Trump and mental illness

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Donald Trump’s behavior is so far outside the norm that many people (including mental health professionals) have suggested that he is mentally ill. The most common suggestions I’ve seen are that he suffers from narcissistic personality disorder (NPD), antisocial personality disorder (ASPD, also known as sociopathy), or a combination of the two (known as malignant narcissism). There is also widespread concern about cognitive decline.

I looked up the diagnostic criteria for NPD and ASPD, and it’s shocking how many of the boxes Trump ticks. Here are the criteria for NPD according to the American Psychiatric Association’s diagnostic manual, the DSM-5-TR:

Narcissistic Personality Disorder (301.81 [F60.81])

Diagnostic Criteria

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
  4. Requires excessive admiration.
  5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
  7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
  8. Is often envious of others or believes that others are envious of him or her.
  9. Shows arrogant, haughty behaviors or attitudes.

I would argue that Trump meets all 9 of those criteria. Only 5 are required for an NPD diagnosis.

Here are the criteria for ASPD:

Antisocial Personality Disorder (301.7 [F60.2])

Diagnostic Criteria

A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

  1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
  2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
  3. Impulsivity or failure to plan ahead.
  4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
  5. Reckless disregard for safety of self or others.
  6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
  7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

B. The individual is at least age 18 years.

C. There is evidence of Conduct Disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a manic episode.

I’d say that Trump meets all of the numbered criteria except #4. Only 3 are needed for an ASPD diagnosis. He’s certainly irritable and aggressive, but I haven’t heard reports of any physical altercations. He meets criteria B and D, but I don’t know enough about his early life to comment on criterion C, which is Conduct Disorder.

Anyway, the point is not whether Trump would qualify for a formal diagnosis. Diagnosis or no, any person who meets that many criteria for both NPD and ASPD is manifestly unfit for office.

421 thoughts on “Trump and mental illness”

  1. Cross-posting from another thread since it’s relevant to Trump’s psychology:

    Allan:

    On the bright side: big ballroom. And look at this gold detailing. You’ve got to tighten your belts; ostentation is not going to pay for itself.

    He’s lining up donors to pay for it, so the taxpayers won’t be footing the bill. Which is worse in my opinion, since he’s so corrupt and easily bought. The two donors I know about are Google and RJ Reynolds.

    He’s so obsessed with gold that in the White House, even the TV remote is gilded. I’m not kidding.

    A look at what it says about him:

    A Psychologist Reveals What Trump’s Fixation with Gold Really Means

    As if his other offenses weren’t bad enough, we have to endure the tacky Oval Office backdrop every time he hosts a meeting there.

    His tastelessness even extends to food. He likes his steaks well done and puts ketchup on them. His former butler said “It would rock on the plate, it was so well done.”

    ETA: A photo I took in Sandpoint, Idaho:
    ketchup-Small

  3. The Nobel Peace Prize winner will be announced in a few hours, and the world is bracing for a tantrum from the Toddler in Chief if he doesn’t win it. Norway in particular:

    Norway braces for Trump’s reaction if he does not win Nobel peace prize

    Think about how pathetic it is that anyone anywhere in the world actually has to worry about that. Try to imagine Biden, Obama, Bush or Clinton throwing a tantrum after being passed over for a Nobel. It’s impossible. They aren’t toddlers, and they all understood that being President requires a modicum of dignity.

    Not Trump. With him, it’s easily imaginable.

  4. The Nobel debacle is amusing. I’m not so sure Obana should have received it, certainly not in his first year, but Trump would be ineligible given nominations close in January. To say nothing of his aggression towards Greenland and Denmark, his troops on the streets against the wishes of local authorities, his weakness with Putin and Netanyahu.

    What’s funny is his ceaseless campaigning for it. It’ is unseemly. Bringing peace should be its own reward. But it’s the measure of the man that he wants a trinket and praise, and his fans are apoplectic on his behalf, which raises a smirk. I am a small, small man in many ways! Cope harder, as right-wingers are fond of saying.

  5. Allan Miller: I’m not so sure Obana should have received it, certainly not in his first year, but Trump would be ineligible given nominations close in January.

