I agree with most of what was said. There are so many variables. One I didn't see mentioned is whether the problem is one he comprehends. My father was declining mentally before he passed. Sometimes he would repeat the same story many times. There was a level of denial. He had things that they (parents) needed done. He would say he'd do it later, but later never came.

What worked for me was realizing what was going on and that I had to learn to function in his world. He wasn't capable of seeing the issue. I would find ways of doing things for them where I wasn't taking "his work", or something he felt he could do.

I guess my question is, "Does he know how damaging his behavior is, or even understand what is going on when he gets in one of those moments?" If he's unable to process what's going on, then a doctor might be able to prescribe something to stabilize his moods. A counselor can help you understand how to respond when these situations do arise. We learn to put out a fire with water, but if it's a grease fire, we can make it worse.

It's hard to know what the drivers are. Is it depression? They say, "Show me a mad kid and I'll show you a sad kid." "Anger and sadness are two sides of the same coin." Once the cause is known, then the best approach can be determined. When I trained horses, I used to make the right thing easy and the wrong thing difficult. Does he know he's doing the wrong or right thing? What needs is he meeting with his behavior? Is he capable of figuring out other ways of meeting his needs if he's forced to? You mentioned he goes off about things he thought he heard. Can you record situations and play them back for him and then let him see the disconnect? I don't know, but there's a lot to figure out before others can say what may help. My heart does go out to you.

One thing is for certain. You can't help him if you're not at your best and equipped with the right tools. You also deserve to be happy as well so please take care of yourself. There are many of us who would love to have a woman as strong as you in our lives, or world in general.