My best friends brother is 19 years old, He seems to have social anxiety, quiet, shy, awkward at times doesn’t come out of his room, barely talks. Ever since he was young he always had to have the same pair of jeans, belt, tucked in shirt and black zipped up sweatshirt. He still wears this even if its 100 degrees out this is what he wears. He has very long hair past his buttocks and long nails he will not cut either. He’s very feminine but has not come out that hes gay. He does not leave his room and does not have any friends, job or social life. He lives day in and day out in his bedroom, and only comes out to eat. he expresses he wants a job or wants to go back to school but does not put much effort in it. We want a better idea as to what is going on. Please help. thank you.

A. Depression and social anxiety are both possibilities, but without being able to interview him it’s difficult for me to know what is wrong. The fact that he doesn’t come out of his room might be a sign of social anxiety. He apparently doesn’t like interacting with people. There can be many reasons why, but clearly it makes him uncomfortable. As a result of his inability to interact with people, he seems lonely. Loneliness can cause depression. There could be other problems as well but again without more information, it’s difficult to offer anything beyond a generalized response.

If possible, encourage him to seek help from a mental health professional. These are treatable problems. Depression and anxiety are two of the most common psychological disorders. Effective and evidence-based treatments exist for both. If you suggest treatment and he refuses, realize that you’ve done all that you can. You can’t force an adult into treatment (except in very rare circumstances). Hopefully, he will understand that he can be helped and will decide to seek treatment. It certainly would change his life for the better. Please take care.

Dr. Kristina Randle