This is dramatically worse than normal, but the paranoia is largely feeding into existing issues. Things he doesn't acknowledge on a daily basis or he wouldn't be able to function around anyone, let alone in a relationship.

Still, when she doesn't just agree and leave, he's confused again. And the fact is... he doesn't know. And is too far gone right now to come up with a single reason. He just shakes his head weakly before trying to roll away.