Astral Codex Ten

bipolar disorder

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bipolar disorder

Article

bipolar disorder is a recurring concept in the Astral Codex Ten archive, appearing 4 times across 4 issues between February 03, 2021 and September 18, 2023. The archive places it in contexts such as “dynamical systems oscillate wildly between very low and very high points, which is pretty suggestive of bipolar disorder”; “to screen for bipolar disorder”; ““severe mental illness” would indicate not schizophrenia and bipolar disorder”. It most often appears alongside US, America, Scott.

Metadata

  • Category: Concepts
  • Mention count: 4
  • Issue count: 4
  • First seen: February 03, 2021
  • Last seen: September 18, 2023

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Ontology Of Psychiatric Conditions: Dynamical Systems
February 03, 2021 · Original source
(also, some dynamical systems oscillate wildly between very low and very high points, which is pretty suggestive of bipolar disorder)
Others are purely dynamical systems, where patients can sometimes be perfectly healthy, but occasionally they shift into a different attractor state. You could sort of think of this as having the “trait” of a weirdly-shaped attractor basin if you want, but there’s still a clear distinction between health and disease. I think depression and bipolar disorder fall into this category.
In conclusion, taxometrics offers a useful way of understanding smoothed-out lifetime averages of mental disorders: as traits or taxa that differ among people. But many mental disorders evolve over time; depression comes in discrete episodes that start at some point and get better at some other point; bipolar comes in patterned waves of mania, depression, and euthymia. To understand these conditions, we have to add a dynamical systems perspective and think of episodes as attractor states.
Book Review: From Oversight To Overkill
April 12, 2023 · Original source
Most IRB experiences aren’t this bad, right? Mine was worse. When I worked in a psych ward, we used to use a short questionnaire to screen for bipolar disorder. I suspected the questionnaire didn’t work, and wanted to record how often the questionnaire’s opinion matched that of expert doctors. This didn’t require doing anything different - it just required keeping records of what we were already doing. “Of people who the questionnaire said had bipolar, 25%/50%/whatever later got full bipolar diagnoses” - that kind of thing. But because we were recording data, it qualified as a study; because it qualified as a study, we needed to go through the IRB. After about fifty hours of training, paperwork, and back and forth arguments - including one where the IRB demanded patients sign consent forms in pen (not pencil) but the psychiatric ward would only allow patients to have pencils (not pens) - what had originally been intended as a quick note-taking exercise had expanded into an additional part-time job for a team of ~4 doctors. We made a tiny bit of progress over a few months before the IRB decided to re-evaluate all projects including ours and told us to change twenty-seven things, including re-litigating the pen vs. pencil issue (they also told us that our project was unusually good; most got >27 demands). Our team of four doctors considered the hundreds of hours it would take to document compliance and agreed to give up. As far as I know that hospital is still using the same bipolar questionnaire. They still don’t know if it works.
Inline links: Mine was worse.
My own consent form story: in my bipolar study, the IRB demanded I include the name of the study on the form. I didn’t want to - I didn’t want to bias patients by telling what we were testing for. Next they wanted me to list all the risks. There was no risk; we would be giving the patient a questionnaire that we would have given them anyway. The IRB didn’t care; no list of risks, no study. I can’t remember if I actually submitted, or only considered submitting, that the risk was they would get a paper cut on all the consent forms we gave them. In any case, another doctor on my team found a regulation saying that we could skip this part of the consent form for our zero-possible-harm study. The IRB accepted it, let us start the study, then changed their mind and demanded the full consent form along with their 26 other suggestions.
Contra Kirkegaard On Evolutionary Definitions Of Mental Illness
September 07, 2023 · Original source
