Charlie Sheen is sick and not in a good way. After a media blitz over the past few weeks, I finally saw one of his many interviews on ABC and it was immediately obvious that he is in the throws of a major psychiatric condition. He talks at length about his drug use and super-human ability to control drugs, which is a common denial we see in drug addicted people. But beyond that, he is showing classic symptoms of the manic phase of a bi-polar illness.
Mania in a bipolar disorder is a hallmark cluster of symptoms and it can quickly spiral out of control as shown by Mr. Sheen. In this disease patients experience increased energy, restlessness and constant activities that keep them going from place to place. (Notice how he has suddenly appeared on talk shows, events, even showing up at UCLA to give a pep talk to the baseball team).
Other symptoms are rapid, pressured speech that is peppered with grouping words based on their sounds and rhyming without much logic in pairing the words. (known as Clang associations).
He shows impaired judgment caused by mania; impulsiveness, grandiose thinking , hyper sexuality and inappropriate humor and a total lack of insight into how others are perceiving him. His interviews also show classic signs of excitability, hostility and feelings of exhilaration. (He believes his life is now magic. "I'm now on a drug and it's called Charlie Sheen. If you try it once you will die, your face will fall off.")
When patients are in a manic phase, they are unable to see how extreme their behavior is. They do not want to take medication or be treated because they are out of touch with reality. Many patients with bi-polar disease self medicate with drugs and become drug addicted. It is often hard to separate the drug affect from the mental disorder, but in Charlie Sheen's case he is currently testing negative for drugs so this is truly psychiatric.
It is sad that Americans seem to love a watching these true "reality shows" and he is getting media attention rather than help. Charlie Sheen has become the Anna Nicole Smith of 2011. I wish my blog today would signal a news blackout and we would hear no more about Charlie Sheen until he gets needed treatment.
There may be two good things that come out of this.
1. Hopefully there will be a greater awareness of serious mental disorders and the need for identification and treatment.
2. My 15 year old son has no idea who Charlie Sheen is. To the kids he is just some old guy.
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