Americans are as unhappy as they’ve been in years — and it seems to be a trend.

That’s one of the main takeaways from Wednesday’s release of the annual “World Happiness Report,” put out to coincide with the United Nations’ International Day of Happiness.

The report, which has been released every year since 2012, surveyed 156 countries using six metrics: GDP per capita, healthy life expectancy, the freedom to make life choices, social support, generosity, and perceptions of corruption.

And despite a having strong economy and low crime rates, the US dropped in the rankings for the third straight year and is now the 19th happiest nation on Earth. (The happiest? Finland, apparently.) That’s America’s worst showing ever, although it’s never made it into the top 10.

Here’s the chart showing the first 52 countries on the list using the criteria. (Note: it’s a big chart, but it’s worth taking a look to see where the US compares to others.)

Some Americans weren’t too impressed with the ranking. “We finished 19th on the list behind Belgium,” ABC late-night host Jimmy Kimmel said on Wednesday. “The people who feel the need to put mayonnaise on their french fries are happier than we are. Cheer up, everybody.”

Why Americans may be so unhappy

It’s not entirely clear why Americans are so dissatisfied, but the report’s authors suggest one possibility: addiction.

“This year’s report provides sobering evidence of how addictions are causing considerable unhappiness and depression in the US,” Jeffrey Sachs, a Columbia University professor and author of the section of the report titled “Addiction and Unhappiness in America,” said in a news release.

“The compulsive pursuit of substance abuse and addictive behaviors is causing severe unhappiness. Government, business, and communities should use these indicators to set new policies aimed at overcoming these sources of unhappiness,” he added.

The Trump administration has made combating the opioid epidemic one of its major initiatives, although its success in doing so is mixed at best.

The hope is that a desperately needed breakthrough arrives soon. My colleague German Lopez explains the extent of the problem:

It is the deadliest drug overdose crisis in US history. In 2016 alone, drug overdoses killed more Americans than the entire Vietnam War and car crashes, gun violence, and HIV/AIDS ever did in a single year. In total, more than 170 people are estimated to die from overdoses every day in the US, and most of the deaths are linked to opioids.

Solving the addiction crisis might increase US happiness standings — but more importantly, it would help thousands of Americans.