A 65 year old man who’s only attracted to adult women 40+. Most people in our society would classify 1 (an ephebophile) and 2 (a non-obligate pedophile) as mentally ill or at least worrying edge cases. But I think Emil’s theory rules that only Person 3 (the man attracted to people close to his own age) is mentally ill, since he’s ruled out mating with the vast majority of fertile women. 4: Plato …never had children. “Platonic relationship” jokes aside, I guess he was too busy philosophizing. Great men (and women) who can’t slow down to raise a family seem to be a type. Is an interest in philosophy (or science, or art, or any other worthy endeavor) that reaches the point where it consumes your life a mental illness? Kierkegaard bites the bullet and admits that the priests and monks who took vows of celibacy were mentally ill by his definition. But I think he has many more bullets of this type to bite. Even if we agree that we should classify Plato as mentally ill, this again seems very different from the practical concept of “this person has mental problems and needs help with them”. 5: Chronic Pain, Panic Attacks, Or, If You Insist, Nightmares Is chronic pain a mental illness? It seems pretty bad. But as long as it doesn’t impede your ability to hunt, gather, or have sex, I think Emil would have to say no. Same with panic attacks, anxiety, etc. If it’s hard to imagine a form of chronic pain that doesn’t impede those things, consider nightmares. These surely don’t impede any daytime activity, but chronic nightmare disorders seem very unpleasant! I think Emil has to bite the bullet that conditions which make people miserable and ruin their lives aren’t mental disorders as long as they don’t affect functioning. 6: Severity In his post, Emil includes a few turns of phrase indicating we can talk about severity - ie some mental illnesses are more severe than others. But by his framing, “severe mental illness” would indicate not schizophrenia and bipolar disorder, but homosexuality and asexuality. After all, schizophrenics are more likely to have children than gays. Again, this is pretty different from the way you want to use words when talking about real-world problems around how to help people with mental problems get better. 7: Is Emil’s Definition Of Mental Illness Itself A Mental Illness? Emil’s crusade to reclassify homosexuality as a mental illness doesn’t sound like it would be very popular in his home country of Denmark. Maybe there are even some nice Danish women who would be willing to date Emil otherwise, but are turned off by his un-PC opinions. Willingness to violate taboos couldn’t have been very helpful in the environment of evolutionary adaptedness. I imagine some distant ancestor of Emil’s standing up in front of the tribe and saying “Me think Bear God stupid and ugly! Me piss on Bear Idol!” Might mean fewer Kirkegaards around today. So is contrarianism a mental illness? I would say no, because it’s a matter of personal choice and serves a valuable social function. I’m not sure what Emil’s answer would be. * * * I don’t want to assert any of these too strongly. Maybe Emil knows something I don’t about the EEA, and can prove that actually ADHD would be maladaptive there, or ephebophilia would get you in trouble. If so, I think that would restore some concordance between our intuitive notion of mental disorders and Emil’s version, but that concordance would be coincidental, not necessary. The next day we might learn some different fact about the EEA that would make the two notions discordant again. So to repeat my claim: mental-disorder-(Emil) and mental-disorder-(Scott) both describe useful concepts, but they’re not the same concept. Mental-disorder-(Emil) is useful for talking about evolutionary genetics; mental-disorder-(Scott) is useful for talking about present day mental health problems and what to do about them. We won’t convince people to literally use the terms “mental-disorder-(Emil)” and “mental-disorder-(Scott)”. So who should keep custody of the current term “mental disorder” and who should have to make up a new word for their thing? I think Emil should have to make up the new word, because: There are a few thousand evolutionary psychologists, and a few hundred million normal people who want to talk about mental disorders for normal reasons (like because they have them).
Highlights From The Comments On Elon Musk
September 18, 2023 · Original source
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.
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. I have never met or talked to him and he probably keeps a lot of his inner life secret so I could be wrong, I’m just not seeing obvious evidence for this.
Surprising to see a psychiatrist write a review of Musk focusing on his psychology and replete with quotations about his erratic sleep habits or obsessive focus, and never use the words "bipolar" or "mood disorder"
Inline links: "bipolar"