for women
- Breakdown by race: 19.3% rate for White population; 19.3% rate for Black population; 12.6% rate for Hispanic or Latino population
- Breakdown by household income: 20.7% rate for $15,000-$24,999 earners; 18.8% rate for $25,000-$34,999 earners; 14.5% rate for $35,000-$49,999 earners; 14.5% rate for $50,000+ earners

Mental Health America ranks Nevada near the very bottom of its list of states with the best access to mental health care. The state comes in at #47 and is part of a block of Mountain West states that together account for the last five places on the list.

#33. North Dakota
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#33. North Dakota

- Population diagnosed with depression: 17.9% (10.1% below national median)
- Breakdown by sex: 12.5% rate for men; 23.6% rate for women
- Breakdown by race: 17.9% rate for White population; 22.4% rate for Hispanic or Latino population; 15.4% rate for Native American or Alaska Native population
- Breakdown by household income: 24.4% rate for $15,000-$24,999 earners; 17.7% rate for $25,000-$34,999 earners; 21.2% rate for $35,000-$49,999 earners; 14.9% rate for $50,000+ earners

The North Dakota State University Counseling Center used CARES Act funding to buy WellTrack, a depression and anxiety assessment application that provides self-help guidance and can also share key data with counselors. More than 2 million students and other individuals already use WellTrack.

#32. Illinois

- Population diagnosed with depression: 18.3% (8.0% below national median)
- Breakdown by sex: 14.5% rate for men; 21.9% rate for women
- Breakdown by race: 21% rate for White population; 15.1% rate for Black population; 14% rate for Hispanic or Latino population; 7.4% for Asian population
- Breakdown by household income: 27.6% rate for $15,000-$24,999 earners; 15.6% rate for $25,000-$34,999 earners; 19.1% rate for $35,000-$49,999 earners; 15.5% rate for $50,000+ earners

In Illinois, COVID-19 cases are rising as a distinct demographic emerges as being particularly vulnerable to depression and other common mental health issues. Students there are far more likely this year to take leaves of absence to seek treatment, and reported cases of major depressive episodes have doubled among both undergraduate and graduate students alike.

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#31. Massachusetts

- Population diagnosed with depression: 18.5% (7.0% below national median)
- Breakdown by sex: 13.6% rate for men; 23% rate for women
- Breakdown by race: 19.5% rate for White population; 14.6% rate for Black population; 20.5% rate for Hispanic or Latino population; 7.6% for Asian population
- Breakdown by household income: 27.9% rate for $15,000-$24,999 earners; 19% rate for $25,000-$34,999 earners; 19% rate for $35,000-$49,999 earners; 16.1% rate for $50,000+ earners

The Massachusetts Health Connector insurance marketplace and MassHealth, the state's Medicaid program, cover most mental health services in the state, including therapy and medication. The Department of Mental Health fills in any gaps by providing supplemental service for the most serious cases beyond what's normally covered.

#30. Delaware
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#30. Delaware

- Population diagnosed with depression: 18.8% (5.5% below national median)
- Breakdown by sex: 13.1% rate for men; 24% rate for women
- Breakdown by race: 22.2% rate for White population; 12.8% rate for Black population; 9.2% rate for Hispanic or Latino population
- Breakdown by household income: 28.2% rate for $15,000-$24,999 earners; 22.9% rate for $25,000-$34,999 earners; 23.1% rate for $35,000-$49,999 earners; 16.5% rate for $50,000+ earners

In 2018, the passage of Senate Bill 230 required insurance companies operating in the state to cover mental health care more consistently after patients and advocates had long complained of inadequate coverage. Aetna and Highmark, Delaware's two largest insurers, were recently hit with nearly $600,000 in fines for thousands of violations of the new law.

#29. Wyoming
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#29. Wyoming

- Population diagnosed with depression: 19.2% (3.5% below national median)
- Breakdown by sex: 13.4% rate for men; 25.1% rate for women
- Breakdown by race: 18.6% rate for White population; 22.5% rate for Hispanic or Latino population
- Breakdown by household income: 29% rate for $15,000-$24,999 earners; 24.2% rate for $25,000-$34,999 earners; 17.4% rate for $35,000-$49,999 earners; 13.3% rate for $50,000+ earners

Wyoming joins Nevada in the cluster of Mountain West states that dominate the bottom of the Mental Health America list, which measures state-by-state access to care. Wyoming ranks #48 out of 51, including Washington D.C.

