You've posted concerns before, with greater detail, but I forget if you've answered / disclosed any of this (not asking you to publicly do so), you can think about it / research it / talk with a counselor with her or separately if you wish.
1. Have there been any medical / hormonal / stress changes for either or both of you, and/or family histories of depression?
2. Also, have you (she) had first child birth in past few years?
3. Money issues with concurrent onset of any of the above?
4. Family member with critical illness / death - even if they are "surviving".
(You can double-count answers - i.e., first or recent child birth resulting in an emergency hysterectomy therefore hormone changes and your wife now staying at home (either more, or for first time) and working less or not at all, and the household income drops by XX%, and you have a parent with a terminal diagnosis - you better believe that's tough to work through even if you two are united. Your body responds in ways your mind and emotions can't fully control.
And I'm not talking about sexual intimacy at all - rather how your total body system - physical, mental, emotional - is impacted by life stressors and/or hormonal changes.
The other thing is what do you want / need from your partner? Have you articulated those needs and what you each believe constitutes fulfilling those needs? - and hopefully you both truly want / need a partner. If you're ambivalent on that, in particular if you agree that you once had a great partnership but the need/want for that has changed, because you have changed then you need to work with a counselor on that, if you're both willing.
1) She recently started taking meds for depression. A slight dose, but needed. Also, she was diagnosed with ADHD a year or so ago. Ive always dealt with mental stuff on my own, but it definitely played a role in where we're at today. Therapy may be good for me, but I also am afraid it'll screw me up even more.
She's also in nursing school, which has impacted the amount of time we have to hangout.
2) We have a son who is almost 5. We both acknowledge that has played a role in our current issues.
3) Money is fine.
4) Nothing too recent, but we've both lost all our remaining grandparents over the past 2 years.
Sexual intimacy is still there, but I think it's due to us feeling like we may lose the other at any moment, so that can draw some intense feelings of need in the moment.
The issue is with the bolded. She believes we love differently. I'm more independent, and rather than the helpless romantic type- I enjoy fun and adventures with my partner. The little things aren't all that important to me, either. She wants more romance and for me to listen to her concerns better. She also believes she may have ignored her true feelings for a while. Things were good for the first 6 or 7 years, but may not have been up to her standards of what she wants in a relationship.
We've been talking and talking and talking. Explaining to each other our needs. Her list is longer than mine, and she's come to the point that she believes we just love differently.
I want longevity in a relationship. I really have hardly any desire of being single, and I really enjoy being with her. I want to change, but given that Ive said I'll change in the past (become more romantic, do more of the little things for her, etc...) and havent- my words have become hollow.
As my man Willie Nelson once sang:
'Little things I should have said and done,
I just never took the time,
But you were always on my mind'