In this case, I would argue that the initial message was pretty unexpected, never mind the response. Who sends a photo of a cuttlefish with a “glub glub” caption, anyway? I can only hope that it was some kind of in-joke back from when they were dating. Otherwise, it’s just too weird for words.
He probably wasn’t expecting being told to get help, though. Or perhaps he was and it was just a last-ditch attempt to rekindle a relationship. I would be tempted to agree that therapy would be a good idea in this case.