Local psychologist shares prevention tips with insights into higher teen depression, suicide rates

Jan. 4—MultiCare clinical psychologist Kimberly Chupurdia knows the stories behind the 2023 data indicating higher rates of depression among teens — and for some — suicidal thoughts.

She regularly sees teenagers, among other patients, at the Rockwood Quail Run Clinic on the South Hill. She believes two reasons factor into the rise in teens' anxiety and depression: lingering effects from COVID shutdowns and an uptick in social media use.

Some teens have had difficulties transitioning back to school and other social structures, even months beyond pandemic closures, Chupurdia said. While many schools returned to in-person classes by January 2022, there are teens still struggling, she said.

"Just the last couple of years, we've seen quite a rise in teens having significant mental health issues, as well as suicidal thoughts, feelings, behaviors," said Chupurdia, who also is a behavioral health specialist.

"Some of these kids really felt like COVID was a traumatic experience, and they're not dealing as well with the transition back into real life," she said. "They aren't doing as well with social interactions and integrating into the school systems. There's a lot more anxiety. They still talk about it like it happened yesterday."

A Washington state report released in July reported similar concerns.

It found 21% of 10th graders in Washington had considered suicide when they took a survey in 2021. About 16% actually planned a suicide, and 8% attempted suicide.

The report also detailed that 14% of 10th graders were bullied within the past month, that 39% felt sad or hopeless for two or more weeks in a row in the past year and that only 51% reported they had a trusted adult to consult with when sad or hopeless.

Signs and ways to help

Children between the ages of 12 and 15 who spend more than three hours a day on social media may be at a heightened risk for mental health problems, a 2019 study found.

Chupurdia urges no more than two hours a day for teens to view social media. Cyberbullying occurs, she said, but there are other online hazards.

"If you get on Instagram and you see your friend is out having fun with other people and posted a picture of that, to a kid who is a little anxious socially, that's going to make them feel bad, 'Why wasn't I included? Why are they having fun without me? They must hate me,' " Chupurdia said. "They spin it in a way that is really unhealthy.

"No teenager should have unlimited access to social media; they are still children."

The state of Washington has joined dozens of other states to sue Meta, the parent company of Facebook and Instagram, accusing the social media giant of fueling a nationwide youth mental health crisis by engineering products to be addictive for children.

Chupurdia offered some signs adults can look for regarding teen depression, including behavior changes such as unusual eating and sleeping patterns, withdrawal from others, impulsiveness, acting out more or arguing. It might be more impulsiveness without thinking through consequences or ongoing feelings of sadness and loss of interest in usual hobbies and activities.

"Prevention is primarily noticing that something is off and having somebody who is a professional — either medical professional or mental health professional — evaluate them," Chupurdia said.

"When you see your kid not being your kid, I don't think it's ever a bad idea to overreact and get them checked out. It might mean going to see your regular provider to make sure."

In Washington state, youths ages 13 and older can get behavioral health services without prior consent from a parent, guardian or family member. Medication can never be forced, Chupurdia said, and antidepressants aren't always necessary.

Intensive group treatment is for serious depression and ongoing struggles with suicidal thoughts, she said.

"Hospitalization might be necessary if a teenager has a pretty specific plan."

The most common therapy is one-on-one with a licensed professional to help the youths build coping skills. If teenagers are struggling with sleep, medication might aid with nightly rest, Chupurdia added.

"Getting a good night's sleep is pretty key to managing depression."

Parents should be aware of teenagers' time spent on cellphones — and set limits ahead of regular bedtimes, Chupurdia said.

"The phone should go away an hour before bed so that they can unwind," she said. "They should have a bedtime and not be allowed to stay up half the night on their phones.

"For someone who is feeling suicidal, I might even suggest a vacation from the phone and social media in general, for a couple of weeks, just to get rid of that saturation and to focus on actual in-real-life relationships."

She said teens refer to IRL, for "in-real-life" friends, versus online friends. Some adolescents have befriended others solely online, such as in playing video games, without ever developing in-person relationships with them.

"That's a problem regardless of suicide, but it certainly would be a risk factor, not having those in-real-life friends."

Suicide risk goes up dramatically when there is also substance use, such as alcohol or marijuana, she added.

One challenge is that teenagers' brains are still developing, so impulsive and experimental behaviors can happen, she said.

"It's a fine line, but if you notice an increase in impulsive behaviors, I'd call that a risk factor."

Parents might try to encourage a teen to do more social activities, she added, such as school sports, clubs or outside activities with peers.

Resources

Many primary care providers can evaluate a teen for mental health concerns and refer to a therapist. It's becoming more common for providers to use a patient health questionnaire, or PHQ-9, with nine questions about depression and its severity. It asks how often someone has found little pleasure in doing things normally enjoyed, or the frequency of feeling down, depressed or hopeless.

The National Suicide Prevention Lifeline is 988.

Excelsior Wellness partners with Spokane County for a free service, at TeenTextSpokane.org or (844) 814-8336, from 9 a.m. to 8 p.m. Monday through Friday. It's available to teens or young adults in Adams, Ferry, Lincoln, Pend Oreille, Spokane and Stevens counties.

The Trevor Project operates a 24/7 national suicide prevention hotline for LGBTQ youth, reachable by calling 1 (866) 488-7386, texting 'START' 678-678 or messaging online at thetrevorproject.org/get-help.