Gifted and high-ability adolescents are often described in school discourse through the language of performance: advanced coursework, rapid learning, strong executive control, and “no visible problems.” Yet the empirical literature and clinical observation converge on a quieter reality: high cognitive potential can coexist with clinically relevant depressive symptoms, while the school environment may detect distress later than it detects underachievement. This paper synthesizes evidence on adolescent depressive symptom burden, socioemotional risk mechanisms that are disproportionately common in high-ability students (maladaptive perfectionism, asynchronous development, identity strain, social mismatch), and school-system factors that keep distress “hidden” (teacher referral thresholds, performance-biased support, limited help-seeking toward school adults). Using epidemiological benchmarks and school-context data, we argue that the central vulnerability is not giftedness itself, but a visibility gap: students who remain academically functional are less likely to trigger care pathways, even when their internal state deteriorates. We propose a school-implementable identification and support protocol that combines universal screening principles, differentiation for high-ability profiles, and a tiered response aligned with evidence-based prevention programs. Practical recommendations emphasize teacher mental health literacy, psychologically safe classroom climates, structured parent communication, and counseling approaches that treat achievement as an insufficient proxy for well-being.