Up to a third of Americans in some parts of the country suffer from depression, according to shocking official data that lays bare the mental health crisis in the US.
Overall, one in five adults say they have been diagnosed with depression at some point in their life, according to a Centers for Disease Control and Prevention (CDC) report released last week.
The new data, from 2020, is up from less than one in 10 in 2016.
At the county level, rates are even higher, with close to one in three in the counties of Logan, McDowell, Lincoln, and Wyoming in West Virginia saying they have been diagnosed with depression at some point.
Mental health problems have been worsening for decades, linked to unhealthy diets, lack of physical exercise and increasing loneliness — as well as reduced stigma.
While the data is from 2020, depression rates are thought to have been exacerbated during Covid due to lockdowns, loss of loved ones and a rise in isolation and anxiety.
There has also been an uptick in suicides and mental illness in general, plus a shortage of psychiatrists.
The top 20 most depressed counties are in some of the poorest, unhealthiest and most obese states.
The percentage of adults who said they have been diagnosed with depression during their life
20 most depressed counties in America
- Logan, West Virginia (31.9)
- McDowell, West Virginia (31.6)
- Lincoln, West Virginia (31.1)
- Wyoming, West Virginia (31.0)
- Cowlitz, Washington (30.9)
- Wolfe, Kentucky (30.7)
- Webster, West Virginia (30.3)
- Mingo, West Virginia (30.1)
- Wirt, West Virginia (29.9)
- Clay, West Virginia (29.8)
- Harlan, Kentucky (29.7)
- Hancock, Tennessee (29.7)
- Scott, Tennessee (29.7)
- Grays Harbor, Washington (29.7)
- Fayette, West Virginia (29.7)
- Kanawha, West Virginia (29.4)
- Mason, West Virginia (29.4)
- Marion, Tennessee (29.3)
- Cabell, West Virginia (29.3)
- Roane, West Virginia (29.3)
20 least depressed counties in America
- Kalawao, Hawaii (10.7)
- Aleutians East, Alaska (10.7)
- Aleutians West, Alaska (11.3)
- Prince George’s, Maryland (12.5)
- Santa Clara, California (12.6)
- San Mateo, California (13.6)
- Alameda, California (13.6)
- Honolulu, Hawaii (13.8)
- Middlesex, New Jersey (13.9)
- San Francisco (14.0)
- DuPage, Illinois (14.2)
- Kodiak Island, Alaska (14.2)
- Cook, Illinois (14.4)
- Lake, Illinois (14.6)
- Nassau, New York (14.7)
- Howard, Maryland (14.8)
- Marshall, South Dakota (14.9)
- Bon Homme, South Dakota (14.9)
- Dakota, Nebraska (14.9)
- Montgomery, Maryland (14.9)
The CDC report found that rates ranged from 12.7 percent in Hawaii to 27.5 percent in West Virginia in 2020.
County-level estimates show that Logan, McDowell, Lincoln, and Wyoming in West Virginia are the most depressed, with around one in three residents suffering the debilitating condition.
The least depressed county is Kalawao in Hawaii, where less than one in 11 people are depressed, followed by Aleutians West and Aleutians East in Alaska. LOWER
It comes as prominent figures such as Dwayne Johnson and Sen. John Fetterman have spoken out about their struggles.
Researchers believe depression is higher in counties in West Virginia, Kentucky, Tennessee and Washington due to the prevalence of other chronic diseases, such as diabetes, and other social factors, including poverty.
West Virginia and Kentucky have the highest rates of obesity in the country. West Virginia is also one of the nation’s poorest states.
‘There was considerable geographic variation in the prevalence of depression, with the highest state and county estimates of depression observed along the Appalachian and southern Mississippi Valley regions,’ researchers wrote in the report.
The researchers said they hoped the new data would ‘help decision-makers guide resource allocation to areas where the need is greatest.’
The study was compiled with data from nearly 400,000 adults across the 50 states.
In Cowlitz, Washington, almost a third of respondents said they had been diagnosed with depression at some point in their life.
Similarly, more than 30 percent of those asked in Wolfe, Kentucky, reported a lifetime depression diagnosis.
The least depressed counties are Kalawao in Hawaii, where less than one in 11 people have been diagnosed with the condition.
