Nev, I'm sorry you're going through this hard time with the woman you love.

If you were a confused woman coming here for help, saying you had a fiance who was bouncing between moods, abusing drugs, verbally and sometimes physically abusing you, refusing to go to therapy and all the other things you've described, there would likely be a line of people telling you to get away from that abusive guy, get some therapy for yourself, build up your self image and find out what's keeping you trapped in this co-dependent relationship with an abuser.

So that's what I'm going to say to you. Get some help for yourself. Gender should not matter in a situation like this. Men, just like women, can find themselves trapped in a relationship with a chaotic partner who swings wildly between loving times and abuse. It's a common dynamic in relationships that aren't working.

I have no idea what your fiancee's diagnosis might be. It could be a combination of any of those things you mentioned or something different like a personality disorder or complex PTSD. The key statement is that she refuses to see a therapist or a mental health professional. She does not think she has a problem. Putting a label on her behavior isn't going to help anything if she refuses to seek treatment.

But you can see a therapist for yourself. Your work and family are suffering, you're confused, you weren't able to properly grieve your mother's death because you were too busy contending with her mood swings. You've lost two pregnancies. She could be grieving over those. What about you? It would be normal to have some unresolved feelings over a termination and miscarriage in such a short length of time. Somewhere along the line the ball was dropped when it came to birth control. It's important that you take responsibility here so you don't suffer another loss or a difficult pregnancy compromised by drug abuse. It's a very complex situation you're in and there would be absolutely no shame in seeking help from a therapist.

A therapist could assist you with all of that and could do a much better job of helping you understand what's going on with your girlfriend and whether or not you can do anything to help her. As the situation stands now, it's unlikely things will get better on their own and they could get very much worse.

I hope you will seek a therapist soon. That doesn't mean I think you have a mental illness of some kind. You have a life problem. Therapy can help us when we're stuck in a bad situation and don't know how to make it better. It sounds like that's where you are right now.

I wish you the best of luck and hope you find a therapist to help you get unstuck soon.