what would you diagnose Debbie with and why?

Debbie a 34-year old woman was referred by her GP to the Psychology Clinic for assessment and treatment. She has beenmarried for 5 years with no children and works part-time as an administrative assistant. Her husband, Mark, is a 37-year-old corporate lawyer. They spend their time between two residences: a lavish decorated townhouse in Brisbane and a large condominium in Melbourne. Debbie is the oldest of four children and she reports having a distant relationship with her parents and siblings.

At the first session, Debbie said she needed help with her marital crisis. Debbie presented agitated and distressed, as she was crying loudly. She described her crisis as her husband left her this morning after having a very heated argument with him last night. The argument was over her fear that he will leave her for another woman. She is worried he is having an affair with another women as he is showing less affection towards her than usual. She stated she called him a liar and a cheat. In the heat of the fight, Debbie stated she threw several porcelain objects at him, each one costing several hundred dollars. Debbie reported that the intensity of the argument with Mark was not unusual as she has broken several pieces of expensive art work during previous angry outbursts. Debbie said "I told him I would kill myself if he left me alone." She reported that Mark did leave this morning to live in Melbourne for a while until she calmed down.

Debbie shares that she has thoughts of suicide. When asked if she had a plan to kill herself and if had ever attempted before to harmherself in the past, Debbie reacted surprised and said "No, I don't really want to die, I get just get so angry with Mark that I say things like that to frightened him and make him show me affection". Debbie repeated that her thoughts of suicide were a frequent threat but that she had no real intention of dying.

She reported that she has felt bored, apathetic, and lethargic for several years. However, these feelings are especially noticeable when Mark was not home, but also are there when he was home as well. Debbie reported having "lightning-fast" changes in her feelings for Mark. She stated "It is like little switch inside me that moves from being nice to Mark one minute then being mean to him the next. Sometimes I feel very fond of Mark and proud of him. However, these feelings can change quickly to not trusting him and not liking him. When I feel like this no matter when we are I start yelling and sometimes hit him, and if we are in a restaurant we have to leave. I feel so overwhelmed with emotions sometimes that I cut myself, not deep, on my forearms and upper arms."

Debbie reported there have been times when she has felt so down she does not want to get out of bed and experiences no pleasure from anything. However, she commented these low moods never last longer than a few hours. Debbie stated that she feels hopeless and tearful during these periods. She has needed medical attention on two occasions for these behaviours. Debbie also reported that she engages in binge drinking and also takes cocaine frequently. She likes to also go on spending sprees, which she did recently and this caused conflict between Mark and her due to financial problems.

Debbie stated "I hate my father as he a demanding tyrant whophysically and emotionally abused me as a child". My mother is a non-entity as she passively submits to my father's intimidation." Debbie reports her mother has a dependence on alcohol and barbiturates. Debbie's parents spent very little time with her as a child. Debbie states "My parents would leave us at home on our own or hire sitters to care for us most of the time." Debbie reported several breakdowns in friendships over the years and she reports feeling "empty" for years. Debbie's physical health is reasonably good.