West Virginia has the highest share of adults reporting symptoms of anxiety or depression in the US, according to a new analysis of survey data. The study by Nova Kratom examined the average percentage of adults in each state who reported symptoms of anxiety or depression to identify where these mental health symptoms are most widely reported across the nation.
West Virginia leads the national ranking, with an average of 27.23% of adults reporting symptoms of anxiety or depression over the period measured. That means more than 1 in 4 adults in the state reported these symptoms, the highest share recorded in the country.
Alaska and Mississippi follow closely, with Alaska recording 27.13% of adults reporting symptoms, just 0.10 percentage points behind West Virginia. Mississippi sits at 27.12%, only 0.01 percentage points behind Alaska. Despite differences in geography, population density, and climate, the three states recorded almost identical figures, placing them within a narrow band at the top of the ranking.
Fewer than two percentage points separate the entire top 10. The close margins highlight how widely symptoms of anxiety and depression are reported among adults across multiple states, spanning rural and urban areas as well as different economic and geographic profiles.
Complete top 10 state rankings
| Rank | State | Average population percentage with symptoms of anxiety or depression |
| 1 | West Virginia | 27.23 |
| 2 | Alaska | 27.13 |
| 3 | Mississippi | 27.12 |
| 4 | Oklahoma | 26.85 |
| 5 | Kentucky | 26.21 |
| 6 | Louisiana | 26.02 |
| 7 | Utah | 25.64 |
| 8 | Oregon | 25.59 |
| 9 | Arkansas | 25.53 |
| 10 | New Mexico | 25.46 |
Further down the list, Oklahoma ranks 4th with 26.85%, marking the 1st clear step down at 0.27 percentage points below Mississippi. Kentucky completes the top 5 at 26.21%.
Louisiana follows in 6th with 26.02%, making it the last state where more than 26% of the population reported symptoms. Utah ranks 7th at 25.64% and is the only state in the top 10 from the Mountain West outside New Mexico.
Oregon takes 8th at 25.59%, making it one of only two Pacific coast states in the ranking and placing it just 0.05 percentage points behind Utah. Arkansas ranks ninth at 25.53%, meaning 4 of the 10 highest-ranking states are in the South. New Mexico completes the top 10 at 25.46%, a difference of 1.77 percentage points from West Virginia at the top.
A spokesperson for Nova Kratom commented on the findings: “What is particularly striking is that this is not confined to one region or one type of state. From the rural South to the Pacific Northwest to Alaska, roughly 1 in 4 adults are reporting these symptoms. Moreover, the data highlights that economic deprivation alone does not explain these figures. Utah and Oregon sit alongside states like Mississippi and West Virginia, which suggests a more complex picture.”
Official data from sources including the Centers for Disease Control and Prevention and America’s Health Rankings also place West Virginia among the states with the highest rates of diagnosed depression. The latest America’s Health figures, based on 2024 CDC Behavioural Risk Factor Surveillance System data, show that 30.2% of adults in West Virginia reported having been told by a health professional that they had a depressive disorder.
Broader mental health data from the National Survey on Drug Use and Health show that any mental illness affects adults across the US, although this is a broader measure than reported symptoms of anxiety or depression. SAMHSA defines any mental illness as a diagnosable mental, behavioural, or emotional disorder occurring in the past year. The distinction means these figures provide wider context rather than a direct comparison with the Nova Kratom findings.
West Virginia has the highest rate of reported adult anxiety or depression symptoms in the Nova Kratom study, at 27.23%.