    Nobel committee has acknowledged that giving the prize to Obama was a mistake of historic proportions. Also the track record of prizes related to Palestine conflict is very bad, lots of people of all sorts on all sides getting those prizes, but still no lasting peace, so the committee is cautious with regard to Palestine.

    However, they still ended up half-giving the prize to Trump by giving it to Venezuelan opposition leader whose main activity is to invite Trump to invade Venezuela. Yet another flawed decision, to put it mildly.

  6. Erik:

    However, they still ended up half-giving the prize to Trump by giving it to Venezuelan opposition leader whose main activity is to invite Trump to invade Venezuela. Yet another flawed decision, to put it mildly.

    Trump says they talked and that she told him he should have won. She understands, like everyone else in the world except for Trump himself, that the way to manipulate him is to flatter him.

  7. keiths: Trump says they talked and that she told him he should have won. She understands, like everyone else in the world except for Trump himself, that the way to manipulate him is to flatter him.

    To what end does she manipulate Trump? According to New York Times,

    After the United States began bombing suspected drug boats in the Caribbean last month, she said in an interview to Fox News: “This is about saving lives, not only Venezuelan lives, but also lives of American people, because as you have said, and we have heard, Maduro is the head of a narco-terrorist structure of cooperation.”

    Ms. Machado, in statements to the press in recent weeks, has said that, should Mr. Maduro fall, her movement was prepared to take territorial and administrative control of Venezuela.

    She has also promoted an economic plan to U.S. and other investors, saying that a democratic Venezuela under her movement’s control has the potential to generate $1.7 trillion in wealth in 15 years, in part by privatizing the oil industry.

    This goes far beyond mere flattering. This Nobel Peace Prize laureate encourages Trump to engage in more war crimes because it is “saving lives” and she promises to give Venezuela’s oil to Trump if Trump helps her to power.

    But yeah, maybe the Norwegian Nobel committee also understands that the way to manipulate Trump is to flatter him, and it is always a good idea to manipulate…

  8. This thread has mostly been about Trump’s evident personality disorder(s), but his cognitive decline is also worth discussing. He posted this on Truth Social yesterday:
    biden-FBI-Phone

    “Biden’s FBI”? Trump had been president for four years on January 6. It was Trump’s FBI.

    Off the top of my head, I also remember these:

    — He forgot that he appointed Jerome Powell

    — Regarding the USMCA, he asked “Who would ever sign a thing like this?”, forgetting that he was the one who signed it

    — He confused Nikki Haley with Nancy Pelosi

    — In one meeting, he was looking around the room for a man who was sitting right in front of him

    — He claimed that his uncle taught Ted Kaczynski, which is impossible

    — He forgot the name of an ocean during an interview on Fox

    — He has claimed more than once to have ended a war between Azerbaijan — which he can’t pronounce — and Albania. Armenia, not Albania, is the country that Azerbaijan was fighting

    — He couldn’t pronounce “acetaminophen” during his autism/Tylenol debacle

    — He forgot that he never ran against Obama

    — He thought that Obama was in office in 2023, not Biden

    Add to these his inability to speak coherently and maintain a train of thought, plus his weird and erratic behavior.

    As Madeleine Dean said (and Mike Johnson agreed) Trump is “unhinged” and “unwell”. He’s also President. Thanks, Trump voters.

  9. keiths,

    What’s remarkable about the ‘FBI’ story is how readily MAGAs are swallowing it. Even when you directly show them that Trump was in charge then. They’re pretty much admittimg to being pathetically easily led, if an FBI agent or Antifa can get them to riot (yet the guy saying “fight like hell” had nothing to do with it). One guy saying “I went to prison for this scam”, though he pled guilty and offered no defence of entrapment. The FBI made me break the law. Cognitive dissonance at its finest.

  10. Trump:

    They are right in the middle of everything. Other countries are there, but they’re an hour, an hour and a half away. A big difference. They’re literally — you walk over from Iran to Qatar, you can walk it in 1 second. You go boom boom and now you’re in Qatar. That’s tough territory.

