James, an 18-year-old freshman at college, has been absent from nearly all her classes for the last month and spends most of her time isolated in her bedroom. She is often still in bed when her parents return from work and frequently skips meals throughout the day. She believes her life is a complete failure and blames herself for being socially awkward and disliked by others. Which of the following conditions best explains James's symptoms?

Explanation

James's symptoms—including social withdrawal, persistent feelings of worthlessness, lack of self-care, and loss of interest in daily activities—are characteristic of major depressive disorder. Unlike hypochondriasis (illness anxiety disorder) which involves preoccupation with having a serious illness, or generalized anxiety disorder which centers on excessive worry, James exhibits signs of significant mood disturbance. Disorganized schizophrenia typically includes disorganized speech and behavior, which are not evident here.