I disagreed with Gwern at first. I’m increasingly forced to admit there’s something like bipolar going on here
What changed your mind? I don’t know any details about the diagnostic criteria for bipolar besides those you and Gwern brought up in that debate. But looking at the points you made back then, it’s unclear to me which of them you’d consider to be refuted or weakened now.
Musk’s ordinary behavior—intense, risk-seeking, hard-working, grandiose, emotional—does resemble symptoms of hypomania (full mania would usually involve psychosis, and even at his weirdest Musk doesn’t meet the clinical definition for this).
But hypomania is usually temporary and rare. A typical person with bipolar disorder might have hypomania for a week or two, once every few years. Musk is always like this. Bipolar disorder usually starts in one’s teens. But Musk was like this even as a child.
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His low periods might meet criteria for a mixed episode. But a bipolar disorder that starts in childhood, continues all the time, has no frank mania, and has only mixed episodes instead of depression—doesn’t really seem like bipolar disorder to me. I’m not claiming there’s nothing weird about him, or that he doesn’t have extreme mood swings. I’m just saying it is not exactly the kind of weirdness and mood swings I usually associate with bipolar.
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I notice the non-psychiatrists (including very smart people I usually trust) lining up on one side, and the psychiatrists on the other. I think this is because Musk fits a lot of the explicit verbally described symptoms of the condition, but doesn’t resemble real bipolar patients.
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This isn’t how I expect bipolar to work. There is no “switch flipping” (except very occasionally when a manic episode follows directly after a depressive one). A patient will be depressed for weeks or months, then gradually come out of it, and after weeks or months of coming out of it, get back to normal. Being “moody” in the sense of having mood swings is kind of the opposite of bipolar; I would associate it more with borderline or PTSD.
Interesting. Borderline or PTSD rather than cyclothymia?
I don’t disagree that’s where a standard clinical interview would end up, but aren’t these basically residual categories where to put people who aren’t sane but don’t clearly fit any of the other boxes? Like, not false, but it doesn’t exactly constrain the space of where that weird outlier mind of his might be going next.
I’d be very interested in what would happen if he couldn’t have his phone for a week.
What changed your mind? I don’t know any details about the diagnostic criteria for bipolar besides those you and Gwern brought up in that debate. But looking at the points you made back then, it’s unclear to me which of them you’d consider to be refuted or weakened now.
Some excerpts:
Interesting. Borderline or PTSD rather than cyclothymia?
I don’t disagree that’s where a standard clinical interview would end up, but aren’t these basically residual categories where to put people who aren’t sane but don’t clearly fit any of the other boxes? Like, not false, but it doesn’t exactly constrain the space of where that weird outlier mind of his might be going next.
I’d be very interested in what would happen if he couldn’t have his phone for a week.