He is verbally abusive towards us. He can't handle the finest bit of stress. He screams and breaks things. He tells me how much he hates me. But when he doesn't know how to handle something he comes to us. If we help him and we do then he later is even more resentful.
Hmmm .... no medical expert here but what you wrote sounds like your son might need medical and/or psychiatric help.
He refuses counselling and takes an antidepressant that doesn't seem to work but won't return to the Dr.
Yup - as I read further into your posting - medical/psychiatric help. But, you cannot dictate to an adult what to do even if it is in his own best interests. I really doubt he enjoys hurting you and I doubt if he is able to focus on the good times - mental health issues tend to block "normal" feelings and responses. Is there any one person he trusts? If so, perhaps that person could try and convince him to return to his doctor. I believe (again no medical expert here) that if an antidepressant does not work, one probably is dealing with personality disorders and/or more severe mental health issues. I really think that your son is "hurting" but it is up to him to seek help. So sorry - been there - not with our sons but with other family members.