I have been finding it difficult to watch reports on Charlie Sheen or listen to his sound bites. The reason being is that his current situation concerns me professionally and personally.

Professionally speaking, I can't help but see the clinical symptoms Sheen demonstrates and conclude that he's in a very fragile place. I never find it easy to witness a person in the depths of a crisis, and wrangle with it even more when help is available, but the road is not taken. From my armchair analysis, all I can do is hope that family and friends will step in before Sheen becomes a tragic headline.

The timeline for Sheen's troubled past has been public knowledge since he was a teenager. Early takes on his exploits were labeled as bad-boy Hollywood behavior, but over the course of time, have dangerously escalated. Drugs, alcohol and money-spending binges overlap with domestic violence, hospitalizations, rehabilitation stints and legal scuffles. Though Sheen reports he's beaten his demons in a "nanosecond" and has provided recent urine and blood tests to prove his sobriety, I don't think he's able to see the issue that appears to be front and center in his life: Bipolar Disorder.

Bipolar Disorder is not something that you can stop or cure in a nanosecond. Nor can we say that about addictions. I wish nothing more than for that to be true.  Bipolar Disorder, however, is a challening illness, usually one that requires lifelong regulation. According to the National Alliance on Mental Illness "Bipolar Disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person's life. While medication is one key element in successful treatment of Bipolar Disorder, psychotherapy, support, and education about the illness are also essential components of treatment."

What happens when manic states emerge in Bipolar Disorder is that they feel good - even great. You feel invincible. And because of this sublime experience, a person is unable to recognize or even desire intervention. This could explain why Mr. Sheen doesn't see his thoughts, feelings or behaviors as self-sabotaging. They feel so good and seem so right. But it's clear to the professional clinician - and even the casual observer - that with each passing day, there appears to be a worsening of his cognitive and emotional states.

Now as a psychologist, I know it's important not to oversimplify mental illness, especially when one glimpses it through mass media. Psychiatric illnesses are complex issues that involve neurobiology, as well as how family, peer, culture and society shape an individual. We need to be mindful that Mr. Sheen is a human being first, and should not be used as an object for mocking, moral outrage or stigma. We also need to realize that though we don't see his family or friends swooping in to perform an intervention doesn't mean they are sitting idly by. Knowing how to manage the care of a person in the grips of a manic episode is not easy. It is also important that mainstream media understand that the way it chooses to report about Charlie Sheen can do one of two things. It can unwittingly create a contagious trend of demeaning mental illness or it can educate and help others receive treatment. 

Personally speaking, Sheen's tailspin reminds me of my own experiences with a Mood Disorder. Unaware of what depression was or how to detect it, I descended into a Major Depressive Episode by the time I was in college. Hopeless and suicidal, I nearly took my life at age 19. Luckily, I had family support and swift medical attention to address my needs. I didn't have the public arena watching my every move, commenting on how crazy or wacko I was, or vying for ratings by broadcasting me at my worst moments. Furthermore, the despair and helplessness from my Unipolar depression was so overwhelming that I was eager to begin treatment to reduce my symptoms. A far different experience than the high-octane sensations mania may bring Mr. Sheen.

When you're in the depths of a Mood Disorder, you swirl in an ocean of mental, physical and spiritual chaos. It's only when you reach the safety of the shore that you realize just how dangerously ill you were. I know how hard it can be to accept the reality of having a serious illness, to acknowledge your own genetics and put in the time to learn skills to function better. I hope Mr. Sheen will find himself on Terra firma soon. 

Note: Dr. Deborah Serani is the author of the forthcoming book "Living with Depression: Why Biology and Biography Matter Along the Path to Hope and Healing" by Rowman and Littlefield Publishers. The information presented here is for educational purposes only and should not be used as psychotherapy.

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Theories of Charlie Sheen is a reply by Stanton Peele

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