Actor Charlie Sheen last night took to his online program, "Sheen's Korner," to lament his recent firing from "Two and a Half Men" and blast his former bosses. Sheen has dismissed widespread suspicion that addiction or mental illness might be fueling his antics, claiming earlier to be on the drug "called Charlie Sheen" and not bi-polar but "bi-winning."
But his increasingly erratic behavior, which cost him his job Monday on the hit CBS comedy, has many health professionals concerned about his well-being even as skeptics say it's all for show.
"When addicts are high on drugs, or a manic person is high due to the biochemical changes in his brain, they reject help because they truly believe that they are 'winners' who know better than everyone else what is best for them," said Dr. Carole Lieberman, a psychiatrist at the University of California, Los Angeles.
But the job loss and the removal of his 2-year-old twins, Max and Bob, from his home last week might signal the end of Sheen's "winning" streak.
Eric Braun, a friend of Sheen's, told GQ magazine "there are just three options" left for the fired actor: "rehab, jail or death."
Mental health experts agree.
"Frankly, we really don't know what leads one person to a specific end," said Dr. Eric Caine, chair of psychiatry at the University of Rochester Medical Center. "No doubt, this man is a mess and his 'destiny' may not be a happy one."
While Sheen's conduct in media interviews and in his online show has shocked viewers, psychiatrists say they've seen it all before.
"There is nothing so unusual about what we are seeing -- for those of us in the mental health field -- just that we are seeing it so publicly," Caine said.
Sheen's long track record of offenses -- from drugs and violence to rumors of trouble on set -- might have hinted at mental health problems in the past. Yet he has consistently avoided major repercussions that could have "tempered his grandiosity," according to Alesandra Rain, co-founder of Point of Return, a nonprofit organization in Westlake Village, Calif., that helps people escape pill addiction.
"Now the consequences are beginning to hit him, but he is still working from the perspective that he is untouchable," Rain said. "His media blitz is being misinterpreted as public support and he is not in the frame of mind to realize the damage he is doing."
To repair the damage to his health, his career and his relationships, Sheen will need a dedicated network of support; one that will likely include many of the people he has publicly offended.
"This may require ex-spouses, family members, friends and colleagues who don't always work together or even get along, to present a uniformed front and work together," said Joshua Klapow, a clinical psychologist at the University of Alabama, Birmingham School of Public Health.
Having everyone on board is critical, Klapow said.
"This is a huge undertaking in a situation like Charlie's," he added. "He has huge social networks."
The long-term effects of what might be a public decline for Sheen are uncertain.
"The world can be very forgiving, especially if his behaviors are viewed by others as victimless," Caine said. "Having a powerful negative impact on the people around him would tip the balance. Short of that, many are allowed to recover from being fools or buffoons."