By Lambeth Hochwald
Charlie Sheen's highly public unraveling (read about his rants to ABC News and NBC News) - and his aura of invincibility despite his recent hospitalization, failed rehab, and cancellation of his top-rated CBS sitcom, Two and a Half Men - has everybody talking. Everyday Health asked leading mental health and addiction specialists for their explanations of Sheen's increasingly bizarre behavior.
Their take: Sheen may very well have bipolar disorder, cognitive disturbances from long-term drug use, or both.
Related: Take our Facebook poll: What's Charlie Sheen's Health Problem?
The Bipolar Disorder-Drug Abuse Connection
"It's not unusual for there to be an overlap between bipolar disorder and substance abuse problems," says Andrea Bonior, PhD, a licensed clinical psychologist in private practice in Washington, D.C., and an adjunct professor of psychology at Georgetown University.
Sheen hasn't been formally diagnosed as having bipolar disorder, a mental illness known for its dramatic mood swings, in which bouts of excess energy and euphoria (mania) alternate with severe depressive episodes. But he's certainly displaying classic mania symptoms during his very public rants on radio talk shows and network news interviews. Such signs include fast, erratic talking; racing thoughts; inability to concentrate; feelings of power; and refusal to admit there's a problem. "Being in a manic state can mimic being high or intoxicated," says Dr. Bonior. "When you're in a manic state, you're more prone to being reckless."In addition, mania can be punctuated by extreme changes in energy, activity, sleep, and behavior. It's possible for someone with bipolar disorder to experience a long-lasting period of unstable moods, writes Michele Berman, MD, on her Celebrity Diagnosis blog.
Sheen's Drug Abuse and Brain Damage
Sheen's angry, rambling tirades may also be fueled by his long-term drug use, which can lead to cognitive disturbances. "Drug use impairs brain function," says Kathryn Cunningham, PhD, director of the Center for Addiction Research at the University of Texas Medical Branch (UTMB) at Galveston. "The part of the brain that controls executive behavior and the ability to control your actions is one particular area of the brain that's especially susceptible to drug use."
Although Sheen, claimed to be clean and sober in his latest interviews, experts are doubtful. Some substances, such as stimulants prescribed to treat ADHD, don't necessarily show up on all types of drug tests, according to Bonior. "A lot of people who are in a manic state are seeking drugs and intoxication," Bonior says. "We can't know for sure if he's clean. He could still be under the influence."
How - or Will - Sheen Recover?
All of the experts Everyday Health interviewed said that Sheen's media outbursts are hurting his chances at recovery. "Charlie Sheen has been given a platform that the average person in a manic state wouldn't have," says Jason Gold, PhD, a clinical psychologist at the New York Psychoanalytic Institute. "He has access to the public and he's unraveling in front of millions of viewers."
In fact, all of these interviews are only enabling him. "We're giving him a microphone instead of encouraging him to get help - and that's important lost time," says Bonior. "If Sheen has bipolar disorder, then he may not recognize that he needs help."
Here's what experts fear most: that Sheen - who seems convinced that he's cured himself of his substance addiction - will meet a tragic end.
"It appears there's nobody who has made any in-roads with him psychologically," Bonior says of Sheen, who has a long history of extreme anger issues and domestic violence. "He has shunned Alcoholics Anonymous and the 12-step community. He hasn't been shaken by what's happened - being hospitalized, having his car go over a cliff. He doesn't see this as a rock-bottom situation."
"The next step is frightening," Bonior continues. "It's unclear whether or not his rock bottom could be so low that rock bottom is death. I think we'll be reading an awful headline about Charlie Sheen within the next few years."
An Addiction Lesson for Everyone
Is there someone in your life exhibiting Sheen-like behavior? Stick your neck out and offer to help if you have a loved one or friend experiencing the early stages of addiction. "If someone had tried to do an intervention with Charlie Sheen early on, or, if he was in danger of losing his job, all of this might have turned out differently," Bonior says. "But he thinks he can do whatever he wants. He's so far gone that he doesn't feel he has that much to lose."
Most important, encourage any friend or loved one to get professional treatment. "By seeking help a person can reduce his or her harmful behaviors, improve their health and productivity at work, and restore relationships," says Dr. Cunningham. "But you have to be committed to getting better for rehab to work."
Photo courtesy of Creative CommonsRelated: Take our Facebook poll: What's Charlie Sheen's Health Problem?
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