To me, this little speech of his (you can't call it a conversation, which implies two-way communication) is simply a show for your benefit--to show how he is "trying" but you simply won't cooperate. It is sheer manipulation.
Maybe he's depressed or has some other mental health issues, or maybe he's just a *gasp!* garden-variety drunk. His claim of an NPD diagnosis, and then the dismissal of said diagnosis, his various "issues", his blaming of everyone but himself for his problems, seems solely designed to keep you off-base as you run around catering to his various "problems". He is UNIQUE and FASCINATING and TRAGIC. In short, the same kind of b.s. your average alcoholic lives, eats, and breathes.
From where I sit he seems like a boringly average, typical alcoholic.
I would echo what Anvil asked--what are you watching and waiting for? An epiphany? Something so horrible that you will finally feel that you have no choice but to leave? For him to leave you first?
We all have the right to make our own decisions to leave or to stay, or to decide how long to stay. It's just not clear to me what it is that you are expecting or hoping will happen, when there's no sign that anything much is going to change, except for you to be worn down a little further each day as time goes by.