September 25, 2025

Case Study: Sean “Diddy” Combs – Potential Mental Health Disorders and Their Contribution to Criminal Behavior

This plan, grounded in trauma recovery, aims for holistic rehabilitation, reducing societal risk while promoting personal growth. Success metrics include sobriety milestones, therapy compliance, and weekly, monthly, quarterly and annual behavioral assessments by licensed medical professionals.

Introduction

Sean “Diddy” Combs, a prominent figure in the music industry, has faced significant legal scrutiny in recent years, culminating in a federal trial. As of September 2025, Combs was convicted on two counts related to transportation for prostitution under the Mann Act but acquitted on more severe charges of sex trafficking and racketeering. His sentencing is scheduled for October 3, 2025, with his legal team advocating for a sentence of no more than 14 months, citing time already served in pretrial detention. 

This case study examines the probability of Combs exhibiting multiple personality disorders, mood disorders, traumatic disorders, substance use disorders, and deviant sexual, emotional, or mental disorders, based on publicly available information from his background, allegations, and trial details. It assesses how these may have contributed to his criminal behavior. 

Probabilities are estimated qualitatively (low, moderate, high) drawing from psychological analyses, expert commentary, and reported behaviors, as no formal public diagnosis exists. The study concludes with a recommended treatment intervention emphasizing trauma recovery.

Note: This analysis is speculative and not a clinical diagnosis. It relies on media reports, court documents, and psychological perspectives, as direct access to Combs’ medical records is unavailable.

Background and Contextual Factors

Combs was born in 1969 in Harlem, New York, and raised in Mount Vernon after his father, Melvin Combs, was killed in a drug-related shooting when Sean was just three years old. This early paternal loss in a violent context is a classic risk factor for developmental trauma. Childhood friends have described a stark contrast between the “Sean Combs” they knew growing up and the “Diddy” persona that emerged in his rise to fame, suggesting a possible compartmentalization of identity influenced by early adversity. 

His career trajectory involved building an empire through Bad Boy Records, but it has been marred by allegations of abuse dating back decades, including physical violence, sexual assault, and coercive control. Recent lawsuits and the federal indictment highlight patterns of manipulation, including “freak offs” – alleged drug-fueled sexual encounters involving coercion and abuse. Combs’ party lifestyle, involving heavy substance use, has been well-documented, further complicating his mental health profile.

Assessment of Potential Disorders

1. Traumatic Disorders (e.g., PTSD or Complex PTSD)

• Probability: High. Early childhood trauma from his father’s murder likely laid the foundation for unresolved grief and hypervigilance. Psychological analyses suggest that such losses can manifest in control-seeking behaviors as a defense mechanism. Allegations of abusive patterns, including emotional and physical dominance over partners like Cassie Ventura, may stem from unprocessed trauma, leading to reenactment cycles where power dynamics recreate feelings of vulnerability. Expert commentary on survivors of his alleged actions notes triggers like PTSD in victims, implying a mirrored dynamic in the perpetrator. Public discussions on X also link his behavior to potential PTSD, exacerbated by fame’s pressures.

• Contribution to Criminal Behavior: Trauma could fuel impulsive aggression and a need for dominance, contributing to coercive acts in “freak offs” as a maladaptive coping strategy.

2. Mood Disorders (e.g., Bipolar Disorder)

• Probability: Moderate to High. During his trial, Combs’ legal team referenced a bipolar diagnosis, suggesting it could link to alleged assaults and impaired judgment. Prosecutors pushed back against claims of diminished mental capacity, but defense arguments highlighted substance-influenced mood swings. Bipolar disorder involves manic episodes that might align with his high-energy lifestyle, risk-taking, and reported grandiosity. Psychological perspectives on his “Love” era describe him as a “demon” with abusive tendencies, potentially during manic phases.

• Contribution to Criminal Behavior: Manic states could exacerbate poor impulse control, leading to exploitative decisions like organizing coercive events or using threats to maintain power.

3. Multiple Personality Disorders (e.g., Dissociative Identity Disorder – DID)

• Probability: Low. There is scant evidence for DID, which typically arises from severe, repeated childhood trauma. While Combs’ early loss qualifies as traumatic, no reports indicate the extreme dissociation characteristic of DID. Some X discussions speculate on personality splits in high-profile figures, but this seems unrelated to Combs specifically. Childhood friends note a shift from “Sean” to “Diddy,” but this appears more like persona adoption for fame than clinical dissociation.

