MedStar Health Blog

Teens today seem to experience depression and anxiety more than ever before. While social pressure to make friends and get along with others in school has always played a role in mental health, today’s teens face unique challenges because of technological developments, like social media, that allow for constant interpersonal exchanges without natural downtime.

We can see social media’s impact on teen depression and anxiety, as it can cause:

• Pressure to fit in: Teens’ desire to fit in with classmates can be magnified by social media, as they naturally can compare themselves to their peers who post pictures of themselves at social events, such as concerts or birthday parties.
• Cyberbullying: Bullying can go to the next level with social media, as teens can message one another instantly and spread secrets or other information to classmates much more easily.
• Decreased social skills: Social media can make it easy for teens to stay home and rely on online interactions rather than real life ones. As a result, teens can miss out on learning important social skills.

Parents often feel confused because some of these effects are similar to common adolescent behaviors. However, there are key symptoms parents should look for to reduce risks associated with anxiety and depression, and red flags that a teen needs behavioral health care.

Spotting symptoms of depression and anxiety

Depression is continuous or cyclical severe despondency and dejection; anxiety is feeling worried, nervous, or uneasy without a specific cause, or about events over which the teen has no control. Some parents report that their children make negative comments about themselves, such as, "I'm stupid,” “School is dumb or boring,” or “I'm just not as good as the other kids."

Other symptoms of depression and anxiety can include:

• Irritability
• Low energy
• Lack of interest in favorite activities
• Risk-taking behaviors, such as drug use, dangerous driving, or self-harm
• Trouble sleeping

Repeated behavior for weeks or months is a key way to differentiate typical teenage mood swings from depression or anxiety. For example, if you notice your teen waking up late and hardly getting out of bed on the weekends, look for patterns or triggers to determine whether this is routine behavior or out of the ordinary for your child. If these behaviors seem to be out of the ordinary, consider talking to your child’s doctor.

Tips for parents, and how a doctor can help

When it comes to social media, we often suggest that parents monitor their child’s usage to help them avoid the implications it can have to their mental health. The American Academy of Pediatrics and Family Practice suggests no more than two hours of screen time (cell phones, laptops, etc.) per day, and none at night. A good tip for helping limit the use is to ask your child to keep their phone in the kitchen at night. Additionally, make sure you have access to your child’s phone so you have the ability to monitor what apps they’re using or websites they’re visiting.

If you visit with a family doctor, we typically act as a “central dispatch.” You can bring your problems to us, and we will help you create a path based on where you and your child want to go. This can include meeting with a therapist and receiving behavioral therapy, taking medication, or making lifestyle modifications that can help relieve symptoms of depression and anxiety. Some helpful lifestyle modifications may include:

• Eating a healthy diet
• Exercising at least 30 minutes a day, four days a week
• Sleeping eight to 10 hours per night

As parents, one of our most important roles is to help our children love themselves. If something seems off with your teen’s mental health, don’t hesitate to speak to them about it and seek medical attention, when necessary.

Ductal carcinoma in situ (DCIS) is the earliest form of breast cancer. DCIS is confined to the milk ducts of the breast, and it’s often considered “stage zero.” Each year, 51,000 women are diagnosed with DCIS during their mammogram.

Women naturally feel anxious when they learn they have DCIS breast cancer. However, DCIS is different from more aggressive cancers—it is highly treatable. For the majority of patients, the primary concern with DCIS is whether it returns after treatment and, if it does, whether it spreads beyond the milk ducts. It’s important to seek treatment for DCIS, and patients today have more options than ever.

Years ago, we treated most forms of breast cancer with mastectomy, which removed cancer cells but also removed the entire breast and required women to undergo chemotherapy and radiation therapy. Today, we know more about DCIS and can offer women a broader range of treatment options—including the potential to avoid surgery all together.

LISTEN: Dr. Patricia Wehner discusses DCIS breast cancer treatment in the Medical Intel podcast.

How is DCIS detected?

Age is the most important risk factor for developing breast cancer. The older a woman is, the greater her risk. As such, DCIS often is diagnosed later in life during a woman’s annual mammogram, which is a breast health check-up and a screening for potential breast cancer.

DCIS can appear as little white dots on the mammogram imaging. If the dots are new, increasing in size, or clustered together, it could indicate that DCIS is present. The doctor may recommend a minimally invasive needle biopsy, in which we numb the area of the breast that potentially contains DCIS and remove a small sample of breast tissue. Under a microscope, a pathologist will determine whether the dots indicate cancer or a benign condition such as calcium deposits.

If we diagnose DCIS, we will recommend a few more tests to help us start a conversation with patients about what type of treatment is best for them.

How is DCIS treated?

The standard treatment is a team approach. In the lab, we’ll test the breast tissue to determine whether the cancer has hormone receptors. If it does, patients have the option to take an anti-hormone medication to treat the cancer.

If the affected area of the breast is small, we generally can remove it by doing a partial mastectomy, or a lumpectomy, in which we remove only the cancerous tissue and a small portion of healthy tissue that surrounded the cancer. We generally recommend radiation therapy after a lumpectomy, which generally starts a month after surgery and continues for three to six weeks. Radiation is localized to treat just the cancer site and, in combination with surgery, can reduce the risk that the cancer will return.

We do not use chemotherapy to treat DCIS. It affects the whole body, and the negative side effects outweigh the benefits for this type of cancer. Radiation therapy reduces the risk of DCIS coming back by about 50 percent.

Observation alone might also be an option for patients with low-risk DCIS. We are involved in the COMET trial, in which women are given mammograms every six months to check for changes in the cancer. The goal is to determine whether more women can avoid breast surgery and effectively manage DCIS through monitoring only.

What can women expect during recovery?

Most patients who have a partial mastectomy can go home the day of surgery. Patients wear a bandage to cover the incision on their breast and a supportive bra that we recommend wearing for a week after surgery to support the breast. Many patients use prescribed pain medication for just a day or two after surgery, and patients have very few restrictions during recovery.

Being diagnosed with any type of cancer is scary. Thankfully, women with DCIS have several options to treat the cancer and reduce the risk that it will return.