This is one top 5 that Minnesota didn't want to make.
Blue Cross Blue Shield has released a study of its own customer data that reveals Minnesota has one of the highest rates of depression diagnosis in the country.
The state's 5.8 percent diagnosis rate was the 4th highest in the country, behind only Rhode Island, Maine and Utah.
That is significantly higher than the national average rate of 4.4 percent, covering 9 million commercially insured Americans who have been diagnosed with major depressive disorder (also known as clinical depression).
The rate of depression diagnoses among Minnesota women is at 8.1 percent – the joint highest level in the nation.
The rate among millennials (aged 18-34) is also high at 6.3 percent, the second highest in the country behind only Utah.
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The rate is higher in the Twin Cities than the rest of Minnesota, with the overall depression diagnosis rate at 6.3 percent, with the rate for women at 8.6 percent.
The number of cases has risen dramatically nationwide, up 33 percent since 2013 and is rising particularly quickly among millennials (up 47 percent) and adolescents aged 12-17 (47 percent for boys and 65 percent for girls).
Impact on wider health
The findings have significant implications for the overall wellbeing of Minnesota's citizens.
Blue Cross Blue Shield notes that major depression is the "second most impactful condition" on overall health for insured Americans, behind only high blood pressure.
Healthline notes that clinical depression is often diagnosed in patients who experience persistent and intense feelings of sadness for extended periods of time.
It impacts mood, behavior, and physical functions such as appetite and sleep. In severe cases it can lead to suicidal thoughts.