By Arastou Aminzadeh, M.D., Founder, BNI Treatment Centers

Nothing can be more exasperating to a parent than when their child throws a fit about going to school. When that child is a teenager, the challenge is much more daunting. At that age, they are much more creative about finding ways to evade both school administrators and parents.

Some teens may wear the parent down, ignoring their pleas and simply refusing to comply with their wishes. Parents often succumb to this pressure and provide the school with excuses for the teen’s absence. Some teens, however, just skip school without the parent’s knowledge.

Truancy is a serious issue. It is not only against the law for the child to be skipping school without an excused absence, but there are other repercussions for the teen as well. To gain a better understanding of school policies regarding truancy, as well as the negative impact of missing school on the teen, read on.

When Your Teen Won’t Go to School

It is perfectly natural for your teen to sometimes bemoan going to school. They may just be in need of a break after a stressful week of exams, or simply want to sleep in. This occasional resistance toward attending school is normal and not at all concerning.

However, when the teen repeatedly fights his or her parents about going to school, day after day, there is probably something going on with them. Parents do a disservice to their teen if they do not address this problem head on. School policies are clear; attendance is compulsory until age 18.

Truancy refers to a child’s unauthorized absence from school. State laws dictate the number of days a child is expected to be present and accounted for at school. Unexcused absences can result in stiff penalties, including the teen not being permitted to graduate.

Trying to convince a teen to go to school when he or she is dead-set against it can result in much strife and turmoil in the family home. Even though parents are disciplining the teen appropriately for failing to go to school, nothing seems to work. Getting to the bottom of the underlying problem should be a parent’s top consideration.

7 Issues that May Be Contributing to the Teen Refusing to Go to School

There are several possible reasons why your teenager is so resistant to attend school. Consider these possibilities, which could guide your next steps:

Bullying. Kids that are being bullied at school are obviously going to avoid putting themselves in that situation. Bullying, including cyberbullying by peers, can have a devastating impact on a teen’s mental health.

Behavior Disorder. Some teens struggle with behavioral problems. Their defiant refusal to attend school might be due to the presence of opposition defiance disorder or conduct disorder.

Academic Burnout. Teens are increasingly under intense academic stress. Some teens are overextending themselves, taking too heavy an academic workload, while others are pressured by parents who want their child to be accepted into a prestigious school.

Peer Relation Problems. Social problems are another common reason a teen might resist going to school. Some teens have underdeveloped social skills and struggle to fit in. Others may be involved in a conflict with a certain kid or group at school.

Falling Behind in School. When a teen has fallen behind in their studies and grades are plummeting, they may feel too overwhelmed to even try. Teens may fall through the cracks and simply give up on school altogether.

Mental Health Issues. Increasing numbers of teens are struggling with anxiety and depression. Some may have ADHD or bipolar disorder. Undiagnosed and untreated mental health disorders cause the teen to feel emotionally unstable within a school setting.

Substance Abuse. When a teenager begins to experiment with drugs or alcohol it can have far-reaching effects. The teen may feel too hung-over to get up for school, or they may have acquired a substance use disorder, keeping them stuck in the addiction cycle.

Recognizing the Signs of Trouble

All of the above potential factors involved in a teen refusing to go to school will cause signs and symptoms of distress. Even if a parent doesn’t yet know what the underlying problem is, they will notice changes in their teen. Some of these might include:

Avoids social events; withdrawn; isolates
Engages in self-harming behaviors
Openly rebellious
Negative attitude; lack of pleasure
Neglects personal hygiene
Extreme fatigue
Sleep disturbances
Changes in appetite; sudden weight gain or loss
Loss of interest in usual activities
Engages in illegal activity
Very low self esteem
Feeling worthless or hopeless
Has thought distortions or irrational fear
Mood swings
Angry outbursts
Sudden decline in school performance
Signs of psychosis
Substance abuse

When parents notice that some of these warning signs are present, it is essential that they have the teen evaluated. Initially, a physical exam by a primary care provider can rule out a health condition. If no medical issue is present, the teen will be referred to a mental health provider for further assessment.

