Thank you (everyone) for your comments and advice.

We have spent many years discussing the need for balance and social activities so I feel I can't get any deeper into that.

I think the social part of it is very taxing for him. It distracts him from learning and wears him out.

He has enjoyed learning and was much more self directed before grade 9 (not a great year for focus for boys in my experience). Also, years of conflict, cajoling, worry etc. between us over the topic (and heaps of bending over backwards to find a good solution) is making the whole area of topic hard on all of us. Perhaps we should step back and get out of his way.

He's currently letting his sleep shift way out of whack which keeps him out of our sphere of influence (as we go to bed at a normal hour). Again, much conflict (reasoned discussion, confrontation, cajoling etc.). He wavers back and forth between getting it and working on it a bit and then sleeping like Rumplestiltskin.

He is sinking his teeth into his pre-calc. Just don't see him keeping up with the course schedule we mapped out. Perhaps that's not as important as getting him healthy and happy again.

I've taken note of the list of supplemental things he could look into (thanks indigo!). I'll look into them myself too.

Thanks again. If you (or anyone else) thinks of anything to add please feel free - all advice welcome.