A 29-Year-Old Woman Comes to the Office Due to Persistent

A 29-year-old woman comes to the office due to persistent fatigue over the last 4 years.  She has also felt unhappy during this period, ever since being let go from her previous job.  The patient describes her fatigue as "having little energy to do things."  When asked what she enjoys, she replies that "everything in life is a chore" and that she feels hopeless that her life will improve.  The patient has no suicidal thoughts, problems with concentration, or changes in appetite or sleeping patterns.  She used marijuana as a teenager and drinks 1 or 2 glasses of wine on weekends.  Detailed workup, including urine toxicology screen, is negative.  Which of the following is the most likely diagnosis?

A) Adjustment disorder
B) Borderline personality disorder
C) Major depressive disorder
D) Persistent depressive disorder (dysthymia)
E) Substance-induced mood disorder

Correct Answer:

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