A teenager begins sleeping through alarms, stops finishing assignments, withdraws from friends, and seems irritable nearly all the time. Depression is one possibility. So are anxiety, ADHD, substance use, chronic sleep deprivation, or a reaction to something happening at home or school. Could a medical problem be producing, worsening, or disguising itself as a psychiatric one? Fatigue, poor concentration, restlessness, disrupted sleep, appetite changes, declining school perfo

Junior and senior year can go wrong without the report card changing. Grades remain solid while sleep disappears, friendships thin out, and parents begin carrying the work the teenager once managed alone. The student still attends school, completes assignments, practices, rehearses, and moves through the college process. Teachers see a capable student. Friends may see the same person they have always known. The cost of producing that appearance has gone somewhere else. It may