“Aidan Jones, a 30-year-old graduate student in English, visited a…

AdmiralProton10767″Aidan Jones, a 30-year-old graduate student in English, visited a…”Aidan Jones, a 30-year-old graduate student in English, visited a psychiatrist to discuss his difficulty staying asleep. The trouble began 4 months earlier, when he started to wake up at 3:00 every morning, no matter when he went to bed, and then was unable to fall back to sleep. As a result, he felt “out of it” during the day. This led him to feel increasingly worried about how he was going to finish his doctoral dissertation when he was unable to concentrate owing to exhaustion. At first he did not recall waking up with anything in particular on his mind. As the trouble persisted, he found himself dreading the upcoming day and wondering how he would teach his classes or focus on his writing if he was getting only a few hours of sleep. Some mornings he lay awake in the dark next to his fiancée, who was sleeping soundly. On other mornings he would cut his losses, rise from bed, and go very early to his office on campus.After a month of interrupted sleep, Mr. Jones visited a physician’s assistant at the university’s student health services, where he customarily got his medical care. (He suffered from asthma, for which he occasionally took inhaled ß2-adrenergic receptor agonists, and a year earlier he had had mononucleosis.) The physician’s assistant prescribed a sedative-hypnotic, which did not help. “Falling asleep was never the problem,” Mr. Jones explained. Meanwhile, he heeded some of the advice he read online. Although he felt reliant on coffee during the day, he never drank it after 2:00 p.m. An avid tennis player, he restricted his court time to the early morning. He did have a glass or two of wine every night at dinner with his fiancée, however. “By dinnertime I start to worry about whether I’ll be able to sleep,” he said, “and, to be honest, the wine helps.”The patient, a slender and fit-appearing young man looking very much the part of the young academic in a tweed jacket and tortoise-rimmed glasses, was pleasant and open in his storytelling. Mr. Jones did not appear tired but told the evaluating psychiatrist, “I made a point to see you in the morning, before I hit the wall.” He did not look sad or on edge and was not sure if he had ever felt depressed. But he was certain of the nagging, low-level anxiety that was currently oppressing him. “This sleep problem has taken over,” he explained. “I’m stressed about my work, and my fiancée and I have been arguing. But it’s all because I’m so tired.”Although this was his first visit to a psychiatrist, Mr. Jones spoke of a fulfilling 3-year psychodynamic psychotherapy with a social worker while in college. “I was just looking to understand myself better,” he explained, adding with a chuckle that as the son of a child psychiatrist, he was accustomed to people assuming he was “crazy.” He recalled always being an “easy sleeper” prior to his recent difficulties; as a child he was the first to fall asleep at slumber parties, and as an adult he inspired the envy of his fiancée for the ease with which he could doze off on an airplane.” What is your diagnosis?  What is your rationale?  Be sure to include the corresponding diagnostic codes and any Z codes that may apply to this case.   Please include citations if used but DSM 5 should be the only source  Social SciencePsychology