It's generally agreed that, tiger blood or not, Charlie Sheen is not well. Still, after days of Sheen's outrageous and revealing interviews on television and radio, the psychiatrists and other mental health experts who've been asked to hazard a diagnosis (without having treated Sheen in person) have not reached a consensus. Here are five theories on what's plaguing Sheen:
1. Extreme narcissism
When Sheen says things like "I'm going to start thinking of me," says psychologist Stewart Beasley, to Oklahoma City's KFOR TV, that's a classic sign of narcissism. In fact, "he's been thinking about 'me' for a long time," perhaps "since the day he was born." Indeed, "he exhibits a great many features of pathological narcissism," says Joseph Burgo, PhD, at After Psychotherapy. And this level of "grandiose narcissism" is usually a defense mechanism to ward off crippling, "unbearable shame."
2. Biploar "acute manic state"
Sheen's "delusions," unrestrained speaking, and almost involuntary "hypersexual" activity all point to "the 'high' phase of bipolar disorder," says Dr. Keith Ablow at Fox News. "The degree of mania for Sheen is almost a caricature," agrees Dr. Deborah Serani, in The Denver Post, "because it's such an extreme case of bipolar disorder." That also explains why Sheen doesn't see his behavior as a problem, she says. "Mania feels good." But this is an "acute psychiatric emergency," says Dr. Drew Pinsky, as quoted by CelebrityDiagnosis.com. "Bipolar patients who are manic are more likely to kill themselves or hurt themselves than when they're depressed. So this is somebody who should be in a hospital."
3. Drug withdrawal
"Everyone's approaching [Sheen] as though he's on drugs," says Dr. Alex DeLuca, to TIME. But he passed drug tests, and "you can't blame the drug if he doesn't have it in him." The first weeks or months of detox are often filled with serious mood swings, and that just make diagnosis harder. Sheen "looks like somebody unraveling due to heavy addiction," says Arthur Schut, deputy director of a Colorado drug treatment center. Still, his on-air meltdown could serve as a cautionary tale for teens, says Pax Prentiss, founder of a California drug treatment center. "This is what drugs and alcohol can do to you. Look at him. He's a mess."
4. Deep denial
Drug addiction is a serious problem for Sheen, but his denial of the problem is what makes him unable to distinguish between "fact and fantasy," says addiction expert Dr. Jeffery Huttman, to Babble. That explains why Sheen has been making such outrageous statements, all of which he appears to truly believe. A "state of denial" as severe as Sheen's can grow to the point where even "basic self-care or handling daily life situations" become impossible.
5. Hedonism... and it's not a psychological disorder
Sheen's "recklessly self-indulgent behavior" is disgraceful, says Brendan O'Neill in The Telegraph, but the "most shocking" thing about this train wreck is "the unstoppable march of a zombie-eyed army of therapists who want to diagnose Sheen from a distance as 'mentally ill.'" In a way, "Charlie Sheen is my hero," because he's refused to "genuflect before the Oprahite altar of psychobabble."