He grew up with an abusive father (abused his mother primarily, but also the children) and is absolutely terrified of becoming his father. It's his worst fear.

So, one of the things that's been happening while he's this depressed is that a little thing will trigger him, he'll go incredibly guilty, decide he's ruining my life and that he's not worthy of me, and will start self injuring. Often the SI is to get rid of suicide idealation.

His family is in denial of the fact that part of it is in response of his traumatic childhood. It's easier to think about it as him being burned out because of doing too much taking care of his disabled girlfriend and her making him do things when she shouldn't while she knows he's in bad shape.