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I'm NOT saying under any circumstances that you should be the one to get him to do this, but it is possible for him to change IF he wants to get help.
Some of these points struck a chord with me..and without going into too much detail, because of various reasons, I've been super-insecure my entire life. I dealt with it fairly well until my senior year of college - or at least I thought I handled it well. I turned to alcohol, food, you name it to shut up the insecurities temporarily, but no one else really knew I had a problem. This past year, however, with graduating from college, trying and then not going to law school, having my friends move away, trying to find a job, adjusting to the new job, seeing coworkers laid off, moving back home, having serious problems with my close friends, losing weight and having people treat me differently, etc added to my normal insecurities - which were no longer kept quiet through food and alcohol (part of the weight loss) - I basically lost it. I entered nervous breakdown land, and I'm VERY surprised that my friends who knew stuck around. I'd start crying for no reason, I'd get paranoid that my friends were all going to up and leave me, and so on and so on.
All the stress just pushed me to a breaking point, but I saw what it was doing to my friends and my family and I went out and got help (even though, once I calmed down, I didn't think I needed it and repeated this over and over to my therapist). I feel awful when I think of how it affected everyone, and I still have the occasional issue to this day and flip out about something ridiculous. But, as my best friend said, she can't really get too mad at me because I'm working through my problems and I'm getting help, so while I might slip up sometimes, it's going to happen along the way.
As I said earlier, I'm NOT saying you should try to help him yourself. He's too far gone for you to help him right now. But coming from someone who's been there...chances are, if he was a great boyfriend, although slightly insecure, before, he could potentially be a great friend or boyfriend again if he gets a handle on what's causing his behavior. If he wants to get better, he can and he will, but he HAS to do it for himself. If he starts getting help - or even takes the first step and admits he needs help - it'll be rocky, but if you decide then that the good outweighs the bad and you can handle sticking through the very hard times that come with dealing with issues, it is possible that things could go back to how they used to be. Hell, it'd probably be 100 times better if he gets a handle on his insecurities.
Until and unless that happens, cold turkey it. With that temper, it'd be unsafe for you to be around him right now.
But you also shouldn't feel bad if you don't want to take off running when someone you care about had issues that surfaced. That's part of the stigma associated with mental illness - that it's a character problem and a weakness and you should stay away. Having insecurities or a disorder or a chemical imbalance or whatever isn't a weakness or a lack of character, it's how you deal with the problem that matters. And if he can realize he has a problem and gets help, that shows a lot of strength.
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