DSM-5 Diagnosis

Write your DSM-5 diagnosis for the case (including any relevant subtypes and/or specifiers).

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Briefly (i.e., approximately one page) but clearly, provide your rationale for the diagnosis you gave.  In order to do so, you must:

1) describe the specific evidence in support of the criteria for your assigned diagnosis

2) describe which competing diagnoses were considered and explain clearly why they were not chosen.

            Jacob is a 30-year-old male who was let go from his job approximately five months ago. Although he has been going on job interviews, he has not been offered any of the positions for which he has interviewed. He recently moved back in with his parents to save some money while he attempts to find another job. His mother referred him for psychological treatment because she believes he is “not himself.”

            During the intake interview, Jacob reported that he has been feeling “down” since losing his job. He also expressed feeling “worn out” and “defeated” about continuously applying to jobs, but not succeeding. Jacob spends most of his days searching for and applying to jobs and spends many nights playing video games. Two or three nights a week, he also consumes several beers, which helps him forget his current difficulties. He reported that after a long day of job searching, he sometimes just “wants a cold one.” At times he drinks alone while playing video games, and at other times he drinks with his friends or relatives who live nearby.

            Jacob described one particular night earlier this week, when he was playing video games with his brother-in-law. His brother-in-law offered him some marijuana to help “clear his mind.” Jacob had smoked marijuana a few times during college, so he decided to try it again. Jacob reported that smoking marijuana did not help clear his mind. In fact, shortly after smoking, he felt “paranoid” that he would never be able to find a job and would become financially dependent on his parents. He also reported feeling very tense and his heart was pounding out of his chest. Furthermore, Jacob reported that his mouth felt extremely dry and he could not make it feel better. Shortly after smoking, Jacob ordered himself a pizza, but, no matter how much he ate, he could not satisfy his hunger. Jacob disliked these unpleasant sensations and thus, has not smoked marijuana since then. Instead, Jacob just sticks to his usual routine of searching for jobs throughout the days and playing video games and drinking some nights. On some nights he also helps his mother with her organization at their local church and babysits his nieces and nephews.

            Jacob denied the use of any medications and has never had any significant illnesses. He recently saw his primary care physician for his annual physical, and no medical complications were found.