It's hard to have sympathy for someone that projects you as being either a "hero" or a "zero" depending upon their mood. My love is constant and true. My partner doesn't believe in unconditional love, either receiving it, or giving it. This person is the same with our children, so I just do my best to protect them from my spouse's perspective shifts (episodes) when they happen. When things are good, they're great. Generally, the home is stable and loving.

I'm at a loss at this point, for when things turn sour. They've been diagnosed, but refuse any attempts at therapy. We can't even have an adult discussion about a concern, because it will be deemed as an existential attack and they will somehow turn the discussion into an attack on me, then actually see themselves as the victim and me the villain. 

Is an ultimatum for therapy, as a couple, individually, or both the only way? Is there a more subtle way to help them manage their episodes?