A study published Wednesday by the JAMA Network medical journal found that the number of Americans reporting symptoms of depression has more than tripled during the coronavirus pandemic.

The study included a nationally representative survey of 1,441 respondents taken earlier this year, which found that 28% of respondents reported symptoms of depression. This data was compared to an earlier survey of 5,065 respondents taken between 2017 and 2018, which found that only 9% of respondents had reported symptoms of depression then.

Catherine Ettman, the lead researcher and co-author of the study, told Health Day the increase in reported depression symptoms was larger than expected.