It would be irresponsible not to rule out physical causes first. My BF got diabetes in his 20's and though he didn't start experiencing ED till later on, the disease wasn't discovered until he had had it for years. The problem is that the damage can take years to show up, even if you are treating the diabetes. He lost his vision a couple years after starting insulin. This is not a disease you want to mess around with. Neither is high blood pressure, or heart disease. The medical conditions that cause ED are mostly very dangerous if left untreated.
<< If he was having issues at 22, then it definitely sounds like there is medical issue to me.>>
When you see it coming, duck!
He could not maintain an erection.