The state you live in may affect your state of mind , according to new report that shows that rates of stress , depression , and emotional problems vary by geographic region . Where you live may affect your state of mind , according to a new mental health report . That 's good news if you live in Hawaii , where only 6.6 percent of people report frequent mental distress . Not-so-good news for those in Kentucky : In the Bluegrass State , 14.4 percent of people said they frequently experienced mental distress -- the highest prevalence in the country . Frequent mental distress is defined as having 14 or more mentally unhealthy days during the previous 30-day period . The researchers were surprised that the study , which will be published in the June 2009 issue of the American Journal of Preventive Medicine , showed such a broad range in mental distress depending on geographic location . `` The occurrence of frequent mental distress in adults differs much more than expected among the residents of U.S. states and counties , '' said lead researcher Dr. Matthew M. Zack , of the Centers for Disease Control and Prevention in Atlanta , Georgia . People who have frequent mental distress may have treatable and preventable mental illnesses or problems , and social programs or interventions may help , Zack said . Health.com : How stress may affect psoriasis In the study , the researchers looked at rates of mental distress by state among 2.4 million adults across two time periods -- 1993 through 2001 and 2003 through 2006 -- as part of the ongoing Behavioral Risk Factor Surveillance System study . Overall , the prevalence for frequent mental distress across both time periods was 9.4 percent , with the lowest rate in Hawaii and the highest rate in Kentucky . Why the difference ? It may be because residents in some areas of the country are more likely than others to have health conditions such as disability or diabetes , untreated mental conditions like anxiety or depression , high unemployment rates , risky behaviors including cigarette smoking and alcohol abuse , and/or social circumstances such as lower incomes . Health.com : Manic spending puts bipolar patients at risk for financial woes An area centered on Kentucky showed high levels of frequent mental distress that remained elevated over time , while in other parts of the country -LRB- such as the upper Midwest -RRB- low levels of frequent mental distress remained low over time , the study showed . Health.com : Secrets to a stress-free home Overall , though , frequent mental distress seems to be on the rise . The rate of frequent mental distress increased by at least 1 percentage point in 27 states , and by more than 4 percentage points in Mississippi , Oklahoma , and West Virginia from the first time period to the second time period . `` In some areas , normal or low frequent-mental-distress levels increased over time , implying the introduction of influences that increased levels of frequent mental distress , '' Zack said . Health.com : Stress-reduction therapy may hike breast cancer survival rates The new state-by-state breakdown of rates of mental distress should have ramifications as the Obama Administration takes on health care reform , said Chuck Holzer , a professor of psychiatry and behavioral science at the University of Texas Medical Branch in Galveston . `` From a public health standpoint , it 's great to be aware of places with high rates of frequent mental distress so we can help make sure that access to care is increasing in those areas , '' he said . Many of the states with high rates of frequent mental distress are struggling economically , as are their residents . As a result , they may not be able to afford health insurance that includes mental health services . `` The big message is that you need to monitor the health and mental health of the country because it will lead to greater equity in mental health services , '' Holzer said . And Zack said , `` Community mental health agencies , social service agencies , and public health agencies in counties where frequent mental distress is increased should recognize that such increases may indicate unmet health and social service needs . '' Enter to win a monthly Room Makeover Giveaway from MyHomeIdeas.com