Entrepreneur Elon Musk has baffled observers seeking rational explanations of his success or ‘4D chess’; a major irrational explanation, however, is that Musk is likely on the mood disorder spectrum—in particular, high-functioning bipolar disorder with hypomania (bipolar II disorder). Some observations, from general to specific:

• Bipolar disorder is not rare, but common: 1–3% prevalence (ie. ~3–9 million people in the USA alone, or more than the Jewish; and >80m worldwide, or the population of Germany), and is a leading burden of mental disease. (How many people, celebrities or historical figures can you think of with bipolar? And is that more or less than 3%?)

• Like most mental disorders, bipolar is comorbid with other mental disorders (correlated phenotypically & genetically)—especially autism, which can mask depression

  • Unusually among mental disorders, bipolar disorder appears uncorrelated or positively correlated with traits like intelligence, education, and SES (perhaps connected to the autism correlation), and so is more common than one would expect among elites (tail effects)

• Bipolar is especially common among risk-taking careers, such as entrepreneurs¹

• Bipolar is much more obscure than other psychiatric disorders of comparable prevalence like schizophrenia, despite being dangerous (manic episodes can destroy lives & careers, while depressive episodes cause suicide)

• Bipolar is under-diagnosed, like personality disorders: people often never seek diagnosis, especially when they enjoy the highs (“The reality is great highs”), and clinicians often differ in diagnosis.

  • Mood disorders can be hidden in plain sight, as the manic aspects get written off as merely a ‘public persona’² or ‘moodiness’ or ‘having a temper’ & the depressive phases are inherently self-concealing or excusable as “burnout” etc

    eg. Andy Dunn; SF author Harlan Ellison, who was diagnosed aged ~77 (and only after a suicide attempt with a gun and involuntary commitment and extraordinary intervention by his family & friends); or Elon Musk’s friend, Kanye West, who was diagnosed with bipolar in 2016, to the surprise of an adoring public—at least, adoring before West’s increasingly erratic behind-the-scenes behavior as he “resisted treatment” finally bled out into highly-public manic phases that destroyed his career. (Or, have you ever noticed how, pre-lithium, famous hardworking figures without tuberculosis are constantly having “nervous breakdowns” or developing “neurasthenia”, and needing to recover in sanatoriums or hot springs?)

• Bipolar is highly heritable and runs in families; Elon Musk has a family history of “wanderers and adventurers”: “Our family is different from other people. We risk more.” (Tosca Musk)

  • Elon’s father Errol Musk has a striking personality & career I will not attempt to summarize here (as does his maternal grandfather, Joshua N. Haldeman).

    But I will note that Elon describes Errol as undergoing a strange transition in his 40s–50s where his “mood swings” became destructive and “he went from being great at engineering to believing in witchcraft. But somehow he made that evolution” or making bizarre claims like “in the United States the president is considered divine and cannot be criticized”; and that Elon’s family would warn him when he was “turning into your father”. (Isaacson, “Jekyll and Hyde”)³

• Mood disorders persist over a lifetime—as have Musk’s impulsive decisions.

  • Musk’s risk-taking & persuasiveness are described by family & friends as emerging in adolescence—long after his autism spectrum disorder traits became apparent as a child, but more consistent with mood disorder lifecycles

  • Musk has engaged in unwarranted risk-taking at least since college, long predating more famous SpaceX/Tesla/Twitter risks, eg. refusing to get insurance on his McLaren supercar (which represented a meaningful percentage of his net worth⁴) because he didn’t think he would crash it (and then crashing it).

  • Even at age 51 he makes snap-decisions like purchasing Twitter (in order to make changes like renaming it to “X” or change the tweet text to “What is happening?​!”)

• Hypomania is associated with:

  • “notable decrease in the need for sleep, an overall increase in energy, unusual behaviors and actions, and a markedly distinctive increase in talkativeness and confidence, commonly exhibited with a flight of creative ideas.”

    • Musk frequently sleeps only a few hours a day (often not for work, but recreationally—concerts, video games⁵ etc.), and must use Ambien (often prescribed in bipolar) to force himself to sleep

    • Musk is noted for his personal energy, confidence and “gift of gab”, and having many ideas (good & bad)

  • “feelings of grandiosity, distractibility, and hypersexuality”;

    • Musk has an admitted hero complex and routinely attempts to do things like broker peace between Ukraine & Russia or propose that Taiwan become a part of CCP China (by adopting Hong Kong’s successful one-country-two-systems approach).

    • binge-buying behavior, often accompanied by grandiose plans for the purchases; Musk routinely goes through purchase fads of new toys he loses interest in, ranging from stunts like flamethrowers to submarine-cars—a James Bond movie prop called “Wet Nellie” purchased in 2013_13ya for ~$1.5^$1₂₀₁₃m with grand plans to turn into a true submarine-car using Tesla car parts, and never heard of since.

      This particularly characterizes his Twitter purchase—as one person with bipolar put it, “Him purchasing Twitter reminds me of people who buy boats/homes in mania”; Isaacson characterized Musk’s main motivation as making a lot of money and then saying “I didn’t want to just leave it in the bank”.

    • Musk is notoriously distractible, and distracted by his accumulating businesses & Twitter use; his schedule is irregular in the extreme.

