DM couch, watching TV or playing video games.” DM

DM appeared to be in a positive mood. When asked how he felt
over the past few weeks, he reported feeling as though he got more easily tired
after work and attributed this to a lack of exercise. “I spend most of my time
sitting, hunched over a computer screen at work and when I return home I spend
most of my time on the couch, watching TV or playing video games.” DM did not
report any difficulty falling asleep, but did report feeling tired even after
receiving 7-8 hours of sleep per night. DM did not report any decrease in
pleasure from activities that he had previously enjoyed engaging in. He also
exhibited no indications of experiencing any suicidal ideation. DM did disclose
that one of his major insecurities was a fear of being perceived as incompetent
or stupid by others. “I don’t think I’m smart in practical situations, so if
someone insults my intelligence, it usually gets to me because I’m afraid they
are spot on”. DM also stated that he didn’t regard himself as an excessive
worrier in regards to day to day activities, but he did state that he had some
neurotic characteristics that surfaced if he was sick. He explained that when
he wasn’t feeling well, he would develop anxiety over this because he was
usually healthy. Sometimes, he would develop preoccupied thoughts of dying from
illness while he was sick, which would only exacerbate his neurotic concerns. DM
went on to say that he never experienced any perceptual disturbances, but did
report that he felt as though he possessed a lot of unconventional views that
he thought others may find peculiar. When asked to elaborate, DM explained that
sometimes when he went online, he would come across a social issue that he felt
he had a different take on then most other people. He would frequently engage
in online arguments where he’d be arguing with several people who disagreed
with him, which further reinforced within him the idea that he had a peculiar
way of seeing things compared to other people. When inquired as to whether he
had ever experienced anything traumatic in his past, DM did disclose that he
did experience physical trauma when he was 13. He had gotten into a fist fight
with one of the other teens living in his neighborhood. During this
altercation, DM was struck in the face and fell onto the pavement, shattering
his two front teeth. Since that altercation, DM’s parents had to pay thousands
of dollars to get those teeth fixed and to this day he has to visit dentists to
maintain the integrity of the two implants he now has as a result from that
incident. DM did not report experiencing any nightmares and stated that he
didn’t usually think too much about this incident because it happened so long
ago.  DM did report a brief history of
experiencing panic attacks such as a racing heart, excessive sweating, and
breathing difficulty, but also clarified that these instances only occurred
approximately 3-4 times in his entire life. DM did disclosed that he
experienced his first panic attack in his early twenties in the middle of the
night, and that initially after that experience he did initially develop
increased anxiety about re-experiencing another attack. However, as time went
on, the attacks were spaced out across years so it never developed into more of
a concern. DM also explained that he never changed his behaviors in order to
avoid future attacks. In regards to history of abuse, DM stated that between
the ages of 5-8, his parents had hired a male baby-sitter who was a distant
relative of one of their friends. DM stated that this babysitter would
frequently coerce him into fighting other children on the playground and would
place bets on who would come out to being the victor. DM explained that the
reason he never told his parents about this was because his babysitter would
bribe him with copies of various American Cartoons, which he was enamored by at
that age. This went on until his family moved from Russia to America.


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