or is this just a normal difficult time in a marriage?

My fiancé and I are in similar life points. I'm also in grad school and he is working. I wish soooo much that he could live with me, but we have a two hour distance from each other on top of everything.

We survived college, work, no home, many times moving, boss issues, school issues, and even the death of a parent. We survived serious mood changes due to medications. The entire time we were constantly near or at poverty level up until recently.

I still love him more than anything. And he loves me more than anything. He is my best friend and and I'm his. Our sex life is still amazing, and I also want a baby very badly but know better than to have one right now.

A spouse is someone who you face the world together with. Someone who, even at their worst, doesn't want to hurt you. No matter how much shit the world throws at you, your spouse should be facing it with you -- not be causing the problems.

You should try one last time to explain to her how much she hurt you, how her behavior is very unfair to you. How she isn't herself and you think she knows that. Try one last time to explain that this isn't what marriage is, and unless she goes out of her way to find a medication that works or learns to talk to you without attacking you -- that you need to divorce her. You also need to put in effort here, too; patience until she finds the right medications if she agrees (assuming she actually goes and changes them). These obviously don't help, but that's the point of there being many medications out there. You can find the one right for you.

If you don't have the energy for it, I understand. And that's your answer right there, on whether you should bother or not. But she's in a dark place right now and self sabatoging. I think you owe her one final shot to understand how horribly unfair she's been and one last chance to try and help herself. If she doesn't take it, it shows where you stand with her, and that's also the answer.