You can only help someone who wants to help themselves. The main character was a prisoner of his own mind and therefore unable to change. His crippling fear of the world and people meant he couldn't ask for help either. Playing his little games of pretend and sinking even lower with each passing year until completely sealing his faith. Maybe, but just maybe, someone could have helped him, but for that to have happened it needed to be a different time period where people could have picked up on the signals and perhaps understood what was going on. Even then, without proper treatment, no one could have gotten thru to him with words alone. A tragic fate of a tragic character.