Amy Winehouse: Career Shadowed by Manic Depression

July 25, 2011— -- Singer Amy Winehouse, who died unexpectedly in her London home Saturday found many of her career success overshadowed by her drug and alcohol addiction.

While Winehouse publicly acknowledged her drug and alcohol abuse, some addiction experts said, like many addicts, Winehouse may not have grasped the severity of her addiction.

"I think she minimized the extext to which her life was impacted by drugs and alcohol," said Dr. David Sack, CEO of Promises Treatment Center in Los Angeles. "She was denying the extent to which it affected her."

In one of her hit songs, "Rehab," Winehouse sings that she will not go to rehab, even though her father encouraged her to go.

"It's not just my pride, it's just 'til these tears have dried," Winehouse sings.

Winehouse admitted in several interviews around the time of the album's release that she suffered from manic depression -- a disorder characterized by extreme -- and in some cases violent -- mood swings.

She also admitted she had an eating disorder and engaged in self-injury.

"I do drink a lot. I think it's symptomatic of my depression," Winehouse said in an interview on the British TV show, "The Album Chart Show." "I'm manic depressive, I'm not an alcoholic, which sounds like an alcoholic in denial."

The song "Rehab" cited a real plea by her friends and father to seek treatment, she said.

"I just felt, no. Do they have a gym there? Who's going to feed my cats?" Winehouse said. "Alcoholism is a horrible thing, but if you can't remember the practical issues, that's when you know you've got a real problem."

Winehouse enrolled in rehab a few times, but left early from each program.

Sack said the anticipation of physical withdrawal and the likelihood that the addict would lose his or her relationship with those that hinder their sobriety keep many from accepting treatment.

"Most who are drug dependent are afraid to seek treatment," Sack said. "Winehouse did better than many others by trying."

Winehouse's environment may have fostered her drug dependency, he said.

"Drugs get glamorized in the creative community," Sack said. "There's a lifestyle situation that creates an environment where it's acceptable."

For Winehouse, addiction was more than just a way to cope with her manic depression or a form of medicating herself from her problems, said Dessa Bergen-Cico, assistant professor of public health at Syracuse University.

"Her persona was inextricably linked to her substance abuse, everything from her name to her top single 'Rehab' reinforced her identity as an eccentric artist who drank heavily and used drugs," Bergen-Cico said.

In June 2011, Winehouse's drunken performance in Belgrade, Serbia, got her booed off stage by fans. Although Winehouse reportedly left rehab a few weeks before her performance, it became the latest indication that her condition impeded on her ability to perform.

Winehouse may not have been given enough time to recover from her addiction before being thrust back into the spotlight, according to Dr. Scott Basinger, associate professor of neuroscience at Baylor College of Medicine.

"Surely someone in her entourage had the power and the sense to stop this exploitation and give her the break she needed from being the 'checkbook' to finding herself and healing the demons that drove her to medicate so desperately," Basinger said.

In a tribute to Winehouse, actor and musician Russell Brand, who is a former addict and a friend of Winehouse, looked past whether the tragedy was preventable.

"Whether this tragedy was preventable or not is now irrelevant. It is not preventable today. We have lost a beautiful and talented woman to this disease. Not all addicts have Amy's incredible talent. Or Kurt's or Jimi's or Janis's, some people just get the affliction," wrote Brand on his website.

"All we can do is adapt the way we view this condition, not as a crime or a romantic affectation but as a disease that will kill. We need to review the way society treats addicts, not as criminals but as sick people in need of care," Brand wrote.

A statement from Winehouse's family said, "Our family has been left bereft by the loss of Amy, a wonderful daughter, sister, niece. She leaves a gaping hole in our lives."

Winehouse's father Mitch Winehouse publicly cited multiple family problems that he said may have spiraled her into depression and led Winehouse to self-medicate using drugs.

Mitch Winehouse told the British paper, the Daily Mail, that he had a public decade-long affair with his coworker that started when Winehouse was 2 years old.

"It was difficult," Mitch Winehouse told the Daily Mail in 2008.

Mitch Winehouse also said the death of Winehouse's grandmother in 2006, whom Winehouse credited for jumpstarting her career, may have pushed her even further into depression.

Besides the chemical addcition to drugs and alcohol, many addicts have previously suffered from a traumatic event or even a psychological disorder such as depression.

"People who struggle with other psych disorders like depression and anxiety also have an increased risk of the severe form of addiction," said Dr. Petros Levounis, the Director of the Addiction Institute of New York.

"There are many children of bad marriages that don't go into addiction," Sack said. "But it does raise the risk of the child to get involved in drugs and alcohol."

Winehouse had reconciled with her father since then, but that did not seem to help her to stay sober.

Mitch Winehouse, an aspiring singer himself, said he knew his daughter's career and the publicity surrounding her personal life helped his chances at a music career.

"It [the relationship between father and daughter] was complicated," said Ian Drew, senior music editor of US Weekly magazine. "She loved her father, but he also fed off of her."

"He couldn't rein her in as much as he loved her," Drew said.

Although family members are primary motivators for addicts to seek treatment, the ultimate decision to follow through lies with an addict, Sack said.

While Winehouse was not seeking formal treatment, she was looking to continue her career. Winehouse was reportedly working on another album.

"It is clear that she was hopeful she'd be well enough to make another album," said Sack. "She was looking to do better."

"She wanted more than she was getting in her life," said Sack.