If it has gotten this bad, it probably is not good to be pushing himself so hard to see her, and maybe time for him to ask for some help... call his doctor and therapist for some help. Maybe you can coax him in that direction.

As triggers go, it seems like he has encounters some triggers that top the list, so maybe talking to his pdoc and T is appropriate even if he wasn't feeling so badly... just to keep the situation in check.

And if he can't make you a firm promise not to hurt himself (one that you believe) there is nothing wrong with calling someone on his behalf. I always like the idea of making short promises for a limited length of time, I think they are easier to keep and it is easier to trust the person making a promise. "Promise you won't hurt yourself for 24 hours, and I'll check in with you tomorrow to see how you are doing."

Let us know how he is doing, and good luck.