      Musk relies on executives like Gwynne Shotwell or Jon McNeill to actually run his companies, while the executives at his companies like Tesla rely on manipulation of his distractibility & outlasting his short attention span to avoid disastrous decisions by the “king-crazy” Techno-Emperor of the Universe.

      When employees are not able to defuse Musk delusions (like a driving-wheel-less Model 3 using solely FSD), Musk will make disastrous decisions like the Model 3 ‘alien dreadnought’ debacle that brought Tesla to its knees, the Cybertruck, or the Twitter acquisition (which has wasted almost 2 years of Musk’s life, much of his reputation, −$20b+, and counting).

      Musk routinely makes absurd claims he apparently genuinely believes & repeats in private, like that a federal judge in Delaware would not force him purchase Twitter, despite his having signed an ironclad contract to do so, because “It would not pass muster with the public.” (Eventually, as his mood cycled, his belief flipped to the opposite: “I should just pay full price…The potential is so great…These [Twitter] people are…such blockheads and idiots.” As of November 2023, Musk’s return on his Twitter investment has been −72%; given that it was still “barely breakeven” in March 2025 as ad revenue continued to plummet—never mind paying the >$1.5b annual debt interest—when he pulled a SolarCity and merged it with X.ai to hide the losses, we can infer that the final loss was probably well in excess of that.)

      One increasingly notable aspect of his business career is an ever-diminishing attention span, bouncing between activities. Where he would spend a decade focused on SpaceX and then Tesla, more recently, his commitment to his wide array of companies and relationship has become ever more transitory: hardly has he ordered the creation of the (failed) Cybertruck than he is purchasing Twitter (failed & bailed out by X.ai), only to cast it aside for X.ai, then the Robotaxi (internally predicted to lose money), then X.ai, then the DOGE debacle, while campaigning for Trump in Wisconsin (also a loss) or advocating for pro-natalism and arranging additional children, etc.

    • hypersexuality: Musk has married 3× and had 1 mistress and unknown number of girlfriends at SpaceX & elsewhere⁶, had >11 children, & a flight attendant sex scandal⁷ (thus far). The number of Musk offspring appears to be dramatically accelerating, with at least 15 rumored as of early 2025, and Musk has urged women to use surrogates to have many more, suggesting 10 to one Musk concubine—speaking of his offspring as his “legion” and telling one mother of his intention “to reach legion-level before the apocalypse”. Further, his X.ai AI company is notable for its unusual embrace of softcore pornography generation & “AI girlfriend” functionality.

• Severe mood dysregulation/lability:

  • Musk, unusually among CEOs, appears highly sensitive to criticism and at times almost about to cry

  • “Demon mode”: whiplashes between munificent & magniloquent moods to malicious (“light and dark, intense and goofy, detached and emotional, with occasional plunges into what people around him call ‘demon mode’”)

• Depressive phases:

  • Acknowledgement of suicidal ideation in adolescence (accompanied by “very wild storm” of thought & “demons…for the most part, harnessed to productive ends [but] Once in a while, they, you know, go wrong.”)

  • Musk self-medicates with ketamine to the point of bladder problems; Musk has reportedly told people he microdoses ketamine to treat “depression”⁸, referring to suffering from “terrible lows”. (It is worth noting that if Musk is not on any mood disorder spectrum, a viable alternative explanation for many of these observations is gradual cognitive degradation from long-term ketamine abuse—which leads to worse memory/cognition, and more dissociation & delusional symptoms, often paranoid, such as John C. Lilly on 150mg of ketamine believing aliens removed his penis)

    (I doubt ketamine is the whole explanation, as is trendy due to the convenience of blaming a drug, because it doesn’t explain most of the observations or timeline; however, it is plausible that ketamine abuse has accelerated his decline. ‘Twitter’ is a terrible ‘set and setting’.)

  • Catatonia: catatonia is one of the most signature features of bipolar, while highly unusual elsewhere; biographers have often described Musk freezing for periods of time, describing it as for thinking, leaving catatonia ambiguous (if they have ever heard of it) but biographer Walter Isaacson describes “foul moods that led to catatonic trances and depressive paralysis” during depressive phases, severely interfering with running companies, where Musk would lay on the floor paralyzed in the dark, unable to carry out critical duties like Wall Street earnings calls⁹. (Employees would desperately rouse Musk long enough to give an initial speech, and then take over when Musk collapsed back into his withdrawn catatonia.)

    These catatonic episodes led an employee with a bipolar relative to convince Musk to seek treatment for bipolar disorder; Musk ultimately did not.

  • Walter Isaacson, after two years shadowing Musk, admits that the “mercurial” Musk could “fluctuate wildly” with “erratic emotional oscillations” and go from ‘very excited’ to ‘somber’, noting that “Musk goes through manic mood swings and deep depressions” (emphasis added).

    Musk periodically mentions his depressive phases and the struggle to “not look like the most depressed guy around.” (in part by leaning on stimulants like caffeine) and the fear of being alone

Is it any surprise that Elon Musk has stated publicly on Twitter & to Isaacson that he may be bipolar, employees urge him to seek treatment for bipolar, and a number of psychiatrists & other observers have speculated about bipolar disorder?