I'm sorry to hear what you've been going through.

There are a lot of variables in play here and some that stick out the most are inadequate sleep, lack of an antidepressant (which often helps with chronic pain issues), and it's unclear why you're removing lamotrigine since it's not an antidepressant but an anticonvulsant/anti-epileptic drug. I was only sleeping for 4-5 hours a night on Abilify but was able to take 1-2 hour long naps as needed throughout the day so it ended up working out, but without those naps I can easily see how a situation could degenerate.

Also, I am surprised you're worried your wife will leave you. Does she know how you're struggling? With all respect, if she's the kind of person who doesn't love you for you and is right out the door when you're down, she can't possibly be the right partner for you. Either you're not giving her enough credit or it's a big mismatch.

Wish you the best.