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Realistically, it may take years for your wife’s symptoms to improve even with therapy, especially if she isn’t on a working medication. It’s really up to your own judgement whether you have the patience or resilience to continue in the relationship in its current state, but bear in mind that there may be no quick fix. Perhaps there’s just too much of a maturity gap between you, or you’re just too different to live together happily. It’s okay to choose divorce for the sake of your own mental health.

On the other hand, if you truly want to stay in the relationship, then I encourage you to continue trying to find a balance between helping her and taking care of yourself. Prioritize reestablishing your self-care habits. Break down your frustrations to specifics and prioritize those: for example, if you’re frustrated about the house being messy, look at each source of mess. (If the dishes lying dirty for a couple of days is mildly frustrating but dirty laundry all over the floor totally drives you nuts, then let the dishes go for now and figure out why the laundry isn’t making it into the hamper.) If the problems with the relationship are superficial, but the foundations are sound, then it should work out in the end. Of course, it is up to you to determine if that foundation is there, if it is strong enough, or if it can be made strong enough.

A tangent on chores: This can be a major issue for ADHD people because it’s one of those essential parts of life, but people also tend to regard everyday housework as something that “shouldn’t be hard” or require a lot of thought/organization to accomplish. However, ADHD makes all tasks seem about the same; a chore with multiple steps can seem as difficult as a school presentation or work project. The monotony of daily chores is turned up to 11: ADHD makes one incredibly sensitive to frustration, so a minor feeling of “ugh, I just did this yesterday” can morph into feeling like you were just drafted into a chain gang (and many of us also drive ourselves into a spiral of shame because we know that’s a little ridiculous, but the self-criticism only worsens the underlying problem). On top of that, there is the impaired perception of time. I can predict to the second when the microwave timer will go off, but I can’t tell ahead of time if vacuuming the living room is going to take 15 minutes or 3 hours. If a task isn’t part of the normal routine, or if the routine is disrupted, it can be difficult to remember to do it at all. An ADHD person without a regular routine (hi, it’s technically past my bedtime) will struggle to decide when in the day to do a task–first thing in the morning, when you already have to worry about getting out of bed, dressed, teeth brushed, and a million other preparations? When you get home from work, even though you know you’ll be a brain-dead zombie then? On the weekend, when you’re desperate to do something fun? –Having multiple different chunks of work (housework, school, work, errands) that require transitions in between can wreck an ADHDer’s ability to balance their routine and take care of themself. With ADHD, it’s doubly important to have simple & achievable priorities.

Worse symptoms every 4-6 weeks might be related to her menstrual cycle. It could be PMS or PMDD, another mood disorder or health condition flaring up at a certain time in the hormone cycle, or just the emotional side of ADHD doing the same. Birth control medications help with PMS for a lot of people, but sometimes they can worsen the symptoms–it depends on the person and the medication. Alternately, there could be some stressful thing that pops up on her life every so often that’s too much to cope with. In any case, this pattern likely has some concrete cause. (I would hope you don’t need to be told to be tactful about bringing up a lady’s period, but that said, if she isn’t aware that the PMS+ADHD combo can be a really rotten deal then you bet she’ll be glad to know. Tracking my cycle and starting to recognize the pattern helped bring me out of a serious depression. Before that, I didn’t recognize the time intervals and just thought I was imploding every other week for no reason. Also, if she wants to start doing that then there’s a great tracking app called “Clue”.)

“I have tried to bring this up in therapy, but how do you tell the therapist that you feel mentally unhealthy because you’re towing the mental line for two adults.”

I’m not sure I know what you mean by “towing the line for two adults,” but if you mean you feel like you’re taking on the responsibility for both of you, then definitely keep trying to express that concern. Questions like whether to stay together are very subjective, but feeling like you’re in a parental role to your spouse is a pretty cut-and-dry unhealthy dynamic to be in.

Also, if you don’t have your own therapist in addition to the couples’ therapist, it may be a good idea for you to see one. Regardless of the cause, it sounds like you’re really struggling with your own emotional health, and a relationship counselor can help with a lot of problems but they can’t address your individual issues with the same depth as an individual counselor. If you feel like you can’t express the problems that are really bothering you in therapy, then the therapy probably isn’t helping you.

It sounds like this relationship is kind of taking over your life. You’re managing your wife’s life to the point of being her unofficial ADHD coach and being at all of her therapy sessions. It seems likely that either she’s dependent on you to an unhealthy degree, or your own behavior has become excessively controlling. I’m not trying to shame either of you by saying that: you’re also both trying really hard to make things work. Just consider that “divorce” and “continue with the life plan we made on our honeymoon” aren’t the only choices available to you. Let yourself seek out different ways of thinking about your relationship, living together, and communicating. Try to revisit the things that brought you together; shared interests and experiences, common ground. Are those still there? Are they being overshadowed by the problems between you? Have they been replaced with different positive qualities? Are there no positive qualities in this relationship at all? Try to balance your worries with remembering the things that are still good in your life as it is now, even while your doubts remain unresolved. If you’ve been through therapy for depression I’m sure you know how much easier it is to remember the negatives of a situation than the positives. I think of it like, positive thoughts need a little boost to get going, but unlike negative thoughts they’ll help you back later.

Well, I’ve rambled on long enough. Hope some of that is helpful to you. Relationships are tough enough without throwing neurodivergence and mental illness in the mix. Whatever the outcome, you’re doing your best and that’s commendable. It’s great that you’re reaching out for support. I hope you find more peace and happiness each day, and the same to your wife.