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Utah may have a large number of sunny days, breathtaking scenery and a tradition of strong families, but residents here feel blue more often than their counterparts in other states.

Among the nation's 20 most depressed cities - as recently scored by Men's Health magazine - Salt Lake City came in 12th, with a D grade. Researchers at the magazine assigned grades based on information from the U.S. Centers for Disease Control and Prevention on antidepressant sales, suicide rates and the number of days residents reported feeling down.

Evidently, Texas is the place to be, with three of its cities - Laredo, El Paso and Corpus Christi - ranking in the four top happiest. People in Philadelphia were the unhappiest, followed by Detroit and St. Petersburg, Fla.

"I think part of the reason [Utah is in the top 20] is depression is more accepted in the culture here, and more people talk about it," said Michael Measom, a psychiatrist at Valley Mental Health in Salt Lake City.

"And there's a lot of pressure for males here to succeed" due to large families and perceived expectations for members of the dominant religion, The Church of Jesus Christ of Latter-day Saints, Measom said.

Measom noted many Utah couples have more children than the national average, yet pay is generally lower here than in other states - often leading to financial stress.

Antidepressant use in Utah is higher than any other state, with 16 percent of the population taking them, according to Express Scripts, a company that compiles a yearly drug trend report. The second highest use is 14.4 percent, in Maine.

"I'm glad that the use of antidepressants is higher here because the vast majority of depression goes undiagnosed or untreated," Measom said. "But I have no explanation for the suicide rates."

Suicide is the eighth-leading cause of death for all Utahns. Nationally, it is the eleventh-leading cause of death.

From 2000 to 2002, the suicide rate in Utah was 14 per 100,000 people, compared with 10.7 per 100,000 countrywide, according to the Utah Department of Health.

"The Rocky Mountain states do rank higher, and we have consistently for many years," said Cyndi Bemis, media and education coordinator with the health department's Violence and Injury Prevention Program. "We've been looking into the whys for years, but we still can't pin down why a person would take his or her life."

Sam Goldstein, a psychologist in private practice and an assistant professor at the University of Utah, was surprised by the rankings.

"I think you need to take into account whether the statistics are inflated because of the availability of treatment for depression here and better access to mental health services," Goldstein said. "There also isn't as much of a stigma related to depression" in Utah.

Goldstein recently co-authored a book called the The Power of Resilience that explains how negative thinking and behavior can lead to hopelessness, depression and anxiety. The book instructs people how to overcome adversity.

"While I wouldn't propose that our resilience model in and of itself is a depression treatment, it certainly forms the core in ways of thinking, feeling and behaving to combat depression," he said.

Andy Peiffer, medical director of the Men's Health Center in downtown Salt Lake City, said the genetics of Utah may hold the answer to why more people suffer from depression.

"The majority of the population, or at least the Mormon [residents], are mostly of European descent, and they have a higher incidence of depression, especially those of Scandinavian descent," Peiffer said.

"One simple word that may explain the reason why depression might be more prevalent in Utahns is genetics. You have larger families, and depression genes can be passed down. The more kids you have, the more easy it is to see genetically passed down traits."