#27. Pennsylvania (tie)
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#27. Pennsylvania (tie)

- Population diagnosed with depression: 19.6% (1.5% below national median)
- Breakdown by sex: 13.5% rate for men; 25.4% rate for women
- Breakdown by race: 19.9% rate for White population; 18.6% rate for Black population; 21.2% rate for Hispanic or Latino population
- Breakdown by household income: 28.1% rate for $15,000-$24,999 earners; 22.1% rate for $25,000-$34,999 earners; 19.8% rate for $35,000-$49,999 earners; 14.8% rate for $50,000+ earners

According to the University of Southern California Schaeffer, "Pennsylvania's mental health system is considered to be among the nation's top regarding prevalence of mental illness." The problem, however, is that the state is facing a shortage of providers, particularly in Pennsylvania's rural communities.

#27. Rhode Island (tie)

- Population diagnosed with depression: 19.6% (1.5% below national median)
- Breakdown by sex: 14.2% rate for men; 24.7% rate for women
- Breakdown by race: 21% rate for White population; 11.1% rate for Black population; 17.1% rate for Hispanic or Latino population
- Breakdown by household income: 25.9% rate for $15,000-$24,999 earners; 17.8% rate for $25,000-$34,999 earners; 19.2% rate for $35,000-$49,999 earners; 15.9% rate for $50,000+ earners

Adolescents in Rhode Island are much more likely than adults to experience a major depressive episode. About 13.4% of people ages 12–17 have such an episode in a given year, compared to 8.1% of Rhode Islanders ages 18 and older.

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#26. Kansas
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#26. Kansas

- Population diagnosed with depression: 19.9% (0.0% below national median)
- Breakdown by sex: 14.3% rate for men; 25.3% rate for women
- Breakdown by race: 19.9% rate for White population; 15.4% rate for Black population; 21.6% rate for Hispanic or Latino population; 9.2% for Asian population; 24.4% rate for Native American or Alaska Native population
- Breakdown by household income: 27.9% rate for $15,000-$24,999 earners; 22.8% rate for $25,000-$34,999 earners; 21.2% rate for $35,000-$49,999 earners; 15% rate for $50,000+ earners

Just as it is geographically, Kansas is in the exact center of the country in terms of depression diagnosis, representing the precise national median. A University of Kansas Ph.D. developed a revolutionary new philosophy on treating depression abbreviated with the acronym TLC: therapeutic lifestyle changes.

#24. New Hampshire (tie)

- Population diagnosed with depression: 20% (0.5% above national median)
- Breakdown by sex: 14.6% rate for men; 25.2% rate for women
- Breakdown by race: 20.1% rate for White population
- Breakdown by household income: 31.9% rate for $15,000-$24,999 earners; 22.9% rate for $25,000-$34,999 earners; 17.7% rate for $35,000-$49,999 earners; 16.5% rate for $50,000+ earners

New Hampshire is one of only two states in the entire Northeast that falls outside the top 10 on Mental Health America's ranking of states with the most comprehensive access to mental health care. New Hampshire is #27, while neighboring Vermont is #12.

#24. South Carolina (tie)

- Population diagnosed with depression: 20% (0.5% above national median)
- Breakdown by sex: 14.2% rate for men; 25.3% rate for women
- Breakdown by race: 22.2% rate for White population; 15% rate for Black population; 14.8% rate for Hispanic or Latino population; 24.8% rate for Native American or Alaska Native population
- Breakdown by household income: 28.9% rate for $15,000-$24,999 earners; 21.3% rate for $25,000-$34,999 earners; 20% rate for $35,000-$49,999 earners; 15.3% rate for $50,000+ earners

South Carolina has experienced an increase both in suicide rates and in the percentage of young children experiencing anxiety and depression. In response, the state launched its Interactive Screening Program, an online mental health diagnostic tool that connects users with a professional counselor instead of just delivering computerized feedback and guidance.

#23. Minnesota

- Population diagnosed with depression: 20.2% (1.5% above national median)
- Breakdown by sex: 14.4% rate for men; 26% rate for women
- Breakdown by race: 21.3% rate for White population; 14.3% rate for Black population; 12.5% rate for Hispanic or Latino population; 11.6% for Asian population; 30.9% rate for Native American or Alaska Native population
- Breakdown by household income: 27% rate for $15,000-$24,999 earners; 23.2% rate for $25,000-$34,999 earners; 23% rate for $35,000-$49,999 earners; 17.5% rate for $50,000+ earners

Depression—along with substance abuse and low academic achievement—is more prevalent among adolescents in Minnesota's large Latino, Hmong, and Somali populations than in the general population. Researchers at the University of Minnesota who studied the issue surmise that the anti-immigrant sentiment that has emerged since 2016 has increased stress in their communities on top of pandemic pressure.

