In my case, after 30 years of severe physical pain, I feel some hopelessness as far as things being truly helpful, or helpful enough. (I have additional PTSD from prolonged untreatable/intractable severe pain). I do work daily to override this; yet, it does take work.
At the same time, I do sometimes procrastinate when doing so might make things even more difficult. Again, I am usually feeling some degree of hopelessness when I do this.
A sense of underlying hopelessness drives my inability to follow through on non-rewarding tasks.

WC