I would like to provide some general psychoeducation and make some suggestions on how to get started in treatment if you are not already in therapy.
I’m going to describe patients who are depressed and a possible way to begin treatment. Ultimately, I don’t know your history and symptoms in enough detail to make many recommendations.
Patients with depression tend to be more socially withdrawn, have low energy, experience loss of interest in activities, become highly self-focused, and often engage in efforts to discover why they are feeling the way they do. They can become lethargic or stop engaging in behaviors that would be helpful to them. This non-engagement can be viewed as a form of avoidance in that the patient escapes the “problematic” thoughts and feelings including discomfort, emotional distress, and perhaps fear of or actual experience of failure that may be associated with attempts to engage with others. For example, a depressed patients who experienced multiple failures then stop trying because of those experiences. In order to avoid feeling any sense of sadness, they close themselves off from the outside world and, continue to be more sad because they have closed themselves off further. The more they attempt to avoid feeling the greater the depression becomes.
A way to begin therapy is for the patient to identify their own values in life. You have already mentioned there are some things that you love to do. The idea here is to identify those values and begin taking actions to make them feel they are moving close to living those values. It is not about setting various goals or expecting a huge change in depression after taking some actions. The idea is that we identify what is important to them and worth getting better for.
Later I recommend starting some mindfulness meditation to get the person to be in the present moment and develop a non-judgmental stance about things. I feel like this is a good start to therapy because it helps the patient be in the present moment and not avoid feeling. As the patient allows thoughts and sadness come and go, they typically notice that the intensity of these symptoms become less over time. Notice I am not saying these techniques completely resolve sadness. It is important to recognize sadness as a normal emotion as well that can continue to reappear in your life but this could be a way to develop a different kind of relationship with that sadness and manage it in a different way.
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