#22. Ohio

- Population diagnosed with depression: 20.3% (2.0% above national median)
- Breakdown by sex: 14.6% rate for men; 25.6% rate for women
- Breakdown by race: 20.8% rate for White population; 18.2% rate for Black population; 22.7% rate for Hispanic or Latino population
- Breakdown by household income: 28.9% rate for $15,000-$24,999 earners; 22.3% rate for $25,000-$34,999 earners; 21.3% rate for $35,000-$49,999 earners; 13.5% rate for $50,000+ earners

Like so many states, Ohio is experiencing a rise in mental health diagnoses among adolescents and teens. There, however, youth suicide rates are actually falling, while instances of underage depression are on the rise.

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#21. District of Columbia
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#21. District of Columbia

- Population diagnosed with depression: 20.4% (2.5% above national median)
- Breakdown by sex: 17.3% rate for men; 23.2% rate for women
- Breakdown by race: 21.5% rate for White population; 20.6% rate for Black population; 18.3% rate for Hispanic or Latino population
- Breakdown by household income: 26.8% rate for $15,000-$24,999 earners; 17.2% rate for $25,000-$34,999 earners; 12.4% rate for $35,000-$49,999 earners; 18.8% rate for $50,000+ earners

Washington D.C. was already experiencing depression diagnosis rates higher than the national median before the pandemic hit. With big cities suffering the most dramatic increases in new instances of depression and major depressive episodes since the onset of the pandemic, however, the District of Columbia is now faring even worse.

#20. Wisconsin

- Population diagnosed with depression: 20.5% (3.0% above national median)
- Breakdown by sex: 15.7% rate for men; 25.1% rate for women
- Breakdown by race: 21.3% rate for White population; 24% rate for Black population; 11.5% rate for Hispanic or Latino population
- Breakdown by household income: 28.8% rate for $15,000-$24,999 earners; 23% rate for $25,000-$34,999 earners; 22.2% rate for $35,000-$49,999 earners; 16.5% rate for $50,000+ earners

Depression cases are rising in Wisconsin, and mental health experts are bracing for an expected rise in seasonal affective disorder as the infamously long and cold Wisconsin winter approaches. Professionals in the state are also reporting a steep rise in visits to eating disorder clinics, as vulnerable residents—many of whom are suffering from depression—take drastic steps out of fear of gaining weight during quarantine lockdowns.

#19. Mississippi
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#19. Mississippi

- Population diagnosed with depression: 20.6% (3.5% above national median)
- Breakdown by sex: 14.6% rate for men; 26.2% rate for women
- Breakdown by race: 24.6% rate for White population; 14.2% rate for Black population
- Breakdown by household income: 27.9% rate for $15,000-$24,999 earners; 21.7% rate for $25,000-$34,999 earners; 18.7% rate for $35,000-$49,999 earners; 15% rate for $50,000+ earners

Medical professionals and researchers have embraced a long-established link between regular exercise and reduced rates of depression. Just 62.3% of adults in Mississippi report engaging in regular physical activity, making it the least-active state in the country. That concerns both traditional medical professionals and mental health workers since the pandemic has led to an even greater reduction in average exercise nationwide.

#18. Indiana

- Population diagnosed with depression: 21% (5.5% above national median)
- Breakdown by sex: 14.9% rate for men; 26.8% rate for women
- Breakdown by race: 22.6% rate for White population; 14.5% rate for Black population; 11.1% rate for Hispanic or Latino population; 32.9% rate for Native American or Alaska Native population
- Breakdown by household income: 29.4% rate for $15,000-$24,999 earners; 25.8% rate for $25,000-$34,999 earners; 19.5% rate for $35,000-$49,999 earners; 16.7% rate for $50,000+ earners

As is so often the case in much of the country, colleges and universities in Indiana are taking the lead in the state's campaign for improving mental health. The Indiana University School of Medicine and Regenstrief Institute recently announced a four-year, $4 million program designed to use telehealth as a primary diagnosis and treatment tool for both substance abuse and depression.

