Getting paid for live performance was the traditional way for musicians to earn money for centuries. Record sales was a temporary thing that is now gone.
At the high end, live performance pays more than it ever has, since the exclusivity is what people are paying for. At the low end, the performers get squeezed because they are competing with lots of amateur DJs or people simply doing without a human.
They have to dedicate a decade or more of their life at a prime age to the character - selling their soul if you will. And not going nuts in the process. Fame and extreme fame would turn any normal person crazy. But you don't have the option of withdrawing, because you have this army of other people depending on you, among other things.
100%, I do feel like fame at such level is a very net negative thing to have. You do get money and fame and there are many times within the media where paparazzi and others have made some celebrities lose their mind. And almost everyone loses a sense of something human with this sense of fame. From Princess Diana to Britney Spears to Justin Beiber.
The tragic true story of Justin Beiber: https://www.youtube.com/watch?v=RvnnbzcAjOU