My teenager won't go to school because of depression

Key Takeaways:

  • School refusal often signifies a larger issue, such as an underlying mental health condition.
  • It’s common for depressed teens to refuse to go to school or avoid school-related activities.
  • Seeking professional help early enough can help alleviate teen depression, enhancing a teen’s engagement with daily life and activities.
  • Parents and educators should collaborate to create supportive environments for depressed teens to improve school attendance and performance.

Teen school refusal can frustrate parents, yet it should be approached with understanding and empathy. Teen depression can make adolescents lose interest in everyday activities, leading to school refusal and poor performance. Simple solutions such as a calm, honest conversation can help you determine why your teen won’t attend school and chart the best course of action. 

Hello, I’m Evan Powell, co-founder of Key Healthcare, one of California’s most trusted teen residential treatment centers. A common concern about school refusal I hear from parents is, “My teenager won’t go to school because of depression.” Depression in teens is a serious problem. It is both challenging and delicate, thus requiring a compassionate, informed approach to support these young individuals effectively. In our center, we prioritize understanding and addressing the root causes of such behavior, ensuring that every teenager receives the care and guidance they need to navigate their mental health struggles and return to their educational journey with confidence and support.

Read further to understand what your adolescent is going through and how you can spot signs of depression in your teen. I have also shared practical advice on how to talk to your teenager, where to find professional help, and how to make things easier at home. Most importantly, I want to tell parents to care for themselves during this tough time. Key Healthcare can help you connect with other parents in the same boat. This way, you can feel more confident and supported in helping your teen get through this tough period.

The Link Between School Avoidance and Teen Depression

Depression in adolescents is commonly associated with feelings of hopelessness and worthlessness, loss of interest in previously enjoyed activities, isolation, and, occasionally, reduced self-esteem: symptoms that can lead to school avoidance. Depressed teens may also refuse to go to school or participate in any school-related activity to avoid additional stressors such as academic pressure, bullying, and high expectations. Before going any further, let’s define school refusal and some of its signs.

Definition of School Refusal

Teen School refusal occurs when an adolescent refuses to attend school or participate in school-related social activities. It is considered a symptom rather than a disorder as it stems from a variety of issues, including bullying and mental health disorders.

Signs of School Avoidance

Common teen school avoidance will look like temper tantrums, crying, feigning illness, and self-harm threats. Teens may also frequently request to stay at home,  invent lies, or report late to school despite leaving home early to avoid attending school or participating in school-related activities. Other tell-tale signs include the following:

  • Sudden decline in school performance
  • Frequently complaining about physical issues such as headaches and stomachaches on school days. 
  • Withdrawal from school-related social activities
  • Increased defiance or resistance towards teachers and school staff
  • Avoidance of school-related discussions

Since depressed adolescents commonly exhibit the above school refusal signs, it’s important to fully explore teen depression, beginning with its common signs and symptoms.

Recognizing the Signs of Teenage Depression

  • You can tell a teenager is depressed through their behavior, emotions, and physical appearance. 
  • Common behavioral changes include drastic changes in sleeping patterns, energy loss, exhaustion, significant appetite changes, increased alcohol/ drug intake, restlessness, agitation, increased isolation, frequent temper outbursts, loss of interest in frequently enjoyed activities, and rebellion. 
  • Emotional indicators of teen depression include feeling empty, sad, hopeless, or worthless, preoccupation with suicide or self-harm, extreme sensitivity to rejection and failure, impaired thinking, concentration or decision-making, exaggerated self-blame or self-criticism, increased fixation on past failures, low self-esteem and memory issues.
  • Teen depression also manifests physically through neglect of personal hygiene, frequent crying spells, self-harm-related bruises and cuts, frequent engagement in risky behaviors, and physical discomforts such as stomachaches, headaches, fatigue, and lower back pain. 

Causes and Risk Factors of Teenage Depression

The causes of teenage depression can include biological, environmental, and physical factors. This is a brief exploration of these aspects.

