TUESDAY, March 1 (Health.com) — Charlie Sheen’s recent and very public unraveling has all the makings of a bad—yet riveting—TV movie. After months of tabloid drama that included a trashed hotel suite, a divorce filing, and a hospitalization following a reported two-day drug binge, Sheen’s hit show, Two and a Half Men, was cancelled for the remainder of the season by CBS executives last week after the star lashed out at its creator in a pair of on-air rants.
In a series of bizarre interviews this week, Sheen appeared increasingly unhinged as he discussed his drug use and his feud with CBS. On the Today Show, he described himself as a “total freaking rock star from Mars” and implied that he had “tiger blood” and “Adonis DNA.” On ABC, he said that he was as a “Vatican assassin warlock” and admitted to using a drug, “a drug called Charlie Sheen.”
This apparent combination of erratic behavior, delusions, and grandiosity—”I’m grandiose,” he told TMZ—has prompted speculation that Sheen may be suffering from bipolar disorder or psychosis brought on by drug use.
Sheen, who has been in rehab in the past, says he is no longer using drugs and passed at least two drug tests given to him by media organizations on Monday. And he has dismissed rumors that he has bipolar disorder, a mental disorder characterized by alternating bouts of depression and a revved-up, better-than-good feeling known as mania.
However, several psychiatrists—who have not treated Sheen and have no direct knowledge of his case—say the actor’s public behavior could be consistent with the symptoms of one or both conditions.
“When someone seems like they’re operating at the wrong speed, [and] they appear to be grandiose and somewhat irritable and irrational, there are a number of things that would need to be considered,” says Kenneth Robbins, MD, a clinical professor of psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison.
Bipolar disorder, sometimes also known as manic depression, is the condition that has been mentioned most often in connection with Sheen. Although all forms of bipolar disorder have some elements of depression and mania, these moods can appear with varying degrees of severity.
In milder cases, the symptoms of mania—lots of energy, euphoria, and little need for sleep—can fall within the range of normal behavior. “These are the stockbrokers who are able to go, go, go, and take some risks,” says Aly Hassan, MD, an assistant professor of psychiatry at the University of Nebraska Medical Center in Omaha. “They have no break from reality.”
In severe cases, however, people in the grip of a manic episode may seem delusional and exhibit symptoms of psychosis “outside of what we call reality,” says psychiatrist Ihsan Salloum, MD, the chief of the division of alcohol and substance abuse at the University of Miami School of Medicine. “In its extreme stages…they think they are Superman or God, and sometimes they could become psychotic to the point where they start hearing voices and becoming paranoid.”
Bipolar disorder generally first appears in a person’s 20s or 30s or even late teens, experts say. (Sheen is 45.) But especially when it’s not severe, the condition is often misdiagnosed and can go unrecognized for
decades, Dr. Salloum says.
Sheen has denied having bipolar disorder. When an ABC News reporter brought up the rumors, the actor replied that he is “bi-winning” and suggested that his brain is “maybe not from this particular terrestrial realm.”
Next page: Is cocaine to blame?