Differential Diagnosis for MJ

• Single Most Likely Diagnosis
  • Major Depressive Disorder (MDD): MJ's symptoms of difficulty focusing, sleeping, loss of interest in activities (e.g., playing basketball), and weight gain are consistent with a depressive episode. His history of anxiety and stress at work also support this diagnosis.
• Other Likely Diagnoses
  • Anxiety Disorder: Given MJ's long history of anxiety, it's possible that his current symptoms are an exacerbation of his anxiety disorder, particularly given his recent stress at work.
  • Substance Use Disorder: MJ's daily marijuana use could be contributing to his symptoms, such as decreased motivation and weight gain. His social tobacco use is also a concern.
  • Adjustment Disorder: MJ's stress at work and subsequent symptoms could be indicative of an adjustment disorder, which is a condition characterized by an emotional or behavioral reaction to a significant life change or stressor.
• Do Not Miss Diagnoses
  • Bipolar Disorder: Although MJ denies any history of manic or hypomanic episodes, it's essential to consider bipolar disorder, especially given his history of antidepressant use and current symptoms. Missing this diagnosis could lead to inappropriate treatment and worsening of symptoms.
  • Sleep Apnea: MJ's obesity, weight gain, and sleeping difficulties increase his risk for sleep apnea, which can have significant health consequences if left untreated.
  • Hypothyroidism: Although less likely, hypothyroidism can cause symptoms similar to depression, such as weight gain, fatigue, and sleep disturbances. Given MJ's family history of autoimmune disorders (e.g., type 2 diabetes), it's essential to consider this diagnosis.
• Rare Diagnoses
  • Chronic Fatigue Syndrome: MJ's symptoms of fatigue, sleep disturbances, and decreased motivation could be indicative of chronic fatigue syndrome, although this diagnosis is less likely given his recent stress at work and other potential explanations for his symptoms.
  • Adult-Onset Attention Deficit Hyperactivity Disorder (ADHD): Although MJ's symptoms of difficulty focusing and decreased motivation could be indicative of ADHD, this diagnosis is less likely given his age and lack of reported symptoms during childhood or adolescence.