screen tearing issues

I've gotten the directx crashes but not very often, my main issue is that I am experiencing a lot of really bad screen tearing, especially in darker areas of the game (inside skyhold for example).

I didn't have this issue anywhere near as badly as I do now after the patch.  I've tried reinstalling my nvidia drivers, I've tried updating them, I've tried rolling them back to older versions (I'm currently using 344.65), I've tried running the game in windowed fullscreen (horrible), windowed (even worse), and fullscreen (seems the best quality/least amount of screen tearing but most unstable because I tab out a lot and it tends to crash more)

System:

AMD Phenom II X6 1090T 3.20GHz

16GB  RAM

Windows 7

NVIDIA GTX 760

Two monitors (I'm not entirely sure if this is part of the problem, in nvida control panel it's set to multiple display performance mode for mutli-display/mixed-gpu acceleration)

I've gone into nvidia control panel many times to try and change settings just to see if anything would work.  I'm not super familiar with this sort of issue so I am not entirely sure if anything I've done would have actually helped anyway.  Enabling/disabling triple buffering, changing from vsync to adaptive vsync, setting up custom resolution/refresh rate, setting graphics to whatever the game thought it should be at (automatically detected I think was the setting for that?  I don't have it open right now so I can't remember).  And not that I figured it would help with this particular issue at all but I have also tried underclocking my gpu as someone suggested in another thread.

Any suggestions to try would be awesome, because I just don't know what else to try at this point.  I don't really want to be stuck running at fullscreen if I can avoid it since with the tabbing it it makes the game way more unstable.