He's hurting on some internal conflict he is having. He is shutting down not telling you is a way of distancing himself from you. His alcoholism is a bi product of it as well as his hoarding. He's hoarding, because he's holding onto something he has lost, and you must find out what that is. You should show you accept that. I also do agree that he does indeed need an intervention he's very ill mentally and physically. He's ailing and he needs you the most, but you possibly could be enabling his actions as well possibly. That in order for him to appreciate you, he needs to find inner peace to get rid of his cloudy mind and actually get back a man you want to give you the affection and sex you need.

It's the appreciation is gone, because he lost himself in his own pain in his heart over who knows what, but once that's been settled. That he sees you've been their for him he will see show his gratitude. This is what I would like to happen in my opinion.