Aleutians East in Alaska is equally as happy, followed by Aleutians West and Prince George’s in Maryland.
It might not come as a surprise that picturesque Hawaii is bottom of the depression rates list.
Very few Hawaiians are obese or smoke — a recipe for good health.
Previous polls have also shown that Alaskans have low rates of obesity, a healthier sense of purpose, less financial stress and better physical health than residents of almost any other state.
Santa Clara, San Mateo and Alameda in California also have depression rates between 12.6 and 13.6.
Nicknamed ‘the Gold State’, Californians have good job prospects, greater wealth and good physical and mental health, leading to an overall high quality of life.
Lake, Cook and DuPage in Illinois also make the top 20 least depressed states.
Previous research showed the state ranked high for personal finance, leisure activities, employment and physical and mental health.
The CDC researchers suggested that the geographical variation may in part be explained by the prevalence of other chronic diseases.
Chronic diseases, such as diabetes, arthritis, and cardiovascular diseases, occur in high concentrations in the Appalachian region, where depression is also high.
They argue that depression is a comorbidity for these illnesses; therefore, high levels of depression are linked to their presence in the region.
Other social factors were also cited as an explanation for high levels of depression.
Adults in the Appalachian region tend to have lower incomes, higher poverty rates, and lower education levels, all of which can negatively affect health and well-being, according to the study.
The results also showed that levels of depression were higher in women, younger adults and adults with lower education levels.
Some 24 percent of women, compared with just 13 percent of men, reported having experienced depression.
The statistics were also higher among adults who had attained less than a high school education, 21 percent, compared with adults with a high school education or equivalent, 18.5 percent. Those with college degrees fared best, with 15.4 percent reporting a diagnosis.
Other recent reports have shown a jump in Americans reporting lifetime depression diagnoses in recent years.
Gallup reported in May that 29 percent of Americans had been diagnosed with depression at some point, which was nearly 10 percent more than in 2015.
‘The fact that Americans are more depressed and struggling after this time of incredible stress and isolation is perhaps not surprising,’ Dr Rebecca Brendel, president of the American Psychiatric Association, said.
‘There are lingering effects on our health, especially our mental health, from the past three years that disrupted everything we knew,’ Dr Brendel, who was not involved in the CDC study, added.
Mental health took an undisputable hit during the Covid pandemic. Depression rates have been increasing since 2015 but have taken on a sharper upward trajectory in recent years.
The pandemic hit many young adults at a crucial point in their development, leaving them more at risk to depression due to social isolation, loneliness and fear of infection.
Drug use rose 16 percent and alcohol use 23 percent, while suicide rates have rocketed, with CDC data suggesting one in ten teens have attempted suicide in 2021.
Increased substance abuse also played a part, as did mental health care deserts due to facilities temporarily or permanently closing.
Experts also say that awareness around mental health has grown and become less stigmatized, which have led to greater rates of diagnosis and is a positive change.
Dwayne ‘The Rock’ Johnson recently opened up about his struggles with depression, following his split from his first wife Dany Garcia.
Mr Johnson said he wrestled with his mental health and described struggling with depression after his college football career ended and, later, after his divorce from Ms Garcia.
He said this time he was able to identify his depression and ‘lean on’ friends.
The wrestling legend turned actor previously spoke out about his secret battle with depression which left him ‘devastated and crying constantly’, one month after he revealed he had witnessed his mother attempt suicide when he was 15.
And Sen. John Fetterman said that depression ‘nearly ruined me’ and he avoided a potentially ‘tragic’ outcome by checking into the hospital for six weeks of inpatient treatment.
The Pennsylvania Democrat said his crippling depression diagnosis left him confined to his bed.
Mr Fetterman, 53, said he ‘had stopped leaving my bed, I’d stopped eating, I was dropping weight, I’d stopped engaging in some of the most — things that I love in my life.’
He checked into Walter Reed National Military Medical Center on February 15 after weeks of what aides described as Fetterman being withdrawn and uninterested in eating, discussing work or partaking in banter with staff.
Mr Fetterman was barely a month into his service, following his defeat of Dr Oz, in Washington and still recovering from the aftereffects of the stroke he suffered last May when he went to Walter Reed on the advice of the Capitol physician, Dr Brian Monahan.
Post-stroke depression is common and treatable through medication and talk therapy, doctors say.
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