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Demi Levato performs on stage in concert at the o2 in east London, Monday, June 25, 2018. Image Credit: AP

Before she’d reached double digits, Demi Lovato had a vision of her future. She had made her TV debut at six in the US children’s show Barney and Friends and idolised Shirley Temple and Amy Winehouse. But by the age of 13, she was already jaded. Signed by Disney three years earlier, she had been cast alongside teen heartthrob Joe Jonas in Camp Rock, the singalong follow-up to the phenomenally successful film High School Musical. Lovato was about to appear on the TV screens of nine million US households.

But, even as she was making it, Lovato worried she was following in the footsteps of troubled Disney stars Britney Spears and Lindsay Lohan. “[During filming I thought], ‘Oh crap. In three years, that’s going to be me,’” she said in a 2016 interview. A year later, she said she regretted her childhood career: “I wouldn’t start that young if I could do it over again.”

Lovato is now 25. Last week, it was reported that the star had been rushed to hospital after an alleged opioid overdose. A month earlier, the singer’s single, Sober, which features the lyrics “Momma, I’m so sorry I’m not sober anymore”, confirmed that she had ended a six-year stint of abstinence from alcohol and cocaine, substances she’d been consuming since her teens.

In recent years, Lovato has been praised for being a very modern star. She has won fans with a brazen honesty about her addiction, as well as her struggles with bulimia, self-harm and bipolar disorder. But Lovato’s reported relapse has thrown yet another spotlight on the teen star machine and the pressures placed on those thrust into Hollywood’s spotlight so young.

Los Angeles is filled with tales of child actors who have battled crises while making the transition to adulthood, and the graduates of the Disney Channel are among the most prominent. Spears, who was a regular on the star-making TV show The Mickey Mouse Club, suffered a brutally public breakdown in 2007 that saw her shave her head and fend off photographers with an umbrella. Miley Cyrus, formerly the perky teen heroine Hannah Montana, underwent a controversial, highly sexualised image change in 2013. Once-frequent Disney film star Lindsay Lohan has had numerous legal troubles, including arrests for drunken and reckless driving, while a host of graduates, less-well known in Europe but stars in their home country, have found their troubled lives splashed across the tabloids.

And while, there are boys among them, the fact that the most prominent are women speaks volumes about the particular pressures foisted upon young female stars.

Could Hollywood do more to prevent the burn-out of these girls? Alison Roy, a child and adolescent psychotherapist, thinks so. “Some questions need to be asked about the roles of these [executives] who are maybe just paying lip service to psychological support. Are they able to say that a child isn’t well enough, or well-supported enough, to perform? Are their individual needs ever assessed?”

Lovato’s troubles started before her career did. She was raised in a house blighted with eating disorders (as suffered by her professional cheerleader mother) and alcoholism (her father, a musician), and was bullied so brutally by her classmates that she resorted to home-schooling.

But in pursuing her dreams, Lovato encountered an industry that made her life less normal. Her acting career sat alongside a musical one via a complex web of music lessons and auditions: in becoming part of the Disney family, Lovato also signed a contract with Hollywood Records. Her musical talent was integral to her big break in Camp Rock, appearing as Jonas’s girl-next-door love interest.

“All of a sudden she had to be this role model, and I don’t think she was ready for that,” said Phil McIntyre, Lovato’s manager, in Simply Complicated, a warts-and-all documentary co-produced by Lovato. “She was living two lives. Here she was, squeaky clean on the Disney Channel... and just intense [scrutiny] around behaviour. Once the camera stops rolling, she’s living another life. She couldn’t be a normal teenager.”

Lovato would later be diagnosed with bipolar disorder, and suffered from unstable mental health throughout her early teens. She first used drugs at 17, while starring in her own show, Sonny With a Chance.

It’s this dichotomy — the need to project perfection while weathering the storms of adolescence — that is at the heart of the pressure heaped on these teen idols, especially the girls, who have to conform to a particularly narrow concept of the way they should look. “From the time I was 11, it was, ‘You’re a pop star! That means you have to be blonde, and you have to have long hair, and you have to put on some glittery tight thing,’” a 22-year-old Cyrus told Marie Claire about starring in Hannah Montana. “Meanwhile, I’m this fragile little girl playing a 16-year-old in a wig and a ton of make-up. It was like Toddlers & Tiaras.”

The confusion is compounded by the fact that while studios want these young stars to be glamorous, they also want to keep them sexually neutral. Joe Jonas, the middle of the three musical Jonas Brothers who became international stars after appearing on Hannah Montana, recalled the furore caused when nude photos of High School Musical lead Vanessa Hudgens appeared online. “We’d hear execs talking about it, and they would tell us that they were so proud of us for not making the same mistakes, which made us feel like we couldn’t ever mess up,” he wrote in 2013. “We put incredible pressure on ourselves, the kind of pressure that no teenager should be under.”

“It’s a big shock when you have someone presented as a lovely Disney character,” explains Roy. “All those darker feelings go underground.”

Then there’s the sheer physical exertions of the hours these teenagers are expected to work. In 2016, Lovato claimed “we were shooting shows and really overworking”. A 2011 study in the journal Child Development found that teenagers who work more than 20 hours a week are more likely to use drugs and alcohol.

When it comes to the issue of child stars, increasing scrutiny is paid to the studios and their duty of care. But while Disney recognises the demands on its teenage stars, it has always maintained that a child’s welfare should be managed by other people. In 2012, Gary Marsh, president of Disney Channels Worldwide, told The Hollywood Reporter: “People know that we don’t control who these individuals are, and we don’t try to. It’s the parents’ job to do that.”

Psychologist John Oates disagrees. “Let’s not blame parents,” he says. “Many parents are under-prepared for the challenges that face them. It takes a lot of knowledge of the industry, and child psychology, to know best how to mitigate what the risks are and how to deal with them.”

Disney has introduced new measures to make things easier. Since 2014, parents and children have been encouraged to go to monthly “life skills” classes, which focus on emotional and physical wellbeing. There’s also the half-day Talent 101 course that tells fledgling stars how to deal with aspects of contemporary fame, such as social media.

Somehow, though, it still doesn’t seem enough: how can a monthly check-in compete against the rapid and surreal changes that take place when a child is put in the spotlight?

At the time of writing, Lovato is recovering with her family, with the messages of support flooding in on social media. But while her honesty is to be commended, we mustn’t forget that the demons she so confronts have been harboured in an industry that routinely produces damaged young women. Until something changes, teenagers will continue to struggle within the confines of Hollywood’s warped reality.