Biological Factors

Common biological factors associated with teen depression include brain chemical imbalances, genetics, hormonal changes, and learned patterns of negative thinking. Depression can also be caused by life-threatening illnesses, chronic or long-term physical health problems, and conditions that lead to significant life changes.

Environmental Factors

Peer groups, family history and circumstances, and socioeconomic situations can lead to or exacerbate teen depression. For example, teens from disadvantaged socioeconomic backgrounds or dysfunctional families are more likely to be depressed than teens from loving and economically stable families.

Physical Factors

Common physical factors associated with teen depression include physical abuse, domestic violence, inadequate sleep, an unhealthy diet, and lack of exercise.

The Impacts of Teenage Depression On Academic Performance

Teen depression can affect several aspects of an adolescent’s life, ranging from academic to familial. Let’s explore further.

Academic Struggles

The relationship between academics and teen depression is complex, intertwined, and worth exploring. Academic-related competition, expectations, and deadlines can cause intense pressure, contributing to the onset of teen depression. 

Conversely, teen depression can cause concentration difficulties, impaired thinking, and reduced interest in school activities, leading to academic struggles. The resultant academic challenges can also increase feelings of hopelessness and worthlessness, further exacerbating depressive symptoms.

Social Isolation

Depressed teens tend to isolate themselves mostly due to reduced interest in daily life activities and increased feelings of worthlessness and hopelessness. Depression can also lead to low self-esteem, prompting a teenager to shut down or pull away from the world. Unfortunately, social isolation in teens is detrimental to depressed teens as it can worsen their condition.

Family Dynamics

Teen depression can have immense impacts on the family unit. It can foster angry, critical, and conflictual family interactions, leading to communication breakdown and strained relationships. It can also cause intense family tension and stress as family members struggle to understand and support their loved ones. Check out Key Healthcare’s family therapy program if you or your family members are trying to help a depressed teen.

Popular Treatment Options and Professional Help for Depressed Teens

Teens unable to attend school because of depression need professional help, delivered through the following interventions:

Teen Therapies and Counseling

Here are a few evidence-based therapeutic interventions for teen depression:

Cognitive Behavior Therapy (CBT)

CBT for teens is a common therapeutic intervention premised on the idea that thoughts and behavior are connected. It identifies and challenges depressive thought patterns and cultivates more realistic and positive perspectives to address depression. CBT sessions also equip teens with practical coping skills and positive behavioral strategies for depressive symptom management.

Family Therapy

A teen’s family background and dynamics can lead to the onset of teen depression or exacerbate symptoms. As a standard teen treatment intervention, teen family therapy seeks to understand and resolve underlying problems within the family system for comprehensive and holistic treatment. It fosters increased support for depressed teenagers by teaching teens, parents, and siblings about depression and allowing them to explore issues causing teen distress. Participants learn new communication strategies and develop healthy relationships in collaboration with the therapist.

Individual Therapy

Teen Individual therapy is a standard structured intervention for several teen mental health issues, including depression. It creates an open and non-judgmental therapeutic environment, allowing adolescents to have closed discussions about their encounters and struggles. Counselors encourage teens to be honest and transparent during individual counseling by building trust and cultivating a non-judgmental environment.

Dialectical Behavior Therapy (DBT)

DBT for teens is a widely used evidence-based therapeutic intervention that helps teenagers acquire the necessary skills for a healthier and happier life. It combines mindfulness techniques and cognitive-behavioral therapy strategies to foster improved distress tolerance, interpersonal effectiveness, emotion regulation, and present-moment awareness. Therapists often use this approach to help depressed teens manage intense emotions, healthily cope with stress, and navigate interpersonal relationships. Unlike CBT, DBT is premised on the idea that two opposing thoughts can exist simultaneously, and both can be true. It helps adolescents learn self-acceptance while pursuing behavioral change.

Medication and Its Role

Besides therapy and counseling, treatment professionals can use pharmacological interventions to address depression-associated school refusal. Medications such as serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs) help modulate the brain’s neurotransmitter levels to alleviate depressive symptoms.

