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Charlie Sheen Substance Abuse: FAQ

Experts Weigh in on Common Questions About Addiction and Outrageous Behavior
By
WebMD Health News
Reviewed by Laura J. Martin, MD

March 1, 2011 -- After actor Charlie Sheen trashed his suite at New York's Plaza Hotel, called Chuck Lorre, the creator of the TV show "Two and a Half Men," a "turd," and rambled incoherently in a television interview about being a "high priest Vatican assassin warlock," people started to wonder whether the TV star had come completely unhinged.

Sheen has admitted to a history of drug use, but is his erratic behavior a sign that he's still addicted and in denial, or that he's also dealing with a mental illness? Sheen certainly isn't the first celebrity to deal with drug addiction. If it turns out, as some experts have speculated, that he's also got a mental illness, he similarly wouldn't be alone in having both conditions.

WebMD asked addiction experts about the connection between mental illness and substance abuse. What's the link? What can happen when someone who is addicted refuses to get treatment? And what are the best ways to overcome an addiction?

What's the Connection Between Addictions and Psychiatric Disorders?

Addiction and mental illness often go hand in hand. Up to half of people with depression, bipolar disorder, or another mental illness also have a substance abuse problem.

Experts say having one of these conditions increases your vulnerability for the other. "If you have a lifetime addiction and have taken drugs over a long period of time it can affect your psychiatric functioning," says Bruce Goldman, LCSW, CASAC, program director of the Project Outreach Clinic in West Hempstead, N.Y.

Conversely, people with mental illness often use drugs and alcohol as a way to cope. "People will self-medicate, and that may be a risk factor for starting an addiction," says Elizabeth Howell, MD, a board-certified addiction psychiatrist at the University of Utah Neuropsychiatric Institute.

The addictive substance itself can cause symptoms that mimic mental illness. Being high or going through withdrawal from drugs can make you feel anxious, angry, or restless, which are also common signs of psychiatric conditions, Goldman says.

Why Are Addictions So Hard to Overcome?

The reason why drugs like cocaine and heroin are so quick to lead to addiction is the effect they have on the brain. When you smoke cocaine, for example, you get increased levels of dopamine and serotonin-- brain chemicals that give you feelings of pleasure.

Then suddenly, that good feeling is gone.

"You're on this roller coaster where you feel this extreme dopamine spike and then you have a crash and you want more," Howell says.

Having an untreated mental illness can make an addiction even harder to shake. So can having a lifestyle that makes drugs easily accessible, which is why so many celebrities, like Sheen, are always making headlines.

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