I hope you’re making progress and unloading some of the externalized stuff. It’s really hard work!

But personally?

Caring but not doing is the path to deep depression and constant guilt.

There is absolutely nothing worse for me than the feeling of "I need/want to do this thing today" and then I just can't get myself to do it. I wind up losing hours of time being completely unable to do anything. Literally sitting in a chair and staring at a wall feeling frustrated with myself. Not replacing what I need to do with anything else either. Not even watching a show or playing a game or something. Just sitting. Or laying down. Unable to make myself do it.

It's miserable. Medication has fixed basically all of this for me.

(a) "socially", as the name implies, is not just about the end result (X thing was done or not done) that's important, but the social perception around it. Someone not caring and not doing is seen and treated as a jerk. Someone caring but with a legitimate issue for not doing, is seen sympathetically, or can be provided accomondations, etc. The same way you'd excuse a blind or person who can't walk for needing special accomondations. This has very real effects, even if the fact that X wasn't done doesn't change.

(b) It also matters hugely for the person, to know themselves that it isn't just that they don't care or are just lazy, but that they have an underlying issue.