#17. Michigan

- Population diagnosed with depression: 21.4% (7.5% above national median)
- Breakdown by sex: 16% rate for men; 26.6% rate for women
- Breakdown by race: 22.1% rate for White population; 18.5% rate for Black population; 22.1% rate for Hispanic or Latino population; 29.3% rate for Native American or Alaska Native population
- Breakdown by household income: 28.7% rate for $15,000-$24,999 earners; 25.7% rate for $25,000-$34,999 earners; 20.4% rate for $35,000-$49,999 earners; 15.4% rate for $50,000+ earners

Michigan has one of the highest rates of seasonal affective disorder in America—and it has also been one of the country's biggest pandemic hotspots, as well as one of its epicenters of civil unrest and political upheaval. Anticipating an expansion of the state's already significant mental health crisis, Michigan officials have created a hotline and developed a range of other resources and tools to help Michiganders cope with what's shaping up to be a long winter.

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#16. North Carolina

- Population diagnosed with depression: 21.6% (8.5% above national median)
- Breakdown by sex: 15.2% rate for men; 27.5% rate for women
- Breakdown by race: 23.8% rate for White population; 18.8% rate for Black population; 11.6% rate for Hispanic or Latino population; 30.2% rate for Native American or Alaska Native population
- Breakdown by household income: 26.8% rate for $15,000-$24,999 earners; 22.7% rate for $25,000-$34,999 earners; 21.5% rate for $35,000-$49,999 earners; 17.5% rate for $50,000+ earners.

In terms of access to care, North Carolina is in the top half of the list, but just barely. Fewer than half of North Carolinians suffering from depression or another mental health issue (48.2%) receive treatment.

#15. Vermont

- Population diagnosed with depression: 22.1% (11.1% above national median)
- Breakdown by sex: 16.9% rate for men; 27.1% rate for women
- Breakdown by race: 22.2% rate for White population
- Breakdown by household income: 32.9% rate for $15,000-$24,999 earners; 31.7% rate for $25,000-$34,999 earners; 15.5% rate for $35,000-$49,999 earners; 18.3% rate for $50,000+ earners

The first state in the bottom 15 of the list is also the first state to top the national median by double-digit percentage points. That's Vermont, one of only two states not only in New England, but in the whole of the Northeast that falls outside the top 10 states with the most access to mental health care. The other is its neighbor, New Hampshire.

#14. Idaho
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#14. Idaho

- Population diagnosed with depression: 22.7% (14.1% above national median)
- Breakdown by sex: 16.7% rate for men; 28.6% rate for women
- Breakdown by race: 22.1% rate for White population; 20.2% rate for Hispanic or Latino population; 39.3% rate for Native American or Alaska Native population
- Breakdown by household income: 30.2% rate for $15,000-$24,999 earners; 22% rate for $25,000-$34,999 earners; 26.8% rate for $35,000-$49,999 earners; 17.5% rate for $50,000+ earners

Officials from the Idaho Department of Health and Welfare told East Idaho News the state's residents have continued to call the COVID Help Now Line, which became available in August 2020, for help dealing with stress related to the pandemic. Idaho is right in the center of the block of Mountain West states that all rank at the very bottom of the list in terms of access to health care. Idaho ranks #49 of 51.

#13. Missouri

- Population diagnosed with depression: 22.8% (14.6% above national median)
- Breakdown by sex: 16.2% rate for men; 29% rate for women
- Breakdown by race: 23.1% rate for White population; 18.6% rate for Black population; 19.3% rate for Hispanic or Latino population; 40.7% rate for Native American or Alaska Native population
- Breakdown by household income: 31.9% rate for $15,000-$24,999 earners; 23.4% rate for $25,000-$34,999 earners; 25.4% rate for $35,000-$49,999 earners; 17.3% rate for $50,000+ earners

Missouri is nearly 15% above the country as a whole in terms of instances of diagnosed depression cases. As is so often the case with states that suffer from high diagnosis rates, Missouri has poorer-than-average access to care.

#12. Oklahoma

- Population diagnosed with depression: 23% (15.6% above national median)
- Breakdown by sex: 16.9% rate for men; 28.8% rate for women
- Breakdown by race: 22.9% rate for White population; 19.3% rate for Black population; 19.9% rate for Hispanic or Latino population; 28% rate for Native American or Alaska Native population
- Breakdown by household income: 30.5% rate for $15,000-$24,999 earners; 24.5% rate for $25,000-$34,999 earners; 21% rate for $35,000-$49,999 earners; 16.4% rate for $50,000+ earners

Despite holding a place among the dozen states with the highest rates of depression, Oklahoma is actually doing better than it was just a few years ago. In 2018, the state ranked at the very bottom of the list, a statistic that represented a striking 29% increase compared to 2013.

