Charlie Sheen is Suffering a Manic Episode; That's Not Funny

Some health professionals can be two-faced about mental health. They will have their day...

Thanks Natasha, I know I'm late getting into the conversation about CS and his bipolar mania/psychosis episode. It just happens that I was in a chemical dependency and mental health counseling graduate school program during this time of Charlie's sickness. Seasoned mental health and substance abuse counselors were mocking and ridiculing his manic behavior. The program I was in is a leader in the field up there with Betty Ford. This goes to show how much stigma and ignorance and pure disdain some so-called professionals have for the mentally ill. If professionals act like this, then how will the stigma ever diminish? We normally don't make it a habit to mock and ridicule someone who is suffering with cancer- so why do it with people suffering from MH/CD illnesses?

I have just read this. Now, Sheen is a brilliant actor, very gifted. Isn't it possible that this public meltdown is a publicity stunt, to engage the public sympathy in regards to his violence and drug abuse? He is worth millions and so his PR will be monitored very very closely.
I am sorry if he is really suffering, very sorry indeed. But I am sceptical.

Hi theocm,
"it seems quite scary that alot of people i know are becoming quite fond of his outbursts as of lately."
You're right, that's terrifying. But I suppose if someone stand on a ledge there are always going to be people who should "jump."
"In my immediate environment he has become idolized for his pro- choice for substance abuse, his “ego” and “confidence” in his actions"
Yes, sorry, those people are ignorant. People think that billions or dollars, snorting coke making insane remarks and hiring prostitutes must be a great lifestyle. This is a ridiculous fantasy. Perhaps someone should remind them that Sheen has been violent, had restraining orders placed against him, been fired, and has had his children taken away. Oh yes, great life.
And if I could explain that (and more) to every living person I would. But people want to believe that type of fantasy would make them deliriously happy. Naturally, they are incorrect, and yes, you're right, they are encouraging awfully dangerous behavior.
- Natasha

Hi Jeff,
"Why people close the Sheen are allowing this to go on publically, without intervening and offering help, is baffling."
Well, there are often two reasons:
1. The mentally ill person has pushed everyone out of their life to the point where this is no communication possible
2. The mentally ill person is convinced they are the only "sane" person and everyone else is wrong.
In either of those two cases no one can stop his behavior. And being a star, many people are going to enable his behavior no matter what. Yes, I think that's very sad.
It occurs to me that we may actually see a suicide of a person that was obviously ill, that _millions_ of people knew about and no one could stop. Yes, I find that shocking.
"This brings his whole “firing” under question, because if his recent behavior has been triggered by a mental illness, they cannot hold him accountable for much of the behavior that led to his dismissal."
Well, yes and no. If I walk up to a CEO and stabbed him because I was manic, you better believe I would be held responsible for it, as I should.
Now Sheen has just been mouthing off, but my guess is that somewhere in his contract there's some clause he's breaking. And while medically he might be held "incompetent" we are still all responsible for our _actions_.
Additionally, employers can fire you for anything they want (assuming they're not breaking the law). It's totally up to them.
Yup, those who have seen this behavior before definitely see it as clear as day in Sheen.
- Natasha

I think it's terribly sad that Charlie Sheen's obvious struggle with mental
health is being made so public.Imagine having your most personal and
tragic struggles exploited in the media again and again for the
titilation of the bored and uninformed....it's hard enough to cope with a chronic mental illness in private. If it's universally true that what goes up must come down,Mr. Sheen is in for an incredibly hard fall.How will he react
and what will the fallout be from the media-blitz that is taking place now?
His life could literally be at stake.Do you think any of the DJs,news commentators,journalists,or tabloids would assume any responsibility for
his demise should the crash and burn he's headed for prove to be too much for him to tolerate???? Scarey.Worrisome.Cruel....

As a wife to a severe bipolar one disorder husband I will say that I thought I was watching my husband in a manic episode! He looks like he has not slept in days.. and the rambling that I would listen to for days at a time literally! He dffinately needs treatment and understanding.

it seems quite scary that alot of people i know are becoming quite fond of his outbursts as of lately. i hope he does get help and soon. in my immediate environment he has become idolized for his pro- choice for substance abuse, his "ego" and "confidence" in his actions is really feeding into an unhealthy mentality that just because you feel ontop of the world at the moment you aren't necessarily in a positive place. mania, substance abuse can confuse people into false realities and any pats on the back are incidentally going to encourage the down ward spiral. mania misleads, it temporarily inhibits our reasoning and pulls us out of our lives and away from our personal goals. he is encouraging the wrong behaviors and being encouraged by misguided fans. scary, when illness isn't seen for what it is.

When I saw Sheen’s video posted last night, all I could think was that he is enacting the symptoms, verbatim, of a friend of mine who had a manic episode brought on by the death of a close friend (symptoms listed above). Why people close the Sheen are allowing this to go on publically, without intervening and offering help, is baffling. He is obviously mentally ill, and is having a manic episode—put on display for the gossip and spectacle of the masses. This brings his whole “firing” under question, because if his recent behavior has been triggered by a mental illness, they cannot hold him accountable for much of the behavior that led to his dismissal. Yes, compassion is what is needed. His family and friends need to intervene and get him help, now! Had I not experienced a manic episode through a friend—who had the same delusions of grandeur, almost completely stopped sleeping, etc.—I would be like a lot of other people, either scratching my head, or blaming his behavior simply on drug addiction.