When creating personalized medication plans, treatment professionals consider possible side effects, the teen’s preferences, existing medical conditions, and medication tolerability. During planning, they involve parents and caregivers to foster a collaborative treatment approach and promote teen medication adherence. The teen’s medication response is also closely monitored, and adjustments are made during regular follow-up appointments. However, medication is mostly used alongside therapeutic interventions and lifestyle changes.

Choosing The Right Treatment Program for Teen Depression

Finding the right treatment program is key to getting your teen back on their feet and interested in school. Consider the following factors when assessing the best treatment programs for school refusal because of depression:

  • Qualified, experienced therapists specializing in teen depression or mental health treatment
  • Evidence-based treatment approaches such as CBT, DBT, and Acceptance and Commitment Therapy
  • Flexible payment options. 
  • Aftercare planning or programs
  •  Peer support/ group therapy
  • Regular assessment and monitoring
  • Open communication channels
  •  Academic support
  • Tailored and holistic treatment plans
  • Family participation opportunities 

Key Healthcare offers accredited teen mental health programs administered by highly qualified and experienced therapists in Los Angeles and its environs. You can also pay for your teen’s treatment via insurance (verify here), saving you from costly out-of-pocket expenses and any associated inconveniences.

How To Encourage Depressed Teen To Go To School

Note that parental or caregiver roles begin long before diagnosis, evaluation, or treatment planning and extend past treatment. More often than not, it’s parents who observe and recognize early signs of teen depression, engage in helpful discussions, and initiate early intervention by consulting therapists or mental health professionals. They are also part of the teen’s primary support system.

Although seeking professional help is a fundamental approach to depression-induced school refusal, it is not a standalone solution. Communication, a supportive home environment, and social connections are equally important. Here are a few strategies that can help:

Communicating with Your Teen

  • You should create a safe and non-judgmental space premised on empathy, active listening, and validation when dealing with a depressed teenager.
  • Remember to prioritize open-ended conversations, avoid criticism, and offer support without imposing solutions.
  • Educating yourself about depression can also help you understand your teen’s experiences better, fostering empathy for improved communication.
  • Other important strategies include regular check-ins, reassurances, and expressing genuine concern.

Building a Supportive Environment

Depressed teens need a sense of stability, increased understanding, and empathy, which only a supportive home environment can offer. Here are a few strategies that can help you build such an environment:

  • Learn more about teen depression to understand your teen’s experiences and how to support them best.
  • Create a safe, non-judgmental environment where your teenager can freely discuss their issues and air concerns.
  • Make positive family lifestyle changes by incorporating physical activities, nutritious meals, and dedicated bedtime routines.
  • Make them feel loved, recognized, and appreciated. For example, include them in family activities and reassure them of your love and support.
  • A supportive school environment can positively impact the well-being of a depressed teenager and help prevent or minimize cases of depression.

Encouraging Social Connections

  • Social withdrawal during depression can exacerbate feelings of hopelessness and worthlessness or lead to suicidal intent and ideation.
  • You should encourage your teenager to form and maintain positive friendships for enhanced peer support by temporarily relaxing your usual rules around socializing, occasionally inviting a few of their friends over, and encouraging them to try new hobbies, positive experiences, or activities.

Encouraging Self-Care Practices

  • Self-care practices can help teens navigate and manage challenging situations and intense feelings of anger, sadness, helplessness, and confusion characteristic of depression.
  • The best self-care tips for teen depression in our programs include regular exercise, healthy sleeping habits, meditation, journaling, establishing a routine, limiting screen time, and engaging in healthy patterns.

Cultivating Parental Coping Strategies

  • Learning to cope with the challenges of dealing with a depressed teenager helps you create a supportive home environment.
  • You should educate yourself about teen depression and take care of your mental health by prioritizing self-care, seeking support from friends, family members, and support groups, setting realistic expectations, establishing boundaries, taking breaks, cultivating patience, and seeking professional help.

Can Teenage Depression Be Prevented?

Teenage depression is preventable. Here are a few prevention strategies that can help parents :

Encouraging Mindfulness and Emotional Regulation

  • Mindfulness practices such as sitting meditation promote present-moment awareness and enhance teenagers’ self-awareness and resilience, helping them cope with challenging situations.
  • Besides mindfulness, emotional regulation techniques such as positive self-talk, forward-looking, and attention-shifting help teenagers deal with intense or fluctuating emotions. 

