A 40-year-old man complains of feeling nervous and sad for 2 weeks. He also experienced constipation and difficulty sleeping during the same time. His wife, who accompanied him, says that he has been unusually short-tempered, and constantly complaining of “decreased energy.” His medical and surgical histories are unremarkable. His family history is significant for a sister with schizophrenia; he himself has never had a psychiatric evaluation. He had been using alcohol and marijuana daily since the age of 16, the latter up to 5 times a day. However, he gave up drinking 5 years ago, and has been cutting down on marijuana for the past 2 weeks. He strongly denies using any other recreational drugs. Upon further questioning, he reveals that during the past 2 to 3 months, he has been hearing voices telling him that his wife would leave him unless he quits using marijuana.