What Are Parents to Do When the Battle Lines are Drawn?

Teens that refuse to go to school are placing their futures in jeopardy, and parents are well aware of this. It is important to remember that the parent is still responsible for the teenager and has authority over them. Finding sources of support is key. Here are some actions a parent can take if their teen refuses to go to school.

Meet with the school administrators. Instead of attempting to control the situation by themselves, parents should instead enlist the help of the school administration officials. They may have additional resources to offer the parents and the teen.

Get psychological support. The teen may have an undiagnosed mental health issue that requires therapy. Also, a therapist can utilize motivation enhancement therapy to provide a reward system for complying and going to school.

Consider homeschooling. If the school setting is so dysfunctional or damaging to the teen, then parents who are able to homeschool might want to give that a try. Parents can access curricula and other materials through the school district or select their own books from private sources.

Residential treatment. If the teen is struggling with a worsening mental health disorder, which has impacted their ability to function in a school setting, parents might want to consider a residential program for teens. These programs provide academic support in addition to the multi-modal evidence-based therapies.

About the Author

Dr. Arastou Aminzadeh is a triple board certified physician in psychiatry, child and adolescent psychiatry, and addiction medicine, and is the co-founder of BNI Treatment Centers in Agoura Hills, California. Dr. Aminzadeh is a fellow of the American Society of Addiction Medicine and also a fellow of the American Psychiatric Association. A well respected leader in the field, he also holds an adjunct faculty position at the University of Southern California, Keck School of Medicine, where he completed his residency and fellowship.

By Ken Seeley, Founder, Ken Seeley Communities

People do enjoy the mild effects that alcohol has on the brain when they have a drink or two on occasion. With occasional use of alcohol, the impact on the brain is minimal. While a couple of drinks provides a pleasant, feel-good effect, even limited consumption reveals the effect on the brain, with slurred speech, slowed reactions, and coordination problems evident.

While most people are aware of the damage alcohol can do to the body, such as liver disease, heart problems, and increased risk for some types of cancer, it is not so well known that alcoholism is indeed a disease of the brain. When alcohol use becomes disordered, resulting in alcoholism, the impact on the brain can be pronounced.

Damage to the brain is apparent in both the physical aspects of the brain as well as in cognitive functioning. Gaining a better understanding of the impact of alcohol on the brain can improve overall awareness about the dangers associated with drinking.

What is an Alcohol Use Disorder?

An alcohol use disorder is diagnosed when chronic excessive drinkinghas resulted in impairment in functioning. Despite the negative consequences of the drinking, which impact all aspects of life including relationships, parenting, career, and health, someone with an alcohol use disorder is unable to quit without treatment.

As a starting point, the CDC has provided safety guidelines for alcohol consumption. According to these guidelines:

Excessive drinking is 8 or more drinks* in a week for women and 15 or more drinks in a week for men.
Binge drinking is 4 or more drinks in a single occasion for women and 5 or more drinks in a single occasion for men.

*A “drink” is defined as a 12-ounce beer, 8 ounces of malt liquor, 5 ounces of wine, or 1 ½ ounces of liquor.

When problem drinking develops, there will be the signs of alcohol use disorder, which include:

Experiences increased tolerance for alcohol, resulting in higher consumption
Neglecting obligations and responsibilities at home or at work
Begin to obsess about drinking, plan the day around drinking, and looking for opportunities to drink
A decline in work performance
Loss of a job due to absences or being intoxicated at work
Telling lies about their drinking; hiding alcohol around the house or at work
Waking up sick
Getting into an auto accident or a DUI arrest
Relationship problems
Continues to drink regardless of the negative consequences
Attempts to quit drinking but cannot stop
Experiences withdrawal symptoms when alcohol wears off

Alcohol has been termed a disease of the brain. The National Institute on Alcohol Abuse and Alcoholism defines alcohol use disorder as “a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when now using.”

