I am still confused about possible help for someone suffering depression caused by life long social anxiety. Treatment for anxiety centres around doing awkward social exposures and hoping the patient gets better through practice. Yet exposure therapy demands motivation, optimism and commitment. It ignores depression which creates hopelessness, negativity and absolutely no motivation or optimism and also the inability to make pleasant small talk or even care any more. For instance how the hell are you supposed to make small talk with a stranger about the weather or anything when you feel and talk like a zombie and see no hope for the future?
Treatment for mild to moderate depression seems to centre around making the patient more active and engage in previous social activities which ignores the fact the patient may be isolated, never goes out and has no friends as they have had long term socially anxiety. I simply dont see how they make the patient optimistic and then motivated enough to engage in exposure therapy without them transgressing into depression and negativity at the inevitable failures. Keep stating how much hard work is involved does not help in the slightest and is much more likely to result in non commitment or refusal to even enrol in therapy.
Despite so many people stating that age does not matter and that it is never too late I wonder if therapy is much more beneficial to people under a certain age and pretty much useless to older people and once feelings of suicide are starting to emerge. Also if living conditions are not especially good with sleeping problems and alcohol dependence then perhaps therapy is of minimal use. Exposure therapy is of no use whatsoever if the therapist can not convince the patient to even take part in the first place as it appears so overwhelming.