When it comes to those far removed from our personal observation and interaction we cannot know for sure what's 'real' vs. 'unreal'. That's why 'hearsay' (second-hand) evidence is ordinarily deemed unreliable proof and excluded from consideration in legal proceedings.

My own experience is that long-term buildup of unrelieved stress triggers emotional 'blowouts' that 'folks with goatees in cherry-paneled offices' now typically refer to as 'bi-polar disorder'. I've endured phases of excessive hyperactivity, extended sleeplessness, desires to wander, cyclically occurring over the years. I've kept track of their progression and the pattern is the same each time, ultimately culminating in a 'touchdown' (crash) followed by a rebuilding period.

Based on what's been chronicled about drug and lifestyle challenges faced by so many creative types in all fields of work, my view is that the exercise of intense creativity requires a drawdown of specific brain chemicals likely resulting in imbalances, which take weeks to replenish. Efforts by victims to 'self-medicate' (e.g., coffee, sugared drinks and assortment of over-the-counter drugs and herbal preparations) exacerbate the symptoms because the body counteracts them while in the throes of the high end (manic) phase. I'm confident that medical research will confirm all this, eventually.

In the final analysis, whether what we've been witnessing with Britney is the 'normal' effect of life's stresses or an 'abnormal' over-reaction is, in my mind, a matter of degree. For us 'ordinary' folks, the best thing is to learn from Britney's experience and try to avoid negative outcomes.