    He’s absolutely right, provided you can walk (or run) on water at a speed of over 400,000 mph.
    qatar-Phone

  11. Allan Miller:
    keiths,

    What’s remarkable about the ‘FBI’ story is how readily MAGAs are swallowing it. Even when you directly show them that Trump was in charge then. They’re pretty much admittimg to being pathetically easily led, if an FBI agent or Antifa can get them to riot (yet the guy saying “fight like hell” had nothing to do with it). One guy saying “I went to prison for this scam”, though he pled guilty and offered no defence of entrapment. The FBI made me break the law.Cognitive dissonance at its finest.

    If it says so on Fox News, it must be so. After all, Fox News never said it wasn’t true…

  12. Here’s a nice example of Trump’s narcissism. Time put Trump on its cover in celebration of the Israel-Gaza peace agreement:
    Trump-Time-cover-Phone

    This was Trump’s reaction on Truth Social:

    Time Magazine wrote a relatively good story about me, but the picture may be the Worst of All Time. They “disappeared” my hair, and then had something floating on top of my head that looked like a floating crown, but an extremely small one. Really weird! I never liked taking pictures from underneath angles, but this is a super bad picture, and deserves to be called out. What are they doing, and why?

    A normal person would be chuffed to have their picture on the cover of Time, and while they might not like the photo — and Trump’s portrait is ugly — they’d shrug it off and enjoy the moment. They certainly wouldn’t whine about it.

    But this is Trump, and the cover photo wounded his vanity, and so suddenly that is the important issue. Me, me, me — “Why didn’t I get the Nobel?” “Why didn’t anyone thank me for the food aid?” “Why did they use a photo that makes me look ugly?” “Why didn’t they give me credit for warning about bin Laden before 9/11? [which he didn’t do.]

    Trump’s Time-related narcissism goes back a long way. During his 2016 presidential campaign, it was discovered that he had hung a phony Time magazine cover in several of his golf clubs:
    Trump-fake-Time-cover-Phone

    One glance and you can tell it’s a fake. No editor would approve a cover that shitty. On a real Time cover, there would be no exclamation points. Instead of

    The “Apprentice”

    it would either read

    “The Apprentice”

    since “The” is part of the name of the show, or they would have used italics and left off the quote marks.

    Also, a real cover would not spell it as “Health-Care”.

    Here we have a guy who is so pathologically narcissistic and insecure that he feels the need to fake a Time magazine cover and hang it all over the place, in hopes that it will make people admire him. A guy who isn’t smart enough to find a competent person to do the faking for him and doesn’t run it past other competent people to make sure it looks genuine.

    Imagine there were a guy in your social circle who hung fake awards in his office and on the walls of his home. You’d think that was pathetic, right? (I remember that in addition to the fake Time cover, there was also some sort of “Man of the Year” award in Michigan that Trump claimed to have won. That award doesn’t exist. Trump made it up.) You and your friends would laugh at the guy behind his back for being so narcissistic, or you might pity him for his insecurity. Yet MAGA cult members manage to look past it when it’s their Dear Leader doing those things. It’s a true blindness.

    ETA:
    Gavin Newsom trolled Trump with this version of the photo, lol:
    Trump-Time-cover-censored-Phone

    He has a point.

  13. Trump:

    We wouldn’t have had — you know there’s Pete Buttigieg, he spent billions of dollars on fixing the air traffic control. They used copper wire going into glass wire. Any union electrician here or any non-union electrician would say you can’t hook copper into glass. It doesn’t work. They spent billions of dollars, they turned on the system, and it was stone cold blank.

    He actually believes that. Can you imagine trying to navigate life, much less the presidency, with a brain that defective? If Trump didn’t have staff to take care of him, could he even survive on his own?

  14. I’ve commented before on how Trump’s cheating at golf, while a minor thing in itself, is scary because it reflects the kind of person he is — insecure, dishonest and lacking in conscience. Here’s Sam Harris reflecting on how it reveals Trump’s psychopathology:

    This Is Why Trump Cheats at Golf

    A couple of excerpts:

    It is central to Trump’s life. He spends 30% of his time on the golf course… Golf is the center of his life, and he cheats at it in ways that should be impossible…

    Pretending to have won, literally stealing the title of a club championship from its rightful winner by lying, right, and putting your name on the wall attesting to your victory. I mean, to call it sociopathic doesn’t even quite get at it. I mean, there’s really…it is the most bizarre… it’s so far out on the tail end of aberration of human behavior, again, given the relevant cultural norms surrounding the whole project [of golf]. It’s just — it’s almost uninterpretable. I mean you literally, you have never met anyone who has ever met anyone who would behave this way, and this guy is President of the United States.

