A 24-Year-Old Man Comes to the Office Because of Mood

A 24-year-old man comes to the office because of mood changes.  He has felt depressed, irritable, and anxious nearly every day for 2 months.  The patient has difficulty getting out of bed in the mornings and staying focused at work.  He has no medical conditions and takes no medications.  The patient drinks 3 or 4 beers daily and more on weekends.  The physician provides education about the link between alcohol and mood changes.  The patient responds, "But it really helps me to unwind and relax after a long workday and makes it easier to fall asleep.  It's also how I hang out with my friends on weekends.  I can't see quitting." Which of the following is the most appropriate statement by the physician at this time?

A) "Alcohol is likely making your depression worse.  It will be harder to treat your depression without addressing alcohol."
B) "Although you feel alcohol helps you to relax, I am concerned that you are using it to self-medicate your depression."
C) "I can understand your reasons for using alcohol.  What are the downsides to drinking from your perspective?"
D) "I get it, but there are other, healthier ways to relax.  Would you be willing to discuss those?"
E) "I understand your reasons and see that you are not ready to make a change.  I am here to help when you feel ready."

Correct Answer:

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