Sitting on a bench laughing with a co-worker during a morning smoke break, Debra Orcutt quickly raises her hand when asked if she knows anyone dealing with depression.
"I am," she tells a visitor to the roadside market where she bakes brownies and peanut butter fudge.
An estimated 32% of adults in Logan County, West Virginia, have been diagnosed with depression — the highest rate in the United States and nearly double the national rate, according to a report released in June by the Centers for Disease Control and Prevention. With heightened awareness of rising depression rates, the Biden administration has announced plans to expand access to mental health care.
He said his state's combination of poor overall health, low education levels, and poverty — as well as the opioid epidemic, which has hit West Virginia particularly hard — takes a punishing toll on residents' mental health. The county's high rates of chronic diseases like diabetes and obesity also make it a breeding ground for depression, health experts say.
Robert Perez, an internist in Logan, estimates more than half of his patients have depression. But he said few want to talk about it or accept a referral to a psychiatrist and he is limited in what he can do for them. "When you come from this area, you know what the challenges are," Brash said. "And the economic challenges affect the depression — it's not a new phenomenon."
Indeed, Chris Palmer, an assistant professor of psychiatry at Harvard Medical School, said the notion that overprescribing or cloudy weather explains high depression rates does not help the problem.
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