"I'm sorry," Dean said. He knew that look. He knew what it was like to feel stuck in a rut, just living for the next distraction, and finding it easier to take care of other people than to deal with your own unsolvable problems. He felt that way himself, most days.
He caught himself blaming himself for Cas being so down and out, for setting the standard to which Cas had applied himself and his humanity. Dean blamed himself for lots of things. He knew that Cas had chosen his side, that Cas had lived and died for them so many times. He hated feeling so powerless to help.
Remembering what Cas had asked for the last time Dean had asked what he could do, Dean stood, and crossed the space between the beds so that he could put a hand on his friend's shoulder. It didn't come quite as naturally as he might have liked, but it wasn't necessarily as awkward as it could have been, either. "I'm here for you, Cas."