Trump and mental illness

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.

395 thoughts on “Trump and mental illness

  1. Trump Liewatch: London, with its terrible, terrible mayor (a Muslim) is under Sharia law. This is bullshit. Is he lying or deluded? In any country, Muslims may choose to have a Sharia court act as a mediation service in certain civil matters. But the law of the land remains paramount.

    I set great store by honesty and integrity. MAGAs, not so much.

  2. Allan Miller,

    available myself

    *avail myself, of course. Frigging autocorrect! I also typed that out in a waiting room while pupil-dilating eye drops were taking effect..

  3. Allan Miller:
    Trump Liewatch: London, with its terrible, terrible mayor (a Muslim) is under Sharia law. This is bullshit. Is he lying or deluded? In any country, Muslims may choose to have a Sharia court act as a mediation service in certain civil matters. But the law of the land remains paramount.

    I set great store by honesty and integrity. MAGAs, not so much.

    You don’t need any formal recognition of Sharia if it’s just voluntary contracts that are compliant with the host country’s contract law. For example, a lender could just assess upfront fees and pretend a loan is interest free.

  4. petrushka: You don’t need any formal recognition of Sharia if it’s just voluntary contracts that are compliant with the host country’s contract law. For example, a lender could just assess upfront fees and pretend a loan is interest free.

    Are you saying that it’s true that London is under Sharia law as Trump says? The other option is that, as usual, you say stuff without having any point or meaning.

  5. petrushka: You don’t need any formal recognition of Sharia if it’s just voluntary contracts that are compliant with the host country’s contract law. For example, a lender could just assess upfront fees and pretend a loan is interest free.

    It is still a complete fabrication. Trump is clearly not stating what any Muslim in any country can choose to do.

  6. This dismal rightwing trope regularly does the rounds. No surprise to hear it from Trump’s mouth; he’s as gullible as the rest. As if everyone in the area will be forced to wear a beard, attend prayers and lose a hand for stealing a loaf.

    Muslims in any country can choose arbitration in civil disputes from within their own community.

  7. Alan Fox:
    Islam is the way of peace.

    (It is said.)

    Hmmm. I see the ‘religion of peace’ thing, with heavy irony, from right-wingers all the time. Most Muslims are peaceful. Tarring an entire group with the ills of the few is the same attitude as Musk’s “the left is the party of murder’.

  8. Down the road from us, a group of Muslim medics at Barrow hospital initiated the building of a mosque at nearby Dalton. Work is well underway. And… there are protests. Because of course there are. I cannot fathom it. Sadly, friends have ‘liked’ the Facebook page of the protest group.

    In other news, departments are closing at Barrow hospital because they can’t attract staff. I’m not saying a mosque would necessarily make the difference in recruitment. But it wouldn’t hurt. Instead we’re sending the opposite message: Not Welcome Here.

    A large far-right rally in London had a succession of speakers urging the complete outlawing of all the trappings of all non-Christian religions. Musk popped up by video link: “the left is the party of murder”, and “violence is coming”. “I completely agree with Musk” said a Facebook friend, who I’d have thought left-wing on casual acquaintance, but turns out to be a big fan of Tommy Robinson, organiser of the Muslim hatefest. I asked her what she thought about the mosque. Silence spoke volumes. Worrying times.

  9. Jimmy Kimmel’s monologue last night (well worth watching in its entirety) included a montage of Trump saying “Don’t take Tylenol” more than two dozen times during that moronic event.

  10. keiths:
    Stock chart of Kenvue, the maker of Tylenol:

    Wouldn’t surprise me if Trump & Co. had been shorting the living hell out of it since the day they concocted that crap about Tylenol causing autism.

  11. dazz:

    Wouldn’t surprise me if Trump & Co. had been shorting the living hell out of it since the day they concocted that crap about Tylenol causing autism.

    Wouldn’t surprise me either. Maybe that’s what Tom Homan used his $50,000 for. Accept a bribe, and then invest it fraudulently. Corruption on both ends.

  12. In the latest version of Us blaming Them, Jesse Watters and Karoline Leavitt agreed on Fox News that the escalator and teleprompter malfunctions at Trump’s UN appearance were the result of sabotage by “UN globalist staffers.” It had already been discovered, hours before, that both of those problems were caused by White House staffers, not UN personnel. But hey — far be it from Watters and Leavitt to let a good conspiracy theory go to waste.

    In reality, the escalator safety shutoff mechanism was accidentally triggered by a White House videographer, and Trump’s teleprompter was operated by White House staff, not UN personnel.

  13. I’m donning my tinfoil hat and I’ll say all this crap about Tylenol is yet another trick straight up from the social Darwinist playbook: if autism is caused by Tylenol (or vaccines), that means if you have it, it’s your parent’s fault and no one else’s. Don’t ask for help from the government, it’s all about personal responsibility, you know.

  14. Alan Fox: was invented around 50 years ago. Acetaminophen was invented/discovered in 1878. I rest my case.

    And perhaps more importantly, there’s plenty evidence (according to Gemini) that autistic people existed well before Acetaminophen was invented in the XX century.

