An open letter to Elon Musk’s Ambien doctor, By Jemima Kankam, MD, FAPA

“Dr. Kankam, make sure to tell them not to prescribe Ambien to anyone who complains of not sleeping.”

That was the advice an internal medicine physician gave me when he learnt I was giving a talk to a group of medical residents and medical students.

He was referring to the alarming increase in doctors who automatically prescribe sleep medications to any patient who complains of sleep problems, rather than adequately exploring the root cause of their insomnia. (Ambien was the first approved “sleep medication”)

Sleep problems are often a manifestation of deeper medical problems; both physical or psychological.

It was the word “Ambien” in the article about Elon Musk that caught my attention. Several years ago, a similar implication had captured my attention. In that instance, involving another celebrity who eventually ‘lost it all’ – the actor Charlie Sheen.

As in Charlie Sheen’s situation, I obsessively searched for anything I could find about changes in Elon Musk’s recent behaviors. I soon came across a scolding article written by Arianna Huffington (Thrive Global, Aug 17, 2018). In the article, Arianna describes Elon Musk as a personal friend and a doting father who proudly showed her pictures of his children.

Yet, Elon Musk had apparently stayed holed up in his office – day and night – for days. Even on his birthday; away from his kids.

It was clear this is a change in Elon’s baseline pattern of behavior  – a key signal in mental health of determining what may be a psychological problem.

Could that be why Elon sought medical help for his sleeplessness?

I found other concerning clues; Elon’s over-the-top socially inappropriate response to a criticism during the entrapped Thai boys’ soccer team saga. (He later apologized for his defamatory statements).

I came across an article entitled “Is Elon Musk struggling with Depression?” (Serenity Malibu, 2018). The article states that Elon admitted that he suffers from “issues of depression which continue to affect” his daily life.

Elon was quoted as stating that his reality was a mix of “great highs, terrible lows and unrelenting stress” because of his battles with mental health.

However, it was a lengthy interview that Elon Musk gave to Rolling Stone magazine that was so revealing. No mental health clinician; indeed no clinician, could be excused for not exploring the unusually long period of sleep changes that Elon was experiencing. The sleep deprivation that Elon was experiencing seemed to be occurring concurrently with his unusual behavior; behaviors that have the potential to negatively impact his personal, social and professional life.

In my usual habit, I started writing a letter to Elon. I have ‘written’ similar cautionary letters to other celebrities; ‘mailed’ into my computer. This time it would be different, I promised myself.

While I tarried, Elon made a thoughtless statement that could have cost him his decades of hard work.

Then, Elon smoked marijuana on national TV- another incident eerily similar to actor Charlie Sheen. Charlie paid a heavy professional price. Fortunately for Charlie, he has his life and got a second chance at redeeming his career.

close up photo of kush on glass container

Though legal in many states this drug is not totally benign.  Most mentally ill patients may use this as self medication – Photo by Yash Lucid on Pexels.com

Then came the bombshell – Elon was ordered to step down as chairman of Tesla – all as a result of a single thoughtless statement probably made at a time when the brain is not in its best state to adequately weigh the pros and cons of actions, verbal or otherwise, a very common occurrence in the other side of depression -the mania period.

My profession is barred by our ethics from making a categorical diagnosis on an individual we have not specifically evaluated and where there is not enough information. However, with the behavior that Elon Musk is exhibiting, I am very concerned for him, not so much because of the negative impact his behavior may have on his wealth and professional future, but as has happened to many patients who have suffered from Elon’s symptoms – both ordinary people as well as celebrities – I worry about his very life!

The behaviors Elon has exhibited and the quotes ascribed to him seem to fit a mood disorder- Bipolar Disorder. Of course this is not a diagnosis, specific evaluation would be necessary to establish that.

Bipolar Disorder is partly a hereditary condition. In Bipolar Disorder, one often experiences uncontrollable cycles of episodes (just as an asthmatic or diabetic may go through cycles -asthmatic attacks; low and high sugar respectively).

In “mania episodes” creative juices seem to be at their peak. There is an uncontrollable ability to burn the candles at both ends; the body not seeming to need sleep, sometimes at the peril of physical health. Despite seemingly great output, overall effectiveness is tempered by the impulsivity and risk-taking behavior of this stage.

People suffering from Bipolar Disorder usually first experience mania in adolescence but it is often relegated to the effects of “hormones”.

Many of my patients were expelled from school because of those behaviors. Some of the behaviors resulted in legal consequences.

Studies have shown, diagnosis of Bipolar Disorder may be missed or misdiagnosed for up to a decade.

The risk of suicide is especially high in the hard crash (“Bipolar Depression”) and the mixed state of symptoms (Mixed Episode).

“Big people” (socioeconomically) and celebrities sometimes don’t get good mental health care. We in the medical profession may be wowed by the social façade of their accomplishments and status and tempted not to probe where we must.

When the unthinkable happens as a society, we collectively scream “We did not see it coming!”

So in conclusion, I appeal to you, Doctor: if you are a mental health clinician- ask about the contents of the Rolling Stone interview by Neil Strauss (Rolling Stone Nov 15, 2017) and engage his family/support network, as we would any other patient.

If you are not, please, refer him to a mental health clinician.

Thanks to anyone else who can help (including Elon’s friend Ariana Huffington) and any media person who can pass this along.

By Dr. Jemima Kankam, a psychiatrist and Mental Health Advocate who practices in Baltimore, MD

Advertisements

Leave a Reply