Mr. Smith reports that he is a 59-year-old cisgender widower, who had been living alone for the last year. His wife had been diagnosed with brain cancer three years prior and died approximately one year ago. He has two grown unmarried children (29 and 25 years old) who are pursuing careers in other parts of the country. Mr. Smith has an undergraduate degree and had worked as an independent contractor for two Fortune 500 businesses in Charlotte but has been out of work since April 2020 (due to the pandemic). Mr. Smith described his major problems as depression (over the last year and a half), difficulty coping with daily life, and loneliness. He reported one prior episode of major depression around age 25, following the death of his father. Mr. Smith said he had become increasingly socially isolated with the onset of his wife’s illness (brain cancer) and that this loneliness had intensified with the pandemic. He also reported having had normal friendships as a child, teenager, and young adult. He and his wife had led a relatively quiet life together, mostly focused on raising their children and respective work. When they had free time, they had enjoyed intellectual and cultural activities together (museums, lectures, concerts, and fine restaurants). They had a few close friends with whom they socialized but those friends had retired in Florida and Arizona during the time of his wife’s illness. Make a differential diagnosis of "Mr. Smith" using the criteria below. Explain why you diagnosed Mr. Smith with the specific diagnosis you chose (100 words).
What other information would you want to know from Mr. Smith to help you make a diagnosis? (50 words)
Specify one alternative diagnosis you considered before arriving at your final diagnosis. Indicate why you considered each and, ultimately why you did not make that diagnosis (100 words).