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  John John is a 45-year-old biracial man of African-American and Caucasian descent. He is attending counseling after becoming fearful of how “down” he has fel   t lately. It seems that the things that once brought John great joy no longer do so. He eats far less frequently than he once did. “Food has no taste,” he says. John’s sleep has been affected. He says, “Months ago I couldn’t sleep enough. Now it seems that I have to force myself to do it. Lying in bed is misery—thinking about how many things I have done wrong in this life.”  John has no wife or children, though he occasionally helps raise his goddaughters, as their mother works night shifts and relies on family and friends to help out. He finds his time with the kids more and more taxing. This is a surprising and painful fact, as he loves them dearly. He works as a handyman and has his primary needs met in terms of housing, food, and other essentials. He does not use alcohol or drugs. He wonders whether medication would be helpful, but John is unsure if he is willing to deal with the side effects. In particular, John worries that he might not be able to perform sexually, given what he has heard from friends that take them.