My son is 19. Since graduation from high school in May 2005, he has steadily become unmotivated to do anything. He started college, but then quit going. He works only occasionally. He sleeps all day, literally all day, then sleeps at night too. He doesn’t live at home because I won’t allow this behavior. He is not on medication and has never been on medication on a regular basis. I don’t know what to do to help him. He doesn’t want to discuss this matter at all.

Dr. Joshua’s Answer

Thank you for your question. Possible reasons for this include, but are not limited to, depression and hypothyroidism. There are many other possible reasons, too. What your son needs is a visit to the primary care physician, a thorough history needs to be taken, physical examination done, and normally some lab tests would be needed, especially thryroid function (TSH), also possibly including blood count, electrolytes — the physician will determine which of these are needed, and if some more tests are needed, based on the history and physical examination.

If depression is diagnosed, an antidepressant medication may be started. Psychotherapy may also be needed. Constant sleeping may be a symptom of so-called atypical depression, which may require a consultation with a psychiatrist.

If hypothyroidism is diagnosed, the cause will be determined, and thyroxin hormone will be started.

These are just some of the possibilities, so a visit to the doctor is needed.