Charlie Sheen’s latest rant: Dr. Drew says “he’s manic”

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Charlie Sheen had a lot to say this week. Most of it rather inflammatory. So much so that CBS has canceled the remainder of the season for his show Two and a Half Men. After several tries at  in-patient rehab, followed by “at-home” rehab, Sheen has been calling into radio shows, ranting about a wide range a topics, from Two and a Half Men creator Chuck Lorre  , Alcoholics Anonymous, and even saying that he has cured himself:

I have cleansed myself. I closed my eyes and in a nanosecond, I cured myself… It’s the work of sissies. The only thing I’m addicted to is winning. This bootleg cult, arrogantly referred to as Alcoholics Anonymous, reports a 5 percent success rate. My success rate is 100 percent. Do the math … another one of their mottoes is ‘Don’t be special, be one of us.’ Newsflash: I am special, and I will never be one of you! I have a disease? Bulls**t! I cured it with my brain, with my mind. I cured it, I’m done … you don’t look like you’re having a lot of fun. I’m gonna hang out with these two smoking hotties and fly privately around the world. It might be lonely up here but I sure like the view, Alex!

Addiction specialist and host of Celebrity Rehab, Dr. Drew Pinsky has commented to both TMZ and HollywoodLife.com that he believes that Sheen is exhibiting signs of mania:

Although we will not diagnose Mr. Sheen as we have not examined him personally, we can talk about mania in general, and what the symptoms of mania are.

Mania should be looked at as part of the spectrum within bipolar disorders. People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.

Symptoms of bipolar disorder are described below.

Symptoms of mania or a manic episode include: Symptoms of depression or a depressive episode include:
Mood Changes

  • A long period of feeling “high,” or an overly happy or outgoing mood
  • Extremely irritable mood, agitation, feeling “jumpy” or “wired.”

Behavioral Changes

  • Talking very fast, jumping from one idea to another, having racing thoughts
  • Being easily distracted
  • Increasing goal-directed activities, such as taking on new projects
  • Being restless
  • Sleeping little
  • Having an unrealistic belief in one’s abilities
  • Behaving impulsively and taking part in a lot of pleasurable,
    high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.
Mood Changes

  • A long period of feeling worried or empty
  • Loss of interest in activities once enjoyed, including sex.

Behavioral Changes

  • Feeling tired or “slowed down”
  • Having problems concentrating, remembering, and making decisions
  • Being restless or irritable
  • Changing eating, sleeping, or other habits
  • Thinking of death or suicide, or attempting suicid

In addition to mania and depression, bipolar disorder can cause a range of moods, as shown on the scale.

One side of the scale includes severe depression, moderate depression, and mild low mood. Moderate depression may cause less extreme symptoms, and mild low mood is called dysthymia when it is chronic or long-term. In the middle of the scale is normal or balanced mood.

At the other end of the scale are hypomania and severe mania. Some people with bipolar disorder experience hypomania. During hypomanic episodes, a person may have increased energy and activity levels that are not as severe as typical mania, or he or she may have episodes that last less than a week and do not require emergency care. A person having a hypomanic episode may feel very good, be highly productive, and function well. This person may not feel that anything is wrong even as family and friends recognize the mood swings as possible bipolar disorder. Without proper treatment, however, people with hypomania may develop severe mania or depression.

During a mixed state, symptoms often include agitation, trouble sleeping, major changes in appetite, and suicidal thinking. People in a mixed state may feel very sad or hopeless while feeling extremely energized.

Sometimes, a person with severe episodes of mania or depression has psychotic symptoms too, such as hallucinations or delusions. The psychotic symptoms tend to reflect the person’s extreme mood. For example, psychotic symptoms for a person having a manic episode may include believing he or she is famous, has a lot of money, or has special powers. In the same way, a person having a depressive episode may believe he or she is ruined and penniless, or has committed a crime. As a result, people with bipolar disorder who have psychotic symptoms are sometimes wrongly diagnosed as having schizophrenia, another severe mental illness that is linked with hallucinations and delusions.

People with bipolar disorder may also have behavioral problems. They may abuse alcohol or substances, have relationship problems, or perform poorly in school or at work. At first, it’s not easy to recognize these problems as signs of a major mental illness.

For more information about bipolar disorders and their treatment, click here to go to the Resounding Health Casebook on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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