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J. C. is a 46-year-old Hispanic female who presents for her initial visit to your primary care clinic. J. C. describes tiredness, difficulty making decisions, and a feeling of “hopelessness” just about every day for the past several weeks. She reports a general lack of appetite accompanied by a weight loss of around 15 pounds over this same time period. She acknowledges that she is obese, but states, “I should be happy about losing the weight but it wasn’t on purpose and I don’t really care either way.” She also describes missing “more than a few” days of work due to tiredness. She reports frustration about feeling tired nearly all of the time but having difficulty falling asleep (although she will sleep around 10 hours once she does fall asleep). J. C. states that she used to enjoy working in her garden and going to work in her job as a receptionist in an insurance company but these activities no longer hold any pleasure for her.
What is your differential diagnosis?
What is the most likely diagnosis? Why is this the most likely diagnosis? [HINT: Include your decision making and diagnostic criteria for reaching this diagnosis]
What is the diagnostic work-up?

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