It's great to hear that the author got a diagnosis for their condition (I hope that "condition" is not too unsuitable a word). I'm not very familiar with such things, but I can imagine that could be an important first step to understand and mitigate it.

But it seems to me that they're still some way off from understanding their condition. They characterise it as having "extremely high standards" or not being able to tolerate things that are "wrong or incorrect" as well as others. But, from the rest of the post, it sounds like the real issue is something else: where there are genuine engineering trade offs to be made, they get fixated on a single aspect at the expense of any others. When a decision has two or more dimensions to it (e.g. syntax cleanliness vs backwards compatibility, or language flexibility vs simplicity), then someone fixated on a single dimension is always going to be unsatisfied by the decision of someone who tries to make a careful balance.

One result of this is that their language to describe their situation continues to problematic. If you disagree with someone, then it's fair to say "sorry, I disagree, I guess aspect X is more important to me whereas aspect Y seems more important to you". But it's unhelpful to say "sorry, I guess I just have trouble tolerating how wrong you are".