Hi McLeod,
It's not that I think someone would admit Sheen to a hospital. It's really not about that. His behaviors have destroyed his life, 3 divorces, restraining orders, removal of children, violence, being fired from a hit sitcom. These are not minor events or things that can be glossed over with a different girl.
(It's true, you don't have to have the depression, there are several illnesses that contain mania. But I would be pretty darn shocked if he hasn't been having/will have a very serious depression. Massive drug use often indicates self-medication of depression.)
- Natasha

As a sufferer of bipolar disorder myself, I can tell you there is no doubt whatsoever to me that he is hypomanic. I've been through the exact same thing, the 10,000 year old brain, the winning, the belief of being from a different plane of existence to everybody else, the inability to concentrate, and, I quote from Charlie Sheen, "I don't sleep, I wait."
However, he can get away with this because he has millions of fans who love him and three women to rotate around every night. When you are hypomanic, you have the belief that you're either a superfuckinggenius or crazy, and you're willing to take the risk (in my opinion, Strawberry Fields Forever sums it up). Charlie already has a successful life, and if he doesn't want to get better, he won't. I don't think anyone can just walk up to a man like that and section him.
Also, you do not need to have the depression part to be classed as manic depressive, or bipolar. You can simply be hypomanic and still be classed as it, it is a mood disorder.

I think we are all watching Sheen's episode and contributing to his heightened manic state. Aren't we all enablers by encouraging it through the media. It seems we cannot get enough of him. How will we all feel when it ends in disaster? I feel he would be better deserved by not getting the media and public attention which is feeding his narcissistic self-belief. Yes it is entertaining but not so funny when you know how it will end. Having watched my own ex-husband destroy my family through drug abuse and bi-polarity, it is all too familiar to me. Took me years to comprehend the crazy behaviour and nearly killed me in the process. This is NOT entertainment. This is mental illness being used as reality tv. Not so entertaining or funny.

Natasha,
We as non-health professionals have to always preface our perceptions as just such, yet we bring to the table an experience and hypersensitivity can can never be learned, only experienced. That said, Charlie Sheen is slam dunk in a manic episode, and the self-medication is not causal, but most likely an effect of his bipolar disorder, a genetic predisposition and nothing that can be acquired from the drug use in itself. Of course, this just continues a legacy of people with bipolar seen as pariahs and not for the human beings they really are inside. Hopefully, this international stage can only help if Sheen were to get medical help and turn around his life. Then, he could just playing that "Charlie Sheen" character in his sitcom and not out in real life, just as Robert Downey Jr and other people with bipolar have learned to harness in their life with proper medications and lifestyle

My flavor of BiPolar 1 is described as "rapid-cycling, most recent episode manic with schizoid features". After my last manic "break" in spring '08 I found that my pdocs (I "train" one resident every year) ruled out any anti-depressants, but were open to ECTs (which I had ruled out) and benzos in early alcohol recovery. Yet I continued to suffer greatly from unrelenting depression. I became physically deconditioned, and had no desire for employment. More than two years later, I at last got a pdoc who was willing to take the risk of employing SSRIs again. We started with Wellbutrin, which is activating but not likely to cause hypomania, then slowly titrated Prozac and Remeron up. I may not go to the gym or work in the art gallery every day, but @ least I'm interested in those things. These days I am proud to be a volunteer videographer for our Community Access TV station, and the door is open for me to expand my role there and even make some money. I remember money. Social Security provides me with a subsistence level of living; I'm greatful for MediCare/MA that provides excellent services and $11,000 in medicatiions/ year, but I'm daring to think outside the box. And that may be my best weapon to keep depression @ bay.

Hi Larry,
Yes, you are right. That is what that study represents. It specifically is using unipolar depressives to illustrate that risk. Some of those people in the study surely were unipolar and experienced mania.
All I'm saying is, the risk is very small. The incidence of being bipolar is considerably greater than being on an SSRI and having the side effect of mania.
(On the label for Prozac (random SSRI I chose) mania is only listed as a side effect for children. Of course it's different for each drug.)

Hi Natasha,
Thanks for the info, I'm aware of the studies.
What you might be misunderstanding is that yes, it is true that users of SSRIs who are bipolar are at a higher risk of mania, but this does not mean that users of SSRIs who are not bipolar have no risk.
If you'll note the side effects listed for each SSRI states that there is a possibility of suffering mania as a result of taking the SSRI, they do not state that the possibility of mania is only for those who suffer from bipolar disorder.

