LFH:
She hasn’t improved as much as anyone had hoped. Finding the right combination of medication is a slow process. She still lies about things but seems to have sincere regret over ruining our marriage. There is so much going on that it’s tough to distinguish between legitimate mental health issues and manipulation.
Do you know her formal diagnosis told to you directly from her doctor? I'm assuming the medication is for mood stabilization? The way you wrote this makes me wonder if you think it's just a case that if she gets on the right medication she'll suddenly open up and become an honest person. You do know that no such medication exists, right?
I echo the advice WoodThrush2 gave you above. Have you informed the OBS yet?
Do your kids now know what their mother did? Surely, they have to have some suspicions about what has caused their mother's mental health crisis at this age after years of normal behavior? In addition, unless you're an Oscar award worthy actor, they have to suspect something based on your behavior about your WW. I reviewed this entire post and it's not clear whether your children have been informed yet.
I am sorry you are now living in limbo hell LookingForHonesty. Months ago, I tried to give you advice to take steps to avoid this and to detach. I advised you to get away, even for only a short time, to clear your mind and think. Did you ever take an opportunity to do so? Do you believe you may be co-dependent on your wife? You may want to explore this in therapy if you're still seeing your therapist.
It appears you are now living with 2 additional roles in life: your wife's Caretaker and Bearer of her secrets. I can understand the caretaker role- all that "in sickness and in health." Although the cynic in me questions the logic in maintaining vows to one who is unfaithful. Marriage vows are not a suicide pact. The second role is not yours to bear in any way. Set that burden down, tell your family the truth, and inform the OBS.