Patient in the Spotlight

In the days since troubled pop star Britney Spears was briefly hospitalized, speculation over her mental state has exploded. Pundits have publicly probed her health. One TV host, Dr. Drew Pinsky, whose show about celebrity rehab is debuting this week on VH1, took a grave view, opining on CNN's "Larry King Live," "I have been saying for many months that her life is in grave, grave danger, and the recent hospitalization is really just symptoms of exactly that."

The grand master of TV psychology, Dr. Phil McGraw, even planned to dedicate an entire show to Spears's health, but at least he had met with her in the hospital on Saturday at the request of her family. But Dr. Phil quickly reversed course, releasing a statement on his Web site saying that he had canceled the episode "out of consideration for the family" and because he said Britney's situation was "too intense."

However, Dr. Phil did make at least one point worth repeating before he bowed out: "Clearly, it is not just Britney's family struggling to find a way to protect adult children who cannot be ordered or compelled to seek help." NEWSWEEK's Jenny Hontz spoke with Dr. Andrew Leuchter, a professor of psychiatry and biobehavioral sciences at the UCLA School of Medicine, about the Spears case and the less titillating issue of ordinary families who struggle with adult mental illness. Excerpts:

NEWSWEEK: Celebrity doctors and therapists have been speculating about Spears's mental state without having examined her. Isn't this problematic?
Dr. Andrew Leuchter: If one speculates about the presence of a mental disorder in the absence of a direct examination, number one, the chances of making errors in judgment are pretty high. And number two, it's really nothing I think most clinicians would be comfortable doing … Psychiatry, at the end of the day, is very much like the rest of medicine. Everything is based upon a careful examination. One would never presume to be able to make a medical diagnosis by looking at somebody on TV. And one should never presume to make a psychiatric diagnosis by looking at someone on TV, either.

Some of these commentators have suggested that Spears may have bipolar disorder. What exactly is it and what are the symptoms?
Bipolar disorder is a disorder where people not only have episodes of depression but also have episodes of mania or hypomania. Those are periods of elevated mood, where people report having increased energy, commonly a decreased need for sleep. Sometimes they can be quite agitated, and in more severe cases of mania one can even have psychotic symptoms—one does not necessarily know what is real and what is not. And people with bipolar disorder sometimes cycle between depression and episodes of mania or hypomania. And some people with bipolar have primarily depression with very rare episodes of mania.

What are the risks of bipolar disorder?
With any mood disorder, such as depression and bipolar disorder, the most common problem is that somebody doesn't function very well. When your mood is very, very down or very up, it's hard to get through day-to-day life. They would show poor judgment and sometimes might be harmful to themselves … There are higher rates of use of alcohol and drug abuse in general among people who have or depression or bipolar disorder.