I disagreed with Gwern at first. I’m increasingly forced to admit there’s something like bipolar going on here, but I still think we’re also missing something—his cognitive state seems pretty steady month to month, rather than episodes of mania alternating with lucidity.
Someone claimed the latest Musk biography said he was much more normal early in the morning, and much crazier late at night. I need to read the biography and see if that’s actually in there; if so, maybe there could be a case for ultradian or ultra-rapid-cycling or something. This could potentially just look like a random mix of good and bad decisions depending on when in the cycle he’s making them, with the cycle itself too fast to notice on the scale of news reports. As you say, presumably something about that changed the past few years (I’ve never heard anyone discuss what happens to ultradian bipolar if you simply never sleep, but I bet it’s nothing good).
“I don’t know how he went from being great at engineering to believing in witchcraft”, [Elon told the biographer about his father]. Errol can be very forceful and occasionally convincing. “He changes reality around him,” [Elon’s brother] Kimbal says. “He will literally make up things, but he actually believes his own false reality.”
I can’t think of a form of bipolar which consistently gets much worse at age 50, but I hope to look into this further.
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.
Revisiting the claim on whether he is Bipolar II: many drugs can prompt bipolar-like behavior. There’s a distinct diagnostic code for this case, which is: bipolar, not otherwise specified. That is, even if he has undergone manic episodes (which I haven’t witnessed, as a sufferer of the occasional manic episode), he wouldn’t necessarily be classified as Bipolar I, even fitting the diagnostic criteria for Bipolar I. Though again, I haven’t seen any manic rather than hypomanic behavior.
Going on my own speculation journey, given the strong biohacking/cognitive enhancing culture in the valley’s tech community, I’d be pretty surprised if there weren’t stimulants in the mix too. TRT has been on the rise which also can tremendously increase impulsivity and risk-taking behavior. I think the “crazier late at night” phenomenon is better explained by a drug taken earlier in the day wearing out over the course of the day than something like rapid-cycling.
I disagreed with Gwern at first. I’m increasingly forced to admit there’s something like bipolar going on here, but I still think we’re also missing something—his cognitive state seems pretty steady month to month, rather than episodes of mania alternating with lucidity.
Someone claimed the latest Musk biography said he was much more normal early in the morning, and much crazier late at night. I need to read the biography and see if that’s actually in there; if so, maybe there could be a case for ultradian or ultra-rapid-cycling or something. This could potentially just look like a random mix of good and bad decisions depending on when in the cycle he’s making them, with the cycle itself too fast to notice on the scale of news reports. As you say, presumably something about that changed the past few years (I’ve never heard anyone discuss what happens to ultradian bipolar if you simply never sleep, but I bet it’s nothing good).
Anatoly Karlin, who apparently also read the biography, says that Musk’s father Errol also went crazy after fifty—see https://x.com/powerfultakes/status/1892003738929238408 . One excerpt:
I can’t think of a form of bipolar which consistently gets much worse at age 50, but I hope to look into this further.
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.
Revisiting the claim on whether he is Bipolar II: many drugs can prompt bipolar-like behavior. There’s a distinct diagnostic code for this case, which is: bipolar, not otherwise specified. That is, even if he has undergone manic episodes (which I haven’t witnessed, as a sufferer of the occasional manic episode), he wouldn’t necessarily be classified as Bipolar I, even fitting the diagnostic criteria for Bipolar I. Though again, I haven’t seen any manic rather than hypomanic behavior.
Going on my own speculation journey, given the strong biohacking/cognitive enhancing culture in the valley’s tech community, I’d be pretty surprised if there weren’t stimulants in the mix too. TRT has been on the rise which also can tremendously increase impulsivity and risk-taking behavior. I think the “crazier late at night” phenomenon is better explained by a drug taken earlier in the day wearing out over the course of the day than something like rapid-cycling.