Why Sam Bankman-Fried’s Lawyers May Want the Jury to Know He Has ADHD

State of Mind

The ADHD Defense

Sam Bankman-Fried’s quirks helped make him famous. Could they excuse his alleged crimes?

Sam Bankman-Fried, wearing a suit, in profile.

Photo illustration by Slate. Photo by Michael M. Santiago/Getty Images.

This is part of Slate’s daily coverage of the intricacies and intrigues ofthe Sam Bankman-Fried trialfrom the consequential to the absurd.Sign up for the Slatestto get our latest updates on the trial and the state of the tech industry—and the rest of the day’s top stories—and support our work when youjoin Slate Plus.

Last Wednesday, following opening statements in one of the biggest financial fraud cases in U.S. history, the defense had a question for Judge Lewis Kaplan. It involved amphetamines.

“As the court is aware, you have issued an order that Mr. Bankman-Fried receive four doses of Adderall per day,” said Mark Cohen, the lead lawyer for fallen crypto king Sam Bankman-Fried in the federal trial that could send him to prison for decades. But thus far, he was only getting two. “When he doesn’t have it, it’s very hard for him to focus, your honor.” (The judge made it clear that this was the domain of the Bureau of Prisons, not him.)

On one level, it seemed to be a dull procedural exchange. But intentionally or not, it served a potentially useful role for the defense: a reminder that SBF may have an attentional disorder powerful enough to require medication four times a day. The prosecution has painted SBF as a power-hungry thief who brazenly stole billions from his customers, deliberately lied to investors and clients, and directed exploitative changes to FTX code in order to pull it all off. This piece of medical information offered a path to buying into an alternative explanation: that though SBF was gifted enough to create the world’s second largest cryptocurrency exchange, he was simultaneously, diagnostically, a mess. If you buy that, then you might buy the defense’s argument that SBF is not a crook, but that he missed ill-doing because he failed to get around to putting proper infrastructure in place, notice what his colleagues were up to, or stay organized with all those billions coming in and out.

Could sprinkling a couple milligrams of Adderall throughout the trial make this explanation more believable?

The idea that Sam Bankman-Fried’s brain was just a little different has long been part of the FTX story. Some of his behavior was familiar to others with attention-deficit/hyperactivity disorder. Some was not. (According to the DSM-5ADHD refers to people who “show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” Such a person often “makes careless mistakes,” is easily distracted, and is likely forgetful, among other tendencies. There are many different subtypes.)

He stayed up all night and then napped on bean bags. He seemed unable to tie his own shoes, even before testifying in front of Congress.He was OK with people knowing that he lacked empathy, an ability to feel true happiness, concern for wrinkles, and also—possibly—a soul.

“Other people felt emotions; he did not,” was Michael Lewis’ read on SBF. Lewis’ most recent book subject “thought of himself as a thinking machine rather than a feeling one.” And those thoughts were so all-consuming, at times, that “he wasn’t built to escape, or even notice a physical threat.” Ultimately though, the real threat—the one that caused him physical pain—was boredom.

Bankman-Fried built a world full of people and systems that were supposed to compensate for his quirks. There was psychiatrist George Lerner, who relocated to the Bahamas and became a sort of performance coach for FTX. There was Natalie Tienwho took on the task of getting the world to abide by SBF’s nonschedule. He relied on effective atruism’s teachings to prioritize this and not that. And he surrounded himself with others who shared his desire to make billions to counter suffering … with the help of stimulants. As Caroline Ellison, his former girlfriend and CEO of Alameda Research, his crypto hedge fund, once tweeted:

It was the nerdier, more philanthropic version of the ‘80s traders snorting coke over caviar. And for those who could look past the fact SBF was munching on some sort of microwavable meal and playing video games as you spoke, it seemed to pay off.

Once FTX collapsed in late 2022, however, SBF’s unconventional ways took on a different sheen. Bloomberg reporter Zeke Faux arrived to a chaotic scene at the CEO’s $30 million Bahamas penthouse, where SBF attempted to contain the fallout after the equivalent of a bank run on the exchange. “Towels are piled in the laundry room. Bat streamers from a Halloween party are still hanging from a doorway,” Faux wrote. Now it felt less like a quirky ascetic savant and more like an actual mess. Or more serious yet, a form of misdirection, intended to back up the story that he was telling reporters: The FTX emperor had gotten lazy about mental math and didn’t notice that he was spending more than he was taking in.

In December, the day after SBF was arrested in the Bahamas, his lawyers explicitly introduced his mental health needs into the court of law for the first time. He’d require Adderall for ADHD and his meds for depression. In a letter this August as his federal trial approached, his lawyers elaborated further. He had been taking 10 mg of Adderall, prescribed for this ADHD, three to four times a day, for the past three years. (The judge in the case sent SBF to jail in August after several instances of misbehavior, including leaking the private writings of Ellison, a key witness, to the press.)

