The Charlie Sheen factor

I’ve stopped following the news about Charlie Sheen. There’s nothing redeeming about watching a celebrity (or anyone else, for that matter) self-destructing in slow motion.

And I’m not going to join the crowd of people dissecting What’s Wrong With Charlie. I don’t know the guy, don’t know anything about his life and couldn’t begin to draw any informed, clinical conclusions about the reason(s) for his behavior.

What’s more concerning is whether Sheen’s public meltdown will influence how we view addiction and mental health and the extent to which it might affect people’s willingness to seek help.

There’s an interesting article in the latest edition of American Medical News that explores this issue. AM News spoke to several psychiatrists and came up with a diversity of opinions. Some said it can be helpful for people to realize that even the rich and famous have their struggles. But others felt Sheen’s story has been milked primarily for the entertainment value and perhaps led the public to trivialize the seriousness of mental illness and substance abuse.

Such reports can be tremendously harmful to patients and doctors working to overcome the stigma of addiction, said Petros Levounis, MD, director of the Addiction Institute of New York and chief of addiction psychiatry at St. Luke’s-Roosevelt Hospital in New York City.

“Instead of most people getting the message that addiction is an illness like other medical illnesses that has a diagnosis and treatment, they see that this is something to make fun of – more like a social ailment rather than a medical illness,” he said.

Media coverage also can “highlight the scandalous or ridiculous” and thus reinforce the stigma of mental illness, he said.

Dr. Philip R. Muskin, a professor of clinical psychiatry at Columbia University Medical Center in New York City, said news stories about struggling celebrities don’t necessarily result in more people seeking help for mental illness or substance abuse, “largely because most people have a hard time relating to them.” In fact, it can encourage ordinary people to deny or make excuses for their own problems, he said.

“Celebrities get away with stuff that none of us could ever get away with,” said Dr. Muskin, chief of service in consultation-liaison psychiatry at Columbia and New York-Presbyterian Hospital. “I think the way it’s portrayed allows people to use it more for denial rather than moving forward.”

The ongoing news coverage of Sheen’s problems also has triggered a public discussion about Alcoholics Anonymous and the role of self-help and peer support in overcoming substance abuse. Sheen has criticized 12-step programs, claiming AA is a cult with a dismal success rate. To some extent he’s right, reports the Los Angeles Times. Many people who undergo treatment for addiction end up relapsing, sometimes several times, and there’s no single form of treatment that’s effective for everyone.

What AA can offer, however, is the support of sponsors who understand addiction because they’ve been through it themselves, the Times reported. It also can help restore the addict’s self-esteem, allowing him or her to reclaim membership in the human race.

I don’t envy Sheen. He has a lot of hard work ahead of him if he wants to repair the damage he’s wreaked on his life.

If there’s any good here at all, it may lie simply in getting the public to talk more openly about mental health and addiction and to recognize what a struggle they entail, regardless of who you are.

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