I think he might be paranoid or have paranoid tendancies. Everything he says tend to confirm this diagnostic. Basically he's saying that everyday when surrounded by random people, he feels threatened by them, and feel the need to "react" physically, like his survival is in question. That's because he has to work on his own perception of himself and the others. He sees everyone as cynical, ironical, ill intentioned toward him. This is typical of people who have been bullied , it's a kind of post traumatic stress disorder. Every new real life situation is like going thru the same trauma over and over, and he chooses to stay at home and avoid everything / and every real relationships fearing to reproduce the past conflictual situation he's been through. Every new situation looks like the past problematic situation(s), his present tastes like his past, his futur has to be like his past it cannot be otherwise; he projects his past over his present, and future unconsciously. There's never anything new in his life. It's been a long time since he discovered new feelings, emotions, now he fears them and prevent himself from doing what could make new things happen to him again anymore. It's a vicious circle. The only way to get out of it is to learn how to see himself and the others differently in a close relationship with a pro. To modify his own perception of the world, his own psychological machinery, his thought process. His current thought process is biased, unproductive, depressing, and potentially life threatening to himself and others.
The problem is that extreme avoidance and addiction to the internet dont go hand in hand well... He has a lot of work to find a way out of all these negative behaviors and cognitions. He obviously has a poor/low self esteem, is insecure, and dont want to work cause he would feel threatened by his colleagues and the hierarchy who might see him as immature being 44 y/o with no skills and only starting to learn a job for the first time in his life. Laziness is a pure trait of immaturiry, of a stopped development. He has to learn things he never learnt, things he lacks.
Replace 44 y/o with 16 y/o and his stories could describe the life of any random teen without a figure father who struggles to find a meaning to his own existence and the others ones.
There's always a way to reverse everything, without pills,just talking with someone who truly cares - either someone you love/loves you or someone you pay in return - a pro. The more you wait the tougher it gets.
Oh, and by the way, dump your psychiatrist, and get a PSYCHOLOGIST.... not the same at all. Psychologists are way more competent.