“This medication has been effective for treatment of Mr. Bankman-Fried’s inattention and ADHD-related rumination,” his psychiatrist, Lerner, wrote.  Unless he could get it—and the Emsam patch for depression that he’s been using for the past five years, he would be unable to assist in his own defense, Lerner stated.

Of course his lawyers brought this stuff up. They were trying to get the man what he needed to make jail bearable and protect him from drug withdrawal. That might be it. But that explanation does not fully explain the questions those lawyers proposed to vet the jury for the criminal trial now underway in New York. Alongside inquiries about potential jurors’ connection to cryptocurrency, SBF’s counsel included:

• The defendant in this case has ADHD, which might affect things like his physical behavior, body language, or eye contact. Please raise your hand if you have never had any personal or professional experience with ADHD.

• If you have never had any personal or professional experience with ADHD, do you have any opinion about the fact that the defendant has ADHD? a. If so, what is your opinion? b. Could you completely ignore that if you were a juror in this case?

His lawyers did not succeed in getting them past the judge. Prosecutors pushed back, seeing it, as Fortune put itas “an attempt by Bankman-Fried to work the refs—the jurors, in this case—before the trial begins.”

Court filings place SBF’s formal diagnosis with ADHD in 2020shortly after FTX began making tons of money—and right before he went on a spending spree, paying $135 million to put his company’s name on a stadium in Miami, for example. (Two years later Fortune would dub him the “next Warren Buffett.)

But all of that followed his success building up his crypto hedge fund—successful enough, anyway, to allow SBF to jumpstart FTX.

If you can accomplish that much without stimulants, do you really need stimulants? This is one of those impossible questions that even reputable psychiatrists disagree on. Kenneth Applebauma forensic psychiatrist at UMass Chan Medical School told me that if a person functions successfully without treatment—as in they get an enormously tricky enterprise off the ground—then it’s unlikely they actually have ADHD.  “If symptoms are uncontrolled, success is unlikely at cognitively demanding endeavors that require attention and focus, such as running a complex business,” he said. (He fears that overdiagnosis “can unintentionally minimize the impairment and distress of people who truly can’t function because of their disorders.”)

David Can, a forensic psychiatrist who works with lots of entrepreneurs, sees it differently. “ADHD often helps these entrepreneurs get where they are,” he said. Indeed, these individuals may have attentional, organizational, and time-management issues, but they also see the world in a different way, have tons of ideas, seek out novelty and take risks, all of which “aligns well with modern Silicon Valley.” The fact that someone performs well with stimulants does not mean they have ADHD. But neither does pre-diagnostic success mean that they don’t.

If SBF does have ADHD, he’s far from an outlier in the criminal justice system. Ten to 50 percent of inmates in prison have ADHD, according to estimates by the Attention Deficit Disorder Association and the Bureau of Prisons. That’s a far greater incidence than the four to 16 percent range those same entities offer up for the general population.

Most of these people’s lawyers do not bother to blame ADHD, though, because there is no history of that working.

“My understanding is that anytime ADHD has been used in a trial either in determining guilt or mitigating sentencing, it has not succeeded,” Russell Barkley, a neuropsychologist who has written numerous books on ADHDtold me.

Perhaps the most high profile (failed) attempt came in the case of Stewart Parnell, the former president of the Peanut Corporation of America. Between 2008 and 2009, peanut butter contaminated with salmonella killed at least nine people and sickened thousands. Evidence emerged that employees knew about the contamination and pushed to continue using salmonella-tainted paste anyway. Yes, his company engaged in fraud, but he was not aware of it, Parnell insisted. To back this up, he hired a neuropsychologist to testify that his ADHD made him too inattentive to serve as quality control manager.

“Mr. Parnell was and remains cognitively incapable of fielding, delineating, organizing, and integrating the daily plethora of phone calls and emails required in managing three companies,” Joseph Conley, Jr. wrote.  The government hired its own neuropsychologist, who countered that cognitive tests failed to show that Parnell was incapable of understanding e-mails.

So far, SBF’s defense has not given any indications that it will attempt to formally introduce ADHD on the stand. Martin Auerbacha former federal prosecutor who has represented clients in many high-profile white-collar-crime cases, noted that there aren’t any relevant witnesses scheduled to testify.

The risk of a half-assed strategy is that jurors may miss it. In 2001, federal prosecutors charged billionaire Alfred Taubmanthe chairman of Sotheby’s Holdings, of conspiring with his company’s rival, Christie’s, to fix fees that they charged auction house sellers. Auerbachwho represented a client who testified in the trial,  recalled that though the defense did not attempt  an ADHD tactic, it employed a similar strategy in absolving Taubman of responsibility for defrauding sellers of commissions. Yes, Taubman, who was in his 70s,  had been present w hen price-fixing had been discussed but he was actually asleep.

Taubman reinforced its believability by nodding off at a pivotal moment in the trial. But much to Auerbach’s surprise, the defense chose not to draw attention to his client’s courtroom snoozing in closing statements. He was convicted.

Nitish Pahwa contributed reporting.

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