He didn't seem to realize that is what was stressing him out. Due to only having access to a real therapist once every 4-6 weeks, I have become very good at being his therapist, I just had him use some stream of consciousness to talk about everything that bugged him and when he hit on that, a look of shock crossed his face and I knew we had the reason. We talked it through and he seemed calm for the first time in ages.
Hopefully, this is it and we can move forward.