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Comment by mtlmtlmtlmtl | Hacker News Reader

Diagnoses are defined through research. The committee part is just about updating diagnostic manuals to reflect current consensus. New diagnoses need to be proven to be distinct entities(i.e not redundant) and clinically meaningful. And they specifically need to have a diagnostic test. Having blond hair has a diagnostic test, sure, but that diagnostic test does not in itself constitute a distinct, clinically useful diagnosis. Of course hair colour can change due to medical conditions, but then the hair colour would obviously be just one symptom of some set of conditions that may have caused it.

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I do not agree. You can research how much of the population has blond hair, and how much this diverges from the "typical" hair color. But the decision to define or not define blond hair as a medical condition is a value call because the definition of a medical condition is ultimately that which people call a medical condition.

And whether something is clinically useful isn't the standard for defining a condition, because ability to successfully treat a disease isn't a standard in deciding whether something is a disease and because therapy isn't limited to people who have diseases. (Unless professionals are now calling marital problems a disease?)

You can agree or disagree, but the fact is that diagnoses almost always include a mandatory requirement that the condition has a significant negative impact on the patient's life. It's not merely a value judgment, and it's definitely not an arbitray judgement. The AMA or the CDC can't just decide that blod hair is now a medical disorder for no other reason than it would be helpful to your strawman. Clearly a lot of research and deliberation goes into these decisions. That's why new revisions of the DSM literally take years to complete.

"...a mandatory requirement that the condition has a significant negative impact on the patient's life."

Lot's of things have negative impacts that aren't considered medical conditions, on the other hand Elan Musk says he has Aspergers. Nobody seems to doubt it. This shows that someone can climb to the top of the social world but still be told they have a disease supposedly associated with "significant negative impact" on social skills.

And FDR had polio. JFK had Addison's disease and required regular treatment. Alan Turing revolutionised pretty much all of science and then committed suicide. Clearly someone can be pretty much maximally successful in their endeavours, and yet still have diseases that have a significant negative impact on their life, whether it's their sense of happiness, problems with interpersonal relations, or mobility.

As for doubting Elon Musk's claims: I generally don't raise doubts about someone claiming a diagnosis. I know from personal experience how shitty it feels to have the veracity of your suffering questioned like that. And in Musk's case, I have no issue believing he has some interpersonal issues, and asperger's(autism spectrum disorder in DSM-V) could explain that, so I don't see any reason to doubt him in this case.

I don't doubt a mental health practitioner told Musk he has Aspergers but we've now moved the bar from medical issues being related to a "significant negative impact" on the patient's life to "...some interpersonal issues..." being sufficient to label someone with a medical condition.

I think you're reading too much into the "significant" part of this the word in this context does not mean "large".

And again, it's pretty presumptuous to act like we know the whole story with Musk's Aspergers. I don't acutely pay attention to his personal life, and I don't see any reason to make the assumption that the only symptoms he has are ones that have been visible in the media(like the $420 tweet and the "pedo guy" thing). Aspergers is a very real disorder, I've multiple friends with it. People with aspergers can be highly intelligent and successful at what they do, yet feel completely miserable and become increasingly depressed because they struggle to connect with other people, which gets lonely.

I never claimed aspergers was not real. This discussion started when someone asked if it was disprovable or provable whether someone was neurotypical.

The fact of the matter is it is not possible to prove someone is neurotypical or not neurotypical. There is no scientific study that can tell you whether Musk's personal problems are "significant" enough to justify the diagnosis of Aspergers.

I don't know anything about Musk's personal life, but he's clearly suffering a lot less than individual on the autism spectrum who have trouble with basic day to day activities like keeping a job or navigating a normal work related conversation.

Unless neurotypical people are definitionally free from loneliness, depression and social isolation the last sentence of your comment seems like a red herring.

> "significant negative impact" on social skills.

Social skills you see them at the micro level , not at the macro level. That is after the halo effect of all the paid for publicity (plus all the abomination that is modern day social media) vanishes.

Once the halo effect vanishes everybody nopes the hell out of Musk life, including his confidantes, children and wives. So he has significant negative impact on social skills.

Manipulating the public and business associates in order to become worth 200+ billions of dollars seems to me to require quite a lot of social savvy. So does the regular interactions with people that go with founding a company.

I think someone can be a bad spouse without necessarily suffering from a social skill disorder. And someone suffering from a social skill disorder can be a good spouse, so I don't know that divorce really tells us much.

> Manipulating the public and business associates in order to become worth 200+ billions of dollars

It's not about manipulation and more riding an already existing wave. The tsunami of environmentalism, green everything etc.

Real bona fide manipulation is all about convincing people that YOU are the solution to each and every of their problem.

It entails jokes, touching people, pointing at people, blowing kisses, smiling a lot, playing an instrument. Most of all it has to be speeches, delivered from a stage.

Think Obama, Bill Clinton, George Bush, Reagan, Trump...

I can't take Musk seriously because he cannot speak properly. When you are a leader you cannot hide behind the bird app forever. At some point you have to go out there and hold hold the crowd in your palm like the Beatles and Led Zeppelin used to do. That to me is social skill.

> This shows that someone can climb to the top of the social world but still be told they have a disease supposedly associated with "significant negative impact" on social skills.

Narcissists, sociopaths regularly climb up while being impaired and causing damage everyone around. People with OCD or hypochondriac too. Bipolar people the same. That does not make those non existent either.

I don't see how your mention of OCD, bipolar disorder, narcissisms or sociopathy is relevant to someone with a supposed social skill disorder being really good at navigating and conquering the social world.

To me the claim that Musk has Aspergers is like being told an Olympic marathon runner has a leg disability.

Asperger is by definition mild variant. It is not equivalent leg disability. Plus, lack of empathy can be advantage in business - you care less about impact on others.

Asperger is not something that excludes you from success.

OCD and being bipolar have much graver consequences on your life and success.

Oscar Pistorius was both a Paralympic and an Olympic sprinter despite having no feet.

> I don't see how your mention of OCD, bipolar disorder, narcissisms or sociopathy is relevant to someone with a supposed social skill disorder being really good at navigating and conquering the social world.

It's not the social world. It's the social media world. Big difference.

Michael Jackson was the greatest in his field too, was on all covers and people would faint when they saw him, but was also a social reclusive.

Big phenomenons like this are more an indication of the amount of money being spent in promotion than the social skills of the person being promoted.

The mental health world is measuring different things from the business world. I mean, Hitler was Chancellor of an advanced European nation, that must make him fine, right?

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