For the past month john has been lethargic; he tries to sleep but either can't fall asleep or wakes often. he's lost weight but can't bring himself to eat. he feels guilty for no real reason and can't find pleasure in the activities he usually loves. john seems to be suffering from

He's depressed and also suffering from insomnia. This is really what the symptoms boss down to. Depressed patients generally find deceased interest in pleasure and everyday activities and often feel quilty. Also, a sudden change in weight, either gaining and especially losing, can be a litmus of depression. The patient is unable to sleep or wakes up quite often which is tells insomina. So he is a depressed patient suffering insomina.