• Contribution to Criminal Behavior: Minimal; any compartmentalization might allow denial of actions but is unlikely a primary driver.

4. Substance Use Disorders

• Probability: High. Combs’ lifestyle involved prolific use of alcohol, opiates, benzodiazepines, MDMA, and other substances, as detailed in court documents. Allegations describe supplying drugs to victims during “freak offs,” with participants requiring IV fluids for recovery. His pretrial detention likely induced severe withdrawal, including hallucinations and physical distress, underscoring addiction severity. Expert analyses link his substance use to self-medication for underlying issues like depression or trauma.

• Contribution to Criminal Behavior: Substances lowered inhibitions, facilitated coercion, and enabled abusive environments, directly tying to his convictions.

5. Deviant Sexual, Emotional, or Mental Disorders (e.g., Paraphilic Disorders, Narcissistic Personality Disorder)

• Probability: Moderate. Allegations portray coercive sexual acts, possibly indicating sex addiction or paraphilias involving power imbalances. Psychological breakdowns suggest narcissistic traits, with delusions of grandeur and manipulative control. Emotional disorders like antisocial tendencies may manifest in verbal abuse and exploitation, as victims reported threats to careers and safety. Trauma experts note that perpetrators often have their own unresolved emotional wounds, leading to deviant patterns.

• Contribution to Criminal Behavior: These could drive the organization of exploitative events, using sex as a tool for dominance and emotional manipulation.

Overall Contribution to Criminal Conviction

The interplay of these disorders likely created a perfect storm: Unresolved trauma as the root, amplified by substance use and mood instability, leading to deviant behaviors. High-probability factors like trauma and addiction may have desensitized Combs to harm, while moderate ones like mood and personality issues fueled entitlement. His convictions on prostitution charges stem from patterns of coercion and transport, potentially exacerbated by impaired judgment from these conditions. Without intervention, such cycles perpetuate, as seen in repeated allegations since the 1990s.

Recommended Intervention: Treatment Plan with Focus on Trauma Recovery

To address these issues and reduce recidivism risk, a comprehensive, trauma-informed rehabilitation plan is recommended post-sentencing. This integrates punitive time served with rehabilitative measures, emphasizing trauma recovery through evidence-based therapies like EMDR (Eye Movement Desensitization and Reprocessing) and trauma-focused CBT (Cognitive Behavioral Therapy). The plan prioritizes healing from early losses and abuse cycles, fostering empathy, accountability, and healthy relational skills.

1. Residential Treatment (Minimum 6 Months): Upon release or as part of sentencing, Combs should fulfill additional time in a secure residential facility specializing in dual-diagnosis (mental health and substance use). Focus: Detox, trauma processing (e.g., addressing paternal loss), mood stabilization via medication (if bipolar confirmed), and group therapy for personality insights. Daily sessions on emotional regulation and deviant behavior roots, with trauma recovery as the core to prevent reenactment.

2. Intensive Outpatient Program (IOP) – Phased Step-Down (6 Months Total). 

After successful residential discharge, return home with mandatory IOP:

- 5 days/week for 3 months: Intensive group and individual sessions on trauma triggers, substance relapse prevention, and rebuilding emotional health.

- 4 days/week for 2 months: Continued trauma-focused work, incorporating mindfulness for mood swings.

- 3 days/week for 1 month: Transition to maintenance, emphasizing integration of lessons into daily life.

- Sex Offender Rehabilitation Program: Post-IOP discharge, enroll in a specialized program for deviant sexual behaviors. This includes risk assessment, cognitive restructuring to address coercive patterns, and victim empathy training, all trauma-informed to link behaviors to underlying wounds.

3. Individual Therapy (Minimum 3 Hours/Week, Ongoing): Upon successful completion of the sex offender program, attend weekly individual sessions focusing on implementing tantric romantic relationships – a holistic approach emphasizing consent, emotional intimacy, and mindful connection. Integrate trauma recovery elements, such as somatic experiencing to process bodily-held trauma, ensuring healthy sexuality replaces deviant patterns. Monitor for mood and substance issues indefinitely.

This plan, grounded in trauma recovery, aims for holistic rehabilitation, reducing societal risk while promoting personal growth. Success metrics include sobriety milestones, therapy compliance, and weekly, monthly, quarterly and annual behavioral assessments by licensed medical professionals.