A 19-year-old college student presents with chronic low mood, feelings of hopelessness, poor concentration, and a significant decrease in academic performance. He also admits to using marijuana regularly to cope with his stress. What is the most likely diagnosis and the next steps?
The patient's chronic low mood, feelings of hopelessness, poor concentration, and decrease in academic performance are suggestive of major depressive disorder. The regular use of marijuana may be an attempt to self-medicate, but it could also potentially be contributing to his depressive symptoms. The next steps include a comprehensive evaluation of his mental health and substance use, providing psychoeducation about the potential effects of substance use on mental health, and discussing evidence-based treatment options for depression, which may include psychotherapy, pharmacotherapy, or both. Referral to a substance use treatment program may also be appropriate.