Promoting Healthy Lifestyle Choices

  • A healthy lifestyle can help prevent and manage depression.
  • Teens should connect with supportive peers, engage in positive social activities, exercise regularly, eat healthy, nutritious meals, explore self-help activities such as mindfulness, adopt a regular sleeping routine, and learn new positive coping strategies.

Educating Teens About Mental Health

  • Teenage mental health education is important.
  • You should help your teen understand what having good mental health means, the number of people experiencing mental health issues, existing mental health stigmas, potential dangers of untreated mental health conditions, and common mental health treatment barriers to foster empathy and promote early intervention.
  • Mental health education can also empower teens to make healthy choices.

Building a Strong Support System

  • Creating a protective environment for teenagers through a strong support system can help prevent depression.
  • Teens with a strong network of friends, family, and mentors enjoy meaningful relationships, allowing them to express their thoughts and emotions without fear of judgment and develop resilience, elevated self-esteem, and healthy coping skills.


Teen depression can lead to reduced interest in daily activities, including school. For the best results, we urge you to approach depression-related school refusal with love and care instead of anger and visible expression of frustration. Contact us for tailored teen depression treatment programs and aftercare planning if you feel overwhelmed.

Frequently Asked Questions (FAQs)

The law requires schools to create an accommodating environment for teens with mental health issues, such as depression, through reasonable modifications and interventions. The Disabilities Education Act and the Rehabilitation Act also prohibit discrimination against them.

Yes. School strategies should be adapted to incorporate necessary interventions and accommodations for depressed teenagers.

Depression can significantly affect a teenager’s future if left unaddressed or unmanaged by causing long-term academic struggles and an inability to form and maintain healthy relationships. It can also negatively impact long-term career success, contribute to physical health complications, and increase the risk of substance abuse, leading to long-term addiction issues.

Teachers support depressed teenagers by detecting the signs of depression early, creating a safe environment, referring them to professional support services, implementing flexible academic accommodations, promoting peer support, and modeling positive behavior.

An open and non-judgmental conversation can help convince your teen to seek professional help. You should express genuine concern, actively listen, reassure them of your love and support, and remind them that seeking help is a positive and courageous decision, not a sign of weakness.

Teenage mood swings have short-lived effects, while depression causes persistent and long-term changes in a teenager’s behavior, academic performance, sleep patterns, and social life. Unlike teen mood swings, depression is usually accompanied by intense feelings of hopelessness and extensive social withdrawal.

Whole grains, vegetables, lean proteins, and foods rich in Omega-3 fatty acids offer essential nutrients for enhanced mental health and can help alleviate teen depression symptoms. However, dietary change is not a standalone solution to teen depression; it should accompany evidence-based therapeutic interventions and positive lifestyle changes.

Peer relationships have a significant impact on teen depression as they are major sources of validation and acceptance. Positive peer groups can help protect against teen depression by offering a sense of belonging and emotional support. In contrast, negative peer experiences such as bullying can lead to the onset of or exacerbate depression.

Substance abuse can intensify depressive symptoms, amplifying teen depression. It can also lead to addiction and dependency, creating a cycle of co-occurring issues.

Inadequate sleep can exacerbate mood swings, diminish coping ability, and impair cognitive function, leading to or worsening teen depression. Depressed teens should prioritize quality and adequate sleep for enhanced memory consolidation and improved mood-influencing neurotransmitter release.

You can help your teenager rebuild their self-esteem during depression by validating and actively listening to them, helping them set goals, acknowledging their strengths, and celebrating their achievements, however small.

Yes. Common alternative education options for depressed teenagers include personalized education plans, online courses, and flexible scheduling. Education can also be provided in alternative settings through hospital and homebound education programs for severe depression.

Yes. Antidepressant medications can help manage severe and persistent teen depressive symptoms. However, they should only be used after thoroughly assessing the teenager’s condition.