Mike is a 18 year-old who reports that he feels depressed and is experiencing a significant amount of stress about school,
noting that he'll "probably flunk out." He spends much of his day in his dorm room playing video games and has a hard time
identifying what, if anything, is enjoyable in a typical day. He rarely attends class and has avoided reaching out to his
professors to try to salvage his grades this semester. Mike has always been a self-described shy person and has had a very
small and cohesive group of friends from elementary through high school. Notably, his level of stress significantly amplified
when he began college. You learn that when meeting new people, he has a hard time concentrating on the interaction because
he is busy worrying about what they will think of him -- he assumes they will find him "dumb," "boring," or a "loser." When
he loses his concentration, he stutters and is at a loss for words., and starts to sweat, which only serves to make him feel more
uneasy. After the interaction, he replays the conversation over and over again, focusing on the "stupid" things he said.
Similarly, he has a long-standing history of being uncomfortable with authority figures and has had a hard time raising his
hand in class and approaching teachers. Since starting college, he has been isolating more, turning down invitations from his
roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how
others view him are what drive him to engage in these avoidance behaviors. The best diagnosis for Mike is
Social Anxiety Disorder
Oa.
Histrionic personality disorder
Ob
Dysthymia
Oc
None of the above
od
