Isn't the thesis of the "he's definitely bipolar!" crowd that he already is treating it with Ketamine or something (and that's why he's able to avoid all of the negative consequences typically associated with bipolarism?)
There is no such crowd, but in any case, should someone make such an argument, the description of Musk as using ketamine would not be adequate: he talks about 'microdosing' it, which is not known to help at all, and even the macro-doses (which he apparently takes at the occasional party) have shown promise only for producing short-term relief. Even there it's unclear how much it'd help - but if you read ACX then I don't need to go into that.
More importantly, we can be sure the ketamine self-medication is not treating his bipolar, and
all Musk self-medication is not working in terms of 'treating it', because your premise is false: he is
not avoiding the consequences of depressive phases. They are simply covered up. Musk has relatively few hard obligations as he has delegated day-to-day operations to CEOs like Gwynne Shotwell, management of his finances to another guy at his family office, and so on and so forth, so the depressive episodes are
mostly hideable... but not entirely.
This is obvious if you read Musk coverage by people who know him closest, and adjust for the fact that he is a mega-billionaire with extensive PR handlers & enablers & circles of employees dedicated to covering for him and hiding depressive phases (see also: Tony Hsieh, whose enablers enabled him unto burning himself to death). But it has been made exceptionally clear by the new biography, which describes his depressive phases much more clearly than other sources do. Particularly amazing is how his depressive phases go all the way to
withdrawn catatonia, and Isaacson describes how employees like the Tesla CEO desperately covered for him so the world wouldn't notice and trying and failing to get him to seek medical treatment for what is obviously bipolar, in a passage worth quoting in full (because apparently most people can't
be bothered to read, so if I stick it here, maybe at least some of it will get through):
Isaacson 2023,
Elon Musk § "Are you bipolar?"
Devastated by the breakup with Amber Heard and the news that his father had a child with the woman he had raised as his stepdaughter, Musk went through periods when he oscillated between depression, stupor, giddiness, and manic energy. He would fall into foul moods that led to almost catatonic trances and depressive paralysis. Then, as if a switch flipped, he would become giddy and replay old Monty Python skits of silly walks and wacky debates, breaking into his stuttering laugh. Professionally and emotionally, the summer of 2017 through the fall of 2018 would be the most hellacious period of his life, even worse than the crises of 2008. “That was the time of most concentrated pain I’ve ever had,” he says. “Eighteen months of unrelenting insanity. It was mind-bogglingly painful.”
At one point in late 2017, he was scheduled to be on a Tesla earnings call with Wall Street analysts. Jon McNeill, who was then Tesla’s president, found him lying on the floor of the conference room with the lights off. McNeill went over and lay down next to him in the corner. “Hey, pal,” McNeill said. “We’ve got an earnings call to do.”
“I can’t do it,” Musk said.
“You have to,” McNeill replied.
It took McNeill a half-hour to get him moving. “He came from a comatose state to a place where we could actually get him in the chair, get other people in the room, get him through his opening statement, and then cover for him,” McNeill recalls. Once it was over, Musk said, “I’ve got to lay down, I’ve got to shut off the lights. I just need some time alone.” McNeill said the same scene played out five or six times, including once when he had to lie on the conference room floor next to Musk to get his approval for a new website design.
Around that time, Musk was asked by a user on Twitter if he was bipolar. “Yeah,” he answered. But he added that he had not been medically diagnosed. “Bad feelings correlate to bad events, so maybe the real problem is getting carried away for what I sign up for.” One day, when they were sitting in the Tesla conference room after one of Musk’s spells, McNeill asked him directly whether he was bipolar. When Musk said probably yes, McNeill pushed his chair back from the table and turned to talk to Musk eye to eye. “Look, I have a relative who is bipolar,” McNeill said. “I’ve had close experience with this. If you get good treatment and your meds dialed right, you can get back to who you are. The world needs you.” It was a healthy conversation, McNeill says, and Musk seemed to have a clear desire to get out of his messed-up headspace.
But it didn’t happen. His way of dealing with his mental problems, he says when I ask, “is just take the pain and make sure you really care about what you’re doing.”
Here's an interesting question: Suppose Musk does have a condition similar to bipolar. Should he get treatment for it?
Yes. Bipolar is extremely dangerous during depressive phases: it has a mortality rate you're more familiar with from, say, schizophrenia. There's a disturbingly high possibility Musk will commit suicide or die in some other way ultimately due to the bipolar (eg. another car accident). And then that's that, the end.
Nor are the manic phases safe: it's been painful for me to watch Musk throw away his life and reputation, Kanye-style, on Twitter - forget the mere $20b+ he lit on fire, he's throwing away some of the best years of the remainder of his life, where he was at the peak of his wealth, personal powers, still in reasonable health (albeit starting to decline, as the back surgery/MMA business shows - Musk is realizing that a 51yo man is not a 20yo when it comes to injuries, their health is now all downhill). SpaceX and Tesla could have been only the start of the Musk story; he could have set his sights higher and done something really great. (AI might not have been a great choice given the past results, but carbon capture and geoengineering come to mind as areas suited to Musk and where the moment was ripe.) But if he lets the mania make ever more high-stakes decisions for him and spiral him into an echo chamber of self-reinforcing delusions (his tweets have gotten breathakingly stupid and ill-informed and falling for fake news since the purchase - I was flattered when he retweeted my anime neural net work & followed me on Twitter, but I would be much less so today), I fear they will become the end of the Musk story. It is worse than a crime, it is a mistake.
The costs of mania have become ever higher for Musk, and the benefits ever more minimal. He doesn't
need to be manic to do the countless cool things he already knows of and wants to do. He doesn't
need to be manic and willing to risk his entire fortune on something, because he's the frigging richest man in the world! Whatever the benefits of hypomania were when he was founding SpaceX lo those many years ago, the benefits have dropped drastically every year even as the costs increase drastically every year (and the annual cost to Musk of manic phases must now be denominated in units of 'decabillion dollars').
And bipolar is treatable fairly well. Not perfectly by any means, but it doesn't seem like the effective treatments are as horrible as schizophrenia drugs often are. If the treatment doesn't work, you stop and you try a different one. But for any treatment to work, one has to seek them, and not issue moronic macho statements like "the way to treat bipolar is to just take the pain and make sure you really care about what you're doing!"
So yes, Musk should seek treatment. There are few benefits to the status quo, very large costs, the potential benefits are large, and learned fairly quickly & cheaply, and so the VoI is extremely large.
Although "BPD" almost always means "Borderline Personality Disorder" and not Bi-polar.
If I had a nickel for every time I pointed out that this is untrue and you can trivially show that with a quick boolean search in Google Scholar, I would... still not have a quarter's worth of change, but it's odd that there seems to be a self-appointed brigade of Internet people who are too lazy to check scientific usage but still industrious enough to go around making tweets and forum threads about it.