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#11. Utah

- Population diagnosed with depression: 23.1% (16.1% above national median)
- Breakdown by sex: 16.8% rate for men; 29.3% rate for women
- Breakdown by race: 24.5% rate for White population; 16.2% rate for Hispanic or Latino population; 30.2% rate for Native American or Alaska Native population
- Breakdown by household income: 32.4% rate for $15,000-$24,999 earners; 27.2% rate for $25,000-$34,999 earners; 26.9% rate for $35,000-$49,999 earners; 19.6% rate for $50,000+ earners

Utah, which consistently reports higher rates of depression than the country as a whole, is part of the cluster of Mountain West states with the worst access to care. In fact, Utah ranks #50, coming in behind only Oregon.

#10. Maine
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#10. Maine

- Population diagnosed with depression: 23.5% (18.1% above national median)
- Breakdown by sex: 18.1% rate for men; 28.5% rate for women
- Breakdown by race: 23.2% rate for White population; 27.4% rate for Hispanic or Latino population; 42.3% rate for Native American or Alaska Native population
- Breakdown by household income: 37.9% rate for $15,000-$24,999 earners; 27.2% rate for $25,000-$34,999 earners; 22.4% rate for $35,000-$49,999 earners; 16.3% rate for $50,000+ earners

Maine is the only New England state and the only Northeastern state to make it into the bottom 10 entries on the list, which is otherwise dominated by the South, Northwest, and Appalachia. Unlike much of the country, however, officials in Maine are reporting that requests for mental health services there have mostly remained steady throughout the pandemic.

#9. Louisiana
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#9. Louisiana

- Population diagnosed with depression: 23.9% (20.1% above national median)
- Breakdown by sex: 17.1% rate for men; 30.1% rate for women
- Breakdown by race: 25.7% rate for White population; 19.5% rate for Black population; 29.3% rate for Hispanic or Latino population; 19.3% rate for Native American or Alaska Native population
- Breakdown by household income: 31.3% rate for $15,000-$24,999 earners; 26.4% rate for $25,000-$34,999 earners; 19.7% rate for $35,000-$49,999 earners; 16% rate for $50,000+ earners

Consistently listed among the states with the highest rates of depression in America, Louisiana's mental health crisis seems to be getting worse, not better. The CDC recently reported that Louisiana has experienced the second-biggest increase in depression in the entire country over the last five years. It also has among the lowest rates of access to care.

#7. Alabama (tie)

- Population diagnosed with depression: 24.1% (21.1% above national median)
- Breakdown by sex: 19.3% rate for men; 28.4% rate for women
- Breakdown by race: 26.6% rate for White population; 17% rate for Black population; 24.7% rate for Hispanic or Latino population; 25.7% rate for Native American or Alaska Native population
- Breakdown by household income: 30.2% rate for $15,000-$24,999 earners; 23.8% rate for $25,000-$34,999 earners; 23.6% rate for $35,000-$49,999 earners; 18.5% rate for $50,000+ earners

Alabama has long suffered from depression rates that are much higher than the national average. Citing a correlation between physical health and mental health, many experts conclude that the state's high rates of metabolic problems and obesity are among the chief contributing factors to its high rates of mental illness.

#7. Montana (tie)

- Population diagnosed with depression: 24.1% (21.1% above national median)
- Breakdown by sex: 16.3% rate for men; 32% rate for women
- Breakdown by race: 23.4% rate for White population; 28.4% rate for Hispanic or Latino population; 31% rate for Native American or Alaska Native population
- Breakdown by household income: 35% rate for $15,000-$24,999 earners; 28.1% rate for $25,000-$34,999 earners; 23.6% rate for $35,000-$49,999 earners; 17% rate for $50,000+ earners

Montana has one of the highest suicide rates in the country and is part of the group of Mountain West states with the worst access to care. Other factors for Montana's high depression and suicide rates are the prevalence of high-risk groups like veterans and Native Americans, social isolation, cultural stigma surrounding mental illness, vitamin D deficiency and high altitude, and high levels of alcohol use.

