Study: Depression rates higher in Appalachia than nation

According to a recent study focusing on the Appalachian region of the United States, things seem to be depressing in more ways than one for its inhabitants.

A study by the Appalachian Regional Commission found a higher proportion of Appalachian adults reporting serious psychological distress and major depressive disorders than in the nation as a whole.

Officially known as the region that encompasses part of Mississippi, Alabama, Georgia, South Carolina, North Carolina, Kentucky, Ohio, West Virginia, Pennsylvania and New York that surround portions of the Appalachian Mountains, the region was known for centuries as an economic hub in the country, mainly because of the coal mining and logging industries.

However, shifts in industry coupled with a sharp decline in coal mining have led many residents and businesses to move west, leaving most of those remaining in the heart of Appalachian in financial and emotional depression.

Psychologist Steve Tackett, of Greenup, Kentucky, said financial difficulty is often a major contributor to the depression of his patients.

"Financial stress is often a significant part of why marriages break up as well," he said. "In our culture, men often define themselves as being the ?provider' for their families, and when they cannot do this due to the inability to find a job, this poses a direct threat to their character and who they are as a person. Excess stress can have a very detrimental effect on us, including depression, anxiety, irritability and health issues as well, such as headaches, backaches, stomach issues, poor sleep, fatigue, etc."

Tackett, who has a bachelor's degree in psychology and a master of education specializing in mental health counseling, said the lack of progress in Appalachia has contributed to economic problems for individuals, as many of the jobs young people expect to be available to them have disappeared.

"When I was growing up, if you were willing to work with your hands and your back, you were able to make a very good living. Today, that is not the case. While you may be able to find a job if you are willing to do physical work, it does not pay the same nor is it as stable as it used to be."

A 2011 study by Gallup not only found Appalachia leads the country in depression, but found the Huntington-Ashland area, at the confluence of Kentucky, West Virginia and Ohio, leads the most depressed areas, with more than 30 percent of its residents saying they have been diagnosed with depression by a medical professional.

Depression Prevalence in the United States | HealthGrove

The generations of individuals who did physical labor for years at companies like AK Steel and CSX and in industries like coal mining, pipefitting and carpentry have more physical problems than those in less physically strenuous jobs. When those physical problems lead to the inability to work, depression often strikes.

"In addition, with the attitude our area has toward people receiving government assistance or on disability, this makes it less likely for these men/women to seek help addressing these serious mental health issues," Tackett said, noting the stigma remains around seeking help for mental health issues.

"Some people think you can just ?pull yourself up by the boot straps' and get moving," he said.

The misunderstanding or distrust of mental health issues reveals a lack of emotional intelligence or lack of communication skills, Tackett said.

"When we stuff our emotions down or avoid them, they only get worse. When we do this over a long period of time, they come back to the surface either by exploding outwardly with anger or we implode internally," he said. "Either way, it can be devastating."

Many in Appalachia react to depression by "self medicating" with a variety of unhealthy behaviors, including drug abuse.

The ARC report found prescription drug abuse is higher in Appalachia than other parts of the country. It's particularly high in coal mining regions, where good-paying jobs have been lost. In fact, the report shows the poorer the region, the higher reported incidents of prescription drug abuse and poor mental health.

Tackett said it's very common for those who are depressed to turn to drugs, alcohol, shopping, sex and other "external" remedies.

"We also have this belief that we should always be happy and should never experience unpleasant emotions, but the avoidance of these unpleasant emotions leads only to more problems," he said. "We look for things to bring us happiness when happiness is actually a journey of how we live our life and not a destination we reach."

Bringing the region and its individuals out of depression might sound like a massive undertaking but Tackett said he believes it's possible.

"There is always hope," he said. "We are a strong people in this area. We just need to be willing to embrace change and diversity more and get outside of our comfort zones because that is where life begins."

Ward writes for the Ashland, Kentucky Daily Independent.