]> 2026-07-31T09:40:16+00:00 WBR0040 0 en Normal grief Major depression disorder Bipolar disorder Dysthymia Cyclothymia Behavioral Science/Psychiatry Gonzalo Romero (Reviewed by Will Gibson and Yazan Daaboul) A 47-year-old man presents to his primary care physician after being concerned about his current state of mind. He started developing extreme fatigue 3 weeks ago after his dog passed away, whom he considered his "best buddy" for 15 years. He never got married, but has had a girlfriend for 5 years. The patient reports being an avid swimmer in the past, but no longer has any interest in swimming these days. He has trouble falling asleep every night. The patient reports difficulty concentrating at work to the extent that his supervisors and colleagues are also concerned. He cries inconsolably several times during the day; and he cannot recall any time when he was not feeling down since his loss. When the physician asks about his overall status, he replies: "I feel worthless and think about ending my life”. The patient denies taking any medication or illicit drug use. His blood pressure is 122/84 mmHg, heart rate is 82/min, temperature is 37.1 °C (98.7 °F). On physical examination, he appears unkempt and has a flat affect. What is the most likely diagnosis? B General Principles 2020-10-27T23:08:19Z 2459150.4641088 WBR0040