Depression, exhaustion, substance abuse -- what's going on?
Celebrities struggle with burnout
From Jodi Ross
(CNN) -- Mariah Carey spends two weeks in the hospital for extreme exhaustion. Ben Affleck and the Backstreet Boys' A.J. McLean go into rehab for alcoholism treatment. Rosie O'Donnell says she's suffering from depression; McLean says he is, too. And other celebrities, from Robert Downey Jr. to "West Wing" creator Aaron Sorkin, admit to -- and struggle with -- substance abuse.
It seems like there's an epidemic spreading through Hollywood.
Yet being a celebrity -- whether actor, director, or musician -- seems no different from what it's always been. From the outside, it seems like a perfect life, complete with fortune, fame, a penthouse in town and a mansion in the hills. But Dr. Norman Sussman, a clinical professor of psychiatry at the New York University School of Medicine, says there can be problems with being in the public eye.
"There's a lot of stuff that goes on with being a celebrity that can make you burn out. A lot of that has to do with drugs and alcohol," he says. "Also, it's a very insecure business. You can be very successful and have one flop of a movie or one flop of a record and you don't have a career anymore. I think a lot of people are very aware of that."
Inside and outside
Additionally, for many a celebrity, the performance persona is just that -- a persona. Inside, he or she may be insecure, introverted or reserved.
Denise McLean, mother of Backstreet Boy A.J. McLean, says she thinks of her son as "Alex," his actual name. "A.J.," she says, is someone else.
"A.J. is the bad boy, crazy boy on stage that ... makes all those pelvic thrusts and does all this stuff to drive the girls crazy," she tells ABC's "20/20" in an interview scheduled to be broadcast Friday. "A.J. is the one that got the tattoos, and A.J.'s the one that colors his hair for the audience ... and the media and does the shock stuff.
"Alex," she continues, "is ... the complete opposite of that. ... He's kind, he's got a heart of gold, he loves his family, he loves his puppies to death."
McLean's rehab impelled the Backstreet Boys to postpone several tour dates. Similarly, Carey's trip to the hospital prompted 20th Century Fox to push back the release date of her new movie, "Glitter," by a month -- to late September.
Anthony Esposito, a producer on another upcoming Carey movie, "Wisegirls," observes that the star worked hard on his film. Still, he says she was always professional and he questions reports of a breakdown.
"She's a total worker and ... I just think that as far as that, I don't even see the reality of everybody's talking about breakdowns and all that," he says. "To me, that's not the reality. I just think that you've got a lady that's a bit tired."
Still, Carey's behavior in recent weeks raised eyebrows. She left a confused, plaintive message on her Web site, saying "I just can't trust anybody anymore right now because I don't understand what's going on." She did a surprise striptease on MTV's "Total Request Live," shocking host Carson Daly and audience members, and then rambled during an appearance at a Long Island, New York, shopping mall, prompting an assistant to take her microphone away.
Sussman believes Carey was more than tired. "To be admitted to a hospital and for it to be said that it's exhaustion -- that's usually a code word for something else," he says. "Certainly, in my experience, I can never remember anyone having been admitted for exhaustion."
At the very least, however -- according to statements by Carey's mother and associates -- the singer was running herself ragged, with daily flights from coast to coast to work just after completing a two-week European promotional tour.
'Coffee only works so long'
It's the flip side to what appears to be an exciting life, and it's not easy to maintain, says Buddy Arnold, a saxophonist and former junkie who founded the Musicians' Assistance Program (MAP), which offers treatment for addiction to anyone in the music business.
"Staying up without artificial aid, without sleep is difficult. Coffee only works so long," he says.
However, he says, more musicians are recognizing their problems and seeking help.
"There is not this stigma attached to it that there was for so many years. The times have changed and it's OK to say, 'I'm in trouble. I need help.' "
Moreover, despite the fickleness of show business, fans are generally supportive -- especially if a celebrity admits having a problem. Carey has received thousands of sympathetic notes at her Web site; McLean's fans appear to be firmly behind him and the band.
Celebrity or no, most people can relate, says Arnold.
"Problems are problems. Everybody has 'em," he says. "It just so happens ours are diagnosed under a microscope a little more than the norm."
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