From shacking up with "goddesses" to claiming to have tiger blood and Adonis DNA, Charlie Sheen's erratic behavior has provided steady entertainment for millions of Americans in recent weeks. But what's really up with the actor? Is he painfully self-destructing in front of cameras as he mounts his media blitz? Is he mentally ill, a serious substance abuser, or more of a "bad boy," high-profile personality?
CBS News is in no position to know or to diagnose Sheen, but we asked clinical psychologist Dr. Stuart Fischoff to offer his insights. Keep clicking as Fischoff - senior editor of the Journal of Media Psychology - answers our questions...
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Is Sheen's behavior suggestive of a psychiatric or substance abuse problem?
Sheen has acknowledged cocaine use in the past. His current wild behavior - including his many self-glorifying comments - is consistent with a dual diagnosis of substance abuse and mania, a condition that is a hallmark of bipolar disorder. Such "comorbidities" are common among psychiatric patients, although it's impossible to diagnose Sheen from just observing him on TV.
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Just what is the link between substance abuse and psychiatric disorders?
There is a strong connection between drug abuse and bipolar disorder, a condition marked by intense highs (periods of mania) and potentially suicidal lows. Both addiction and drug abuse can be exacerbated by psychological stress. And the use of illicit drugs, including cocaine, can trigger symptoms of bipolar disorder, a.k.a. manic depression.
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Sheen says he is now drug-free. Can drug withdrawal itself trigger behavior of the sort Sheen has exhibited in recent weeks?
Drug addiction and withdrawal invariably have both physical and psychological components. It's possible for the stress associated with rehab to result in odd, defiant behavior of the sort Sheen has exhibited in recent weeks - the way he has gone after former colleagues, his Twitter blitz, and the grandiose statements about his physiology. And any stress that Sheen is feeling from detox may be compounded by his professional and financial worries and the struggle over the custody of his children.
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What can be inferred from Sheen's unusual and often troubled relationships with women?
Like many male celebrities, Sheen has a history of exotic sexual appetites. Fame is an aphrodisiac for the celebrity and potential partners. Both mania and cocaine abuse are known to cause hypersexuality. And some people use sex as a way to "self-medicate" away painful emotions. Capri Anderson (shown at left) is one of several "porn stars" linked to Sheen.
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What effect does being famous have on someone who is battling addiction or other physical or emotional probems?
Being a major celebrity can work against getting effective treatment for problems of the sort Sheen seems to be grappling with. Wealth and power can impair the judgment of the celebrity and his/her associates and blind everyone to what's really going on. It's not always easy to have a good sense of reality when one is used to hearing "yes" from the people around you.
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Is it possible to be a good parent when grappling with emotional or psychiatric problems?
It's certainly possible, but only with lots of help. Then again, it depends on how you define "good parent." Having psychological or substance abuse problems can interfere with the judgment needed to make good parenting decisions. And witnessing a parent going through such difficulties can be psychologically scarring to children.
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Sheen has said that he is undergoing rehab at home. Is that an appropriate treatment for addiction?
At-home detox is generally a bad idea. At home, the addict may lack medical supervision and the help it takes to cope with the emotional and physical difficulties substances abusers typically experience as they detox. Another problem with at-home detox is that the environmental cues - the people and situations that fueled the addiction - may still be present.
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What can family members do to help someone who is going through such a rough period?
Substance abuse and psychological problems can often be traced, in part, to relationships within the family. For that reason it's often best to bring the family together with the troubled person for regular family therapy sessions. Of course, this depends on how well the troubled person gets along with people in his/her family. Educating family members about the nature of the problem and the way to treat it can speed recovery and help prevent relapses.
It's been said that Sheen's off-camera life did not interfere with his TV work. Is it really possible to have a substance abuse problem and still work effectively?
Absolutely, at least for a while. So-called "functional" drug users are able to keep up with the demands of work - even working on-camera. And if someone is very valuable to his/her employer, co-workers may be likely to overlook the "dysfunctional" moments.
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If someone fails to get help for severe psychiatric problems, can the state intervene at some point?
That varies from state to state. In California, the person must be deemed by a judge to represent a danger to himself or others or to be "gravely disabled." At this point, the person may be involuntary committed for a 72-hour "hold" for observation - and possibly to a 14-day period of treatment.