@briarrose —This might seem too simplistic, but what if you called a moratorium on any discussion of mental health and treatment?

Discussing it gets you nowhere, and it just increases his anger and suspicion.

On top of his losses, he has now lost his therapist who might have been helping him. I can see why he wouldn’t want to go through that again—and risk losing another one. Ideally, the therapist would have announced her leaving a few months beforehand and would have actively suggested names of other therapists. She could’ve had him make an appt. w/ one to let him “test the waters.” If that one didn’t work out, another could’ve been proposed. Few of them do that. Many therapists don’t understand how important they can become to a patient. Odd, but true.

I doubt that he is a paranoid personality disorder since you state he was different before these losses and was close to you. That’s not the picture of a PPD.

I think what I would do in this situation is keep the lines of communication open. Continue to be his friend as well as his loving mother. I’d write a note on a pretty note card weekly (or at another interval) telling him what was going on with me. It could be just a chatty, short note. Include some jokes or little stories, or pictures or photos that you like. Send him little gifts or baked items—treats you know he loves.

The point of this is to re-establish that you are safe and can provide a safe space. I’m not necessarily suggesting he visit. You might visit him tho’ once this safety has been established. You want to be what others haven’t been: present, unruffled and loving. The message is that you have always been there for him and will always be.

When people suffer major losses, they don’t just suffer from the pain of loss. They are stuck wondering why. That almost always leads to over-examination of what they did wrong, if anything. If he was involved w/ a self-centered person w/ low empathy (narcissistic), those kind of people can be very difficult to extract oneself from, in part because they take little to no responsibility for the rupture and often excessively fault find.
If your son was a giving person who was empathic, he would’ve been a target for narcissists.