More Colorado youth experienced depression in 2019 than two years earlier, data from a biannual statewide survey of more than 100,000 students released Monday shows.

Nearly 35% of youth reported feeling sad or hopeless in 2019, up nearly 4% from 2017, according to data from the biannual Health Kids Colorado Survey, the state’s only comprehensive survey on health and well-being in middle and high school students. Rates of suicide and attempted suicide did not change.

The rise in mental health concerns among young people didn’t come as a surprise to Dr. Eric Sigel, an adolescent medicine physician at Children’s Colorado, who said the survey’s results mirror what Children’s providers have seen clinically.

“Mental health has always been a huge concern,” he said, emphasizing the survey data was collected last fall, before the coronavirus pandemic and the resurgence of the Black Lives Matter movement.

He also pointed out that the survey only includes students who show up to school on one particular day, inadvertently omitting the “10% or so of higher risk kids who don’t happen to be going to school on the day the survey is administered.”

Sigel said, if a survey were conducted now, he would not be surprised to see an increase in youth depression or a rise in severity of symptoms in those who were already depressed.

The study also found the percent of Colorado youth who vape has not significantly changed since 2015, and cigarette use is decreasing, down 1.5% from 2017. The percent of youth who think vaping is risky rose more than 23% in 2019 from 2017.

Survey results showed the although marijuana use among young people has not significantly changed since legalization in 2012, among those who use the drug, more youth are now vaping and dabbing — consuming concentrated doses of the psychoactive chemical in marijuana. Vaping was up more than 5% over 2017, and dabbing up more than 15%.

Anti-youth marijuana use advocacy group Smart Colorado on Monday warned of that it called an “alarming increase” in “ultra-potent pot products.”

“It’s no surprise that kids are switching to easily concealed ultra-potent pot when they are bombarded with images and marketing for these high-THC products that have proliferated since legalization,” Rachel O’Bryan, one of Smart Colorado’s co-founders, said. “This is not the much milder marijuana of their parents’ generation.”

Additionally, the survey found sugary drink consumption decreased, dropping nearly 1.5% over two years. The youth obesity rate, however, has not significantly changed since 2015.

The survey also found the percent of youth who have had sex has not significantly changed since 2015. Nor has the percentage of youth who use alcohol, marijuana or vape products.

The more than 100,000 students surveyed in 2019 attended 503 public schools in 59 Colorado counties, amounting to the largest survey administration so far. The survey was administered by the Colorado School of Public Health, within the University of Colorado Anschutz Medical Campus. The survey occurs in odd-numbered years, according to a news release sent Monday by the state health department.

Survey results can be viewed here.