Maybe you could write a letter to him, one that you don't send. Get your feelings out on paper. At this point, it's really more about YOU and how YOU feel, not about him and what he does/feels/says. If he's ready to get help, he will. Any words you say to him will just be heard as "blah blah blah blah blah." He won't hear you. He can't. He won't. He is just not there.