    Jaron Lowenstein, who’s chatting with Sam, comments that in golf, much of the point is “playing the course” — testing your skills against the difficulties of the course as much as trying to outdo the other players.

    Sam responds:

    It’s like cheating at prayer, or something. It’s insane. It’s not insane in the sense of being psychotic, delusional, but it is morally insane.

    He’s right. Antisocial personality disorder — sociopathy — really is a form of moral insanity. That’s Trump.

  15. I get it why for Sam Harris, with his heightened sense of morality, moral insanity would seem a big problem. But this is not only Trump’s problem and not his main problem. Moral insanity is not even a specific new-found form of insanity – it is simply the absence of morality. It begins with the general attitude of the class of the powerful that rules are for other people, not for themselves, and it ends with absolute selfishness, total lack of consideration for anyone or anything else.

    But ever since he became the president (and then the president again), the main problem of Trump is his dementia, senility, the general deterioration of his mental health and all health. He deploys an army of collaborators to cover up his flaws and prop up his malignant narcissism. And his collaborators can only be mentally and morally broken like himself. It is a big problem for the whole country that these are the people who make up the government.

  16. Erik:

    But ever since he became the president (and then the president again), the main problem of Trump is his dementia, senility, the general deterioration of his mental health and all health.

    The dementia is a big problem, but I’ll stress that malignant narcissism is a lifetime condition. Trump has been a horrible person his entire life. From earlier in the thread:

    I have since learned more about Trump’s early life, and I’m sure no one will be surprised at what I discovered. Among other things, as a kid, Trump got caught throwing rocks at a toddler in a playpen. At military school, he fought with a fellow student and tried to push him out of a second story window. He was widely known as a bully. Great kid.

    I’ve only watched the beginning of the Gartner video, but I recommend people watch his brief recitation of Trump’s words, starting here. Whenever the Orange Moron opens his mouth, our expectations are so low that we no longer feel the full impact of his stupidity and excessive self-regard. When you hear it in somebody else’s voice, it hits you full force.

  17. The Toddler in Chief is at it again:

    CANADA CHEATED AND GOT CAUGHT!!!They fraudulently took a big buy ad saying that Ronald Reagan did not like Tariffs, when actually he LOVED TARIFFS FOR OUR COUNTRY, AND ITS NATIONAL SECURITY. Canada is trying to illegally influence the United States Supreme Court in one of the most important rulings in the history of our Country. Canada has long cheated on Tariffs, charging our farmers as much as 400%. Now they, and other countries, can’t take advantage of the U.S. any longer. Thank you to the Ronald Reagan Foundation for exposing this FRAUD. MAKE AMERICA GREAT AGAIN!!!

    Trump is such a baby that he actually ended trade talks with Canada over this.

    The ad was accurate. All it did was rearrange the order of clips from Reagan’s speech without changing the meaning in the slightest. Reagan was a staunch free trade advocate and would have been disgusted by Trump’s tariff policy.

    Canada’s anti-tariff ad

    Reagan’s speech (only five minutes long)

    It’s so weird that Republicans who support Trump also revere Reagan, totally blind to the fact that Reagan would be horrified by what Trump is doing. Besides the tariff fiasco, try to imagine how Reagan would have reacted to Trump cozying up to dictators, invading American cities, tearing down the East Wing, accepting bribes, and screwing Ukraine and backing Russia, for starters.

    Bill, Trump says that Reagan “LOVED TARIFFS”. Watch the ad and the Reagan speech and tell us what you think. Is Trump telling the truth?

  19. In case anyone had doubts, ABC reports:

    President Donald Trump will likely name his new $300 million White House ballroom after himself, according to senior administration officials.

    Already, officials are referring to it as “The President Donald J. Trump Ballroom.” That name will likely stick, ABC News was told.

    Trump has not publicly said what he intends to name the ballroom, but he is known for branding his construction projects after himself — and it appears this project will be no different.

    When asked by ABC News Chief White House Correspondent Mary Bruce on Thursday if he has a name for his ballroom yet, Trump smiled and said: “I won’t get into that now.”

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