Hi Larry,
I think you might be misunderstanding the issue.
Most people who experience mania with SSRI treatment do so because they _are_ bipolar. It is difficult to diagnose BP II and thus sometimes it's missed and sometimes these people flip to mania when treated with an SSRI.
In a study from 2008:
Treatment of an SSRI for unipolar depression produced mania/hypomania, on average, in 2.3% of patients over 9 months.
However, this represents 344 patients across 2 centers: Pisa and Pittsburgh, who found switches in 6.8% in Pisa and 0% in Pittsburgh.
(Also worth noting is .9% of patients in _therapy_alone_ switched to mania during this time, so obviously, they were incorrectly diagnosed as unipolar in the first place.)
It may be the case that the US is diagnosing bipolar more effectively (for a variety of reasons), at this time, than Italy. I suspect this is the case, and this may account for the large disparity in cases.
http://www.ncbi.nlm.nih.gov/pubmed/18837867
- Natasha

yes people can experience mania when bipolar, but a number of antidepressants have side-effects that can cause mania. more people are on SSRIs than people there are people who are bipolar, the odds are in favor of charlie having a SSRI induced mania. in fact mania is listed as a possible side-efffect on all SSRIs. i imagine Charlie is experiencing something like paxil psychosis. this would explain his confidence, and rapid thoughts, with him verbalizing them in interviews he of course sounds crazy. he needs to be weened off of SSRIs, and not give interviews until he feels better after getting off of the SSRI

For those of us who already have the T-Shirt, we know that Charlie is on a trajectory toward disaster. The pressured speech, expanded ego with special powers, and rambling attempts to "connect the dots" are reminiscent of my own history with Mania. I was actually disappointed that he tested negative for drugs; that can be detoxed in short order. Psychotic breaks are much more devastating, long-lasting. I'm appalled that the media is watching him spin as his handlers participate in his denial. We saw something similar in the "crackup" (Philip Vonnegurt's phrase) of a female singer's very public crisis a few years ago. I have much compassion for Mr. Sheen, and hope his dad quietly has him treated for "exhaustion". While I acknowledge personal freedom and the requirement to ask for help, I feel that severe mental illness is "an equal-opportunity destroyer" and interventions must be made to save lives. The bloodbath in Tuscon didn't occur just because of a 30-round clip;
it happened because too many felt helpless to intervene.

I saw his interview on the Today show earlier, and I was scared of how gaunt he looked. And the way he talked really did seem like he's slightly unhinged and out of the normal range of reality. I really do wish he can get himself better, and get the help that he needs.

the truly unfortunate thing is his manic is recorded for his children and for the world to see -- and the children will be able to watch their dad uncontrollably self-destruct without any filter of reason and with information overload from all directions. praying that he gets help soon -- real soon.

Oh, as an FYI, he had at least two clean drug tests just before these interviews and it may have been 3, one conducted by a lab in California in conjunction with some TV show.
- Natasha

Might be mania, but it's definitely drug/alcohol induced!!!

He screams MANIC! The crash is going to be HARD.

Hi Jake,
"It is unfortunate he is getting mocked in the media, it seems to be par for the course when people act mentally sick.
I think it makes people more secure in their own denial about their mental health when they mock the foibles of others."
I don't know if that's the case. I think it's just stigma. It's "OK" to make fun of the guy walking down the street talking to the voices. Not because it reaffirms someone else's sanity but simply because society seems to think it's OK. Society has not yet caught onto the idea that mental illness is just - illness - like any other illness.
And, if mental illness wasn't on your mind, and you had no experience with it, perhaps it wouldn't even occur to you when you see Sheen's interviews. I don't know.
(I haven't not had mental illness on the mind for about a decade so I'm not quite sure how other people think about it.)
- Natasha

Hi Ash,
Yes, it occurs to me also that if this is mania and he makes it through, then depression is coming and that _really_ scares me.
- Natasha

He sure seems manic eh? I can certainly relate to the prostitutes and drugs. I spent away a marriage and a career that way. Hopefully he finds some help before he starts to hear voices(as I did) or before he crashes.
It is unfortunate he is getting mocked in the media, it seems to be par for the course when people act mentally sick.
I think it makes people more secure in their own denial about their mental health when they mock the foibles of others.

It would make a lot of sense to me if he did have bipolar disorder.
Drug use in the past could have been a form of self-medication, as well he seems to be screwing a new model/actress/stripper every week (could be hypersexuality, could be him being a horndog).
Again, this is all just speculation. I fear if this goes unrecognized by him, things will get REALLY bad when he hits a depression.

MMC,
Yes, I would say "diagnosis" is not the right word. One can comment on his actions but no "diagnosis" can be made outside of his actual doctor.
But that's how the news media reports things. They get some doctor to make an interpretation and then the person has been "diagnosed". Luckily for me, no one would mistake my words for diagnosis, what with me not being a doctor and all.
(Doctors could just tell the media to shove it, but somehow I don't think you could get all the doctors to agree to that.)
- Natasha

Yah, that was my first thought too though with his drug history, it would be hard to tell. Still seems weird when APA refer people to article with doctor "diagnosing" him based on a tv interview--maybe it's a teaching moment, but it still seems inappropriate for them to comment when he's not their patient.