Behavioral health problems are taking a toll on millennials—from depression to anxiety and substance use. And as a result, they’re less healthy than GenXers were at their age.

So says the Health of America study from the Blue Cross Blue Shield Association, which found that a third of millennials are suffering from health conditions that impair both quality of life and life expectancy. The study also found that millennials diagnosed with eight of 10 leading health conditions more often than Gen X are more likely to be less healthy than their Gen X counterparts when they’re older.