Dear Dr. Wes and Gabe: Do you have any advice for parenting a teen who goes to bed very, very late and sleeps through college classes? I suspect depression, but talk therapy is not an option because he won’t talk about it. He has acknowledged the problem. Physical self-harm is not an issue.

Gabe: This is a tough situation. When communication breaks down, it’s hard to make progress. We’re wired to take in information from each other when making decisions, and conversation is the clearest way to do that. The issue you bring up with your son is no different. Working on scarce data can make you feel helpless, and the fact that he is away at college probably makes you feel even more so.

Definitely schedule an appointment with a psychologist. I know that you said talk therapy is off the table, but that’s their job and they have probably seen many cases like this. Tell your son that you would like him to try three sessions and see how it goes. It’s better than not trying to get him help at all.

Depression is a disease like any other medical condition. If your son broke his arm, making his home life easier certainly helps him out, but only a doctor can set his arm and truly heal him. Trust that the professionals will do well, and you’ve done your job.

Double Take columnists Gabe Magee and Dr. Wes Crenshaw

Other than this, there aren’t myriad things that you can do to help him. Most are just good parenting regardless of the situation: reminding him that you care about him, visiting him, or sending him care packages. But because you seem well enough engaged with him to notice this behavior, it sounds like you’re already doing compassionate acts for him.

Wes: I’ve a confession to make. Second only to bullying, these are about my least favorite cases and I don’t know many therapists who feel differently. Gabe is correct. It’s hard to get to the bottom of a situation when someone won’t give you a hint as to what that bottom might be or how deep it goes.

On paper, your young man does seem to have several signs of depression — lethargy, lack of interest, sleeping too much, maybe even withdrawal from social contact. However, many medical and mental health providers make depression their first stop on the diagnosis train, whether it fits the larger context of the client or not. It’s just too easy to diagnose depression without taking a good psychosocial history and if readers think ADHD is over-diagnosed or over-treated, they haven’t examined the statistics on depression.

We’ve succeeded over 30 years in taking the stigma out of mental illness, but in doing so we’ve emphasized treatment and medication, which can be very helpful, and de-emphasized healthy living and environmental change, which is the best way to avoid mental health problems in the first place.

As it is with many young people at college, your guy is way off on sleep and apparently pursuing a curriculum that isn’t meaningful enough to get him up every day to attend. If he’s also playing a lot of video games or surfing the Internet or watching Netflix all night, he’s contributing more to his own mental decline than any therapist or medication can counter. Although that’s a depressing situation, it may be the result of his lifestyle and not the cause.

So, between Gabe and I you have two ways of looking at this. What your guy really needs is a family-based psychological assessment from a provider expert in this age group. I emphasize family therapy, because as a general rule, young men differ from young women in that they are less verbal and revealing and thus require a more systemic intervention.

I suggest working with this young man to set up three appointments in advance, then going to his college to attend them with him, as many parents do. After that, you’ll know better what you’ve got on your hands and how to deal with it. And if he doesn’t want to go, remind him who is paying the bill and that in return you expect him to put forth all necessary effort or begin remapping his life so he can live it productively and achieve independence as an adult.

— Wes Crenshaw, Ph.D., ABPP, is author of “I Always Want to Be Where I’m Not: Successful Living with ADD & ADHD.” Learn about his writing and practice at dr-wes.com. Gabe Magee is a Bishop Seabury Academy senior. Send your confidential 200-word question to ask@dr-wes.com. Double Take opinions and advice are not a substitute for psychological services.