Found myself reading a thread of these, so, one one-worder from the 'verse:
“Deploy”.
Adm. Caliene Sargas
Although, really, the chillingness can’t be properly represented in text alone, insofar as it’s the complete lack of altered affect between “Deploy (the Megiddo Device).” and “Deploy (a nice hot cup of tea).”
I don’t think we’ve gotten any official diagnosis (especially insofar as their DSM likely differs from our DSM on the grounds of them knowing how minds work and all that). (It would be interesting to see some sort of report card from the MoHS.)
I think the admiral is still very sane and rational, by local standards (being trusted with Megiddo Devices to “deploy”), but also with very little empathy. (I think there’s a reference somewhere to the necessary stability and rationality standards necessary for licensure to possess nuclear weapons as a private citizen; I suspect the admiral could easily pass those standards.)
So, er, by humans standards, yes, she’s probably insane, but they all are by human standards.
(You can tell because she casually kills people when it’s ethically permissible and tactically expedient, rather than, say, when it would be a laugh. To quote one of her ancestors, General Traest:
“There is a time and a place to treat a military force as expendable. That time and place is when you have manipulated one of your other enemies into fighting on your side.”)
She is as sane as anyone on Earth cleared to handle and potentially employ nuclear weapons.
(Side note: The USN awards a Combat Pin for strategic deterrent patrols, having been awarded this pin is one of the acceptance clauses for the VFW. The pin is awarded for going out to sea and coming back with the same number of missiles onboard that you started with.)