According to a Gallup-Healthways survey, Hickory-Lenoir-Morganton, N.C is America’s 5th most miserable metropolitan area/city.

Here is the explanation:

Roughly 51% of residents in the Hickory region of North Carolina were considered to be struggling, based on self-evaluations of their current lives and futures, compared to just 44% of Americans. Residents were less optimistic about their futures than respondents in all but seven other cities. About 19% said they did not have enough energy to keep pace with their daily lives within the previous 24 hours, which was close to last nationwide. Additionally, only 77.4% said they had not been sad within the past 24 hours, among the lowest rates in the nation. Possibly adding to the unhappiness of residents was the area’s economy. The median household income was just $37,364 in 2012, among the lowest in the country.

No North Carolina metropolitan areas/cities made the list of “most content cities.”

The most miserable metropolitan area/city was the Huntington, WV metro area.  Provo-Orem, Utah was the most content metro area in the survey.