5 Ways Alcohol Damages the Brain

Chronic alcohol abuse can take a heavy toll on the brain. Consider these five ways that alcohol can damage the brain:

1. Brain matter shrinkage. MRI imaging studies show that the hippocampus literally shrinks as a result of alcoholism. This is the region in the brain that is associated with reasoning skills and memory.

2. Neuropsychological effects. Alcohol-related cognitive impairment can be significant. These include short-term blackouts and memory lapses, as well as the long-term effects on cognitive functioning, such as difficulty concentrating and memory loss.

3. Increased impulsivity. This is caused by changes in the brain’s frontal lobe, where executive functions like decision-making and self-control are regulated.

4. Wernicke-Korsakoff syndrome. Thiamine deficiency due to alcoholism can result in a serious brain disorder called Wernicke-Korsakoff syndrome (WKS). WKS is an acute neurological condition that features encephalopathy, or brain lesions that cause mental confusion and paralysis of the nerves in the optic region. It can also lead to psychosis.

5. Dementia. Alcohol dependency can slow brain cell development and accelerate dementia.

Other Health Risks of Alcoholism

In addition to the damage alcohol can do to the brain, this toxic substance has been found to be associated with myriad health conditions, including:

Heart disease. Heavy drinking over an extended period takes a heavy toll on the heart. Signs of serious cardiac issues that could result in death include atrial fibrillation and ventricular tachycardia, or alcoholic cardiomyopathy.

Gastrointestinal problems. Alcoholism can cause excess acid, such as acid reflux, in the stomach that can lead to gastritis. It also causes irritation and inflammation of the stomach lining, which can cause ulcers and internal bleeding.

Liver disease. Excess alcohol consumption is highly toxic to the liver. Cirrhosis of the liver, which often begins as fatty liver disease, is fatal without a successful liver transplant.

Cancer. Alcoholism causes an increased risk of developing multiple types of cancer. Types of cancer associated with heavy alcohol consumption include oral, throat, esophageal, colon cancer, liver cancer, pancreatic cancer, rectal cancer, and breast cancer.

5 Ways the Brain Heals in Recovery

Although the damage sustained to the brain can be significant, the organ is able to regenerate with sustained abstinence from alcohol. However, not all brain damage will be immediately restored, and some effects of alcohol abuse on the brain may be permanent. Regardless, the brain has an amazing capacity to heal in these five ways:

1. New cell growth. Although a certain amount of neuronal destruction is permanent, sustained abstinence can result in new brain cell growth within the hippocampus.

2. Restored brain volume. Within as little as two weeks of abstinence, there is a dramatic increase in brain matter volume. Brain imaging tests clearly show this result.

3. Improved motor skills. As sobriety progresses, executing particular motor skills towards predetermined movement outcome will improve.

4. Improved visual-spatial abilities. While visual-spatial abilities will not recover completely in recovery, there is some improvement seen with prolonged abstinence.

5. Improved cognitive abilities. As the brain heals over time, cognitive functions and most executive functions will improve.

Thanks to the restorative capabilities of the body and brain, it is possible to arrest the damage to overall health, including brain health, with a commitment to sobriety and a comprehensive treatment approach to recovery.

About the Author

Ken Seeley is an internationally acclaimed interventionist, having years of experience in this field. Certified as a Board Registered Interventionist-Level 2, Seeley has worked full-time in the business of recovery and intervention since 1989. He is a regular contributor to CNN, MSNBC, NBC, CBS, Fox, and ABC on the topics of addiction and intervention. He was one of three featured interventionists on the Emmy Award winning television series, Intervention, on A&E. He is also the author of “Face It and Fix It,” about overcoming the denial that leads to common addictions while bringing guidance to those struggling with addiction. Ken Seeley is the founder and C.E.O. of Ken Seeley Communities
, a full spectrum addiction recovery program located in Palm Springs, California.