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#6. Washington

- Population diagnosed with depression: 24.2% (21.6% above national median)
- Breakdown by sex: 17.1% rate for men; 31.2% rate for women
- Breakdown by race: 26% rate for White population; 26.4% rate for Black population; 17.9% rate for Hispanic or Latino population; 12% for Asian population; 35.8% rate for Native American or Alaska Native population
- Breakdown by household income: 33% rate for $15,000-$24,999 earners; 28.5% rate for $25,000-$34,999 earners; 23.8% rate for $35,000-$49,999 earners; 21.5% rate for $50,000+ earners

Like Montana, Washington state has drastically higher rates of both depression and suicide than the country as a whole. Also like Montana, it's part of the Northwestern collection of states that have not only among the highest rates of depression, but also the worst access to care in America. In terms of access, Washington ranks #46, ahead of only Nevada, Wyoming, Idaho, Utah, and Oregon.

#5. Oregon
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#5. Oregon

- Population diagnosed with depression: 24.6% (23.6% above national median)
- Breakdown by sex: 18.9% rate for men; 30.2% rate for women
- Breakdown by race: 25.5% rate for White population; 23.9% rate for Black population; 18.4% rate for Hispanic or Latino population; 36.4% rate for Native American or Alaska Native population
- Breakdown by household income: 31.9% rate for $15,000-$24,999 earners; 29.8% rate for $25,000-$34,999 earners; 26.4% rate for $35,000-$49,999 earners; 20.5% rate for $50,000+ earners

Oregon made history in November 2020 when it became the first state to legalize psilocybin, the active ingredient in hallucinogenic mushrooms, for use in supervised mental health therapy. There's significant evidence suggesting that psilocybin has incredible potential in the treatment of depression.

#3. Arkansas (tie)

- Population diagnosed with depression: 25% (25.6% above national median)
- Breakdown by sex: 17.7% rate for men; 31.9% rate for women
- Breakdown by race: 26.8% rate for White population; 19.2% rate for Black population; 15.8% rate for Hispanic or Latino population; 35.1% rate for Native American or Alaska Native population
- Breakdown by household income: 32.9% rate for $15,000-$24,999 earners; 23.8% rate for $25,000-$34,999 earners; 20.5% rate for $35,000-$49,999 earners; 19.3% rate for $50,000+ earners

About one in four Arkansans struggle with depression. Suicide is the leading cause of violent death in the state, which has watched its suicide rates climb by a staggering 41% since 2000.

#3. Tennessee (tie)

- Population diagnosed with depression: 25% (25.6% above national median)
- Breakdown by sex: 18.5% rate for men; 30.9% rate for women
- Breakdown by race: 26.8% rate for White population; 19.4% rate for Black population; 18.3% rate for Hispanic or Latino population; 23.7% rate for Native American or Alaska Native population
- Breakdown by household income: 31.6% rate for $15,000-$24,999 earners; 30.6% rate for $25,000-$34,999 earners; 23.8% rate for $35,000-$49,999 earners; 17.2% rate for $50,000+ earners

The first of a trio of Appalachian neighbors that take all three of the bottom spots on the list, Tennessee has a diagnosed depression rate of 1–4. According to a new survey from the CDC that factored in spikes in depression related to COVID-19, Tennessee had the highest depression rates in all of America.

#2. Kentucky
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#2. Kentucky

- Population diagnosed with depression: 25.7% (29.2% above national median)
- Breakdown by sex: 18.3% rate for men; 32.6% rate for women
- Breakdown by race: 26.8% rate for White population; 15.2% rate for Black population; 23.3% rate for Hispanic or Latino population
- Breakdown by household income: 34.2% rate for $15,000-$24,999 earners; 31.4% rate for $25,000-$34,999 earners; 26.3% rate for $35,000-$49,999 earners; 20.5% rate for $50,000+ earners

Kentucky has been listed among the top five states with the highest rates of depression for at least the last five years. It also suffers from low rates of access to mental health care.

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#1. West Virginia
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#1. West Virginia

- Population diagnosed with depression: 28.8% (44.7% above national median)
- Breakdown by sex: 21.7% rate for men; 35.5% rate for women
- Breakdown by race: 28.4% rate for White population; 27.6% rate for Black population
- Breakdown by household income: 40.2% rate for $15,000-$24,999 earners; 26.6% rate for $25,000-$34,999 earners; 21.8% rate for $35,000-$49,999 earners; 20.2% rate for $50,000+ earners

With depression diagnosis rates nearly 45% higher than the national median, West Virginia ranks dead last on the list after a decline in statewide mental health that's been years in the making. Depression rates have increased by a full 25% over the last five years alone.

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