@DesperateForAdvice,
Your business is successful. So hire some help before your insane hours and probable stress put you in an early grave.
You
are neglecting your wife. Of course you are! Because 200 hours + per month = about 48, 49 hours per week on average. So either you are working one or both weekend days or you are putting in 9 or 10 hour days on the regular.
That's a recipe for neglecting anyone.
You come home, you're exhausted. You don't want to talk. You just want to screw and sleep.
Your wife isn't bringing in the big-time bacon. You are the one who is contributing to the financial status of the household. And her contributions are not being included in that. Her labor, her time, etc. She may be feeling you don't appreciate her contributions. And, according to your post, you don't.
You just want your sex reward for putting in ridiculous hours that, considering your cash flow,
you no longer need to do.
And you have also decided that only she needs to see a doctor. You aren't taking any responsibility for the issues in your marriage.
Is she responsible for some of the issues? Absolutely. But right now, if you want anything else to be reciprocal, you have got to step up to the plate and be present in your marriage.
Right now, you are busy being a work martyr and, as I have already stated, you no longer have to be. You are treating your home like a hotel, and your wife like a fringe benefit of overworking yourself, and not like the person you fell in love with.
Marriage counseling for both of you would be a really good idea-- and by forcing you to take time and deal with things, maybe you'll learn how to delegate at work.
Because this schedule is going to kill you.