  15. dazz, Oh, I’m sure autism as variation from the norm is as old as humankind, if not older. Evolutionary selection always needs something to work with. I was being a bit flippant with autism as a name only arising in the sixties.

  16. Criterion number one for narcissistic personality disorder is

    Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

    There were so many striking examples of that during Trump’s autism debacle. Here are some of them:

    I want to thank the man who brought this issue to the forefront of American politics along with me, and we actually met in my office, is it like 20 years ago, Bobby? It’s probably 20 years ago, in New York. I was a developer, as you probably heard, and I always had very strong feelings about autism and how it happened and where it came from. And he and I — I don’t know. The word got out and I wouldn’t say that people were very understanding of where we were, but it’s turning out that we understood a lot more than a lot of people who studied it, we think.

    A dim-witted real estate developer and a crackpot, neither with any scientific or medical training, spitballing in an office 20 years ago, and they had autism all figured out, unlike the scientists who studied it for a living. He really seems to believe it. Could there be a more quintessential demonstration of grandiosity?

    Even if they had turned out to be right, by sheer luck, it wouldn’t have validated what two untrained idiots were speculating about in an office 20 years ago. But he thinks they had some sort of special insight that the eggheads lacked.

    The MMR, I think should be taken separately. This is based on what I feel.

    What you “feel” is irrelevant, moron. What does the science say? But he truly believes that what he feels is more important and trustworthy than the results of decades of research. Pathological grandiosity writ large.

    You know, I’m just making these statements for me. I’m not making them from these doctors because when they, uh, they talk about, you know, different results, different studies, uh, I talk about a lot of common sense.

    Ignore the studies. My common sense is superior. Trump is right about everything.

    And I feel very certain, and I know I’ll be criticized. Some day, they’ll look back and they’ll say, well, it wasn’t, but I think it will. I think we’re going to have a tremendous — I want — this is one of the most — this is the most important.

    That’s a beautiful example of Trumpian linguistic dysfunction, so it’s hard to translate it into intelligible speech, but he seems to be trying to preempt the criticism by saying “You may mock me now, doubters, but just you wait. History will vindicate me!” Which is one of Bill’s tactics, too. His Dear Leader may look like an idiot now, but history will recognize his greatness in retrospect.

    We cured inflation that Biden gave us. He gave us so much inflation, the biggest ever in history. We got inflation done. We brought prices down. We gave you the largest tax cuts, all that stuff…

    And I — I will consider this — I believe, you know, with the wars, I’ve stopped seven different wars. I’ve saved millions of lives. I’ve done a lot of things.

    It wouldn’t be a Trump appearance without false boasts on completely unrelated topics. From the criterion: “exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements.” That is a defining trait of Trump’s character.

    It’s textbook narcissism.

  17. keiths: It’s textbook narcissism.

    Trump is also a good example of textbook Antichrist https://biblehub.com/top10/signs_of_the_antichrist_in_scripture.htm

    1. Denies the True Identity of Jesus

    2. Operates in Lawlessness

    3. Exalts Himself as God

    4. Conjures Powerful Deception

    5. Draws People into False Worship

    6. Blasphemes God

    7. Rules with a Ruthless Grip

    8. Performs Fake Miracles to Mislead

    9. Connected to the Mysterious Number

    10. Appears Just Before Christ’s Ultimate Triumph

    I can see why Christians love him so much – the Bible predicted they would.

  18. Haha. Being the Antichrist certainly counts as a personality disorder, so that’s number three for Trump.

  19. Trump boasts incessantly partly because he thinks it causes people to admire him, but some of his boasting seems more like self-reassurance to me. His audience is himself. It’s the Trumpian version of Stuart Smalley’s affirmation: “I’m good enough, I’m smart enough, and doggone it, people like me.”

    He’s staving off narcissistic collapse. For instance, repeatedly insisting that his poll numbers are sky high, against all evidence, is his way of reassuring himself that he’s a great guy who everybody loves. The reality would puncture his self-image, so he simply ignores or denies it.

    One of the things that worries me is that when a narcissist’s self-image is threatened, they will go to great lengths to shore it up. That can make them dangerous. Every time he suffers a humiliation, like ABC putting Kimmel back on the air, I ask myself “What crazy, idiotic thing is he going to do now, to compensate?”

    I know a very smart narcissist whose self-image is inflated and fragile, like Trump’s. Unlike Trump, she’s savvy enough to know that excessive boasting looks ridiculous, so she goes in the other direction. She almost never boasts, and to people who only know her casually, she truly seems to be modest. She’s smart and successful and there’s a lot that she could boast about, if she chose to, but she doesn’t. She’s extremely proud of being so modest. People who know her well can see the contradiction, but others just see the modesty.

    Unlike her, Trump seems to have no idea how ridiculous his relentless self-aggrandizement makes him look.

  20. So Trump is authorising troops to use lethal force against US citizens. And claiming that the FBI (under his appointee) orchestrated J6 (while he did nothing for 3 hours…).

    All perfectly normal.

  21. Allan:

    So Trump is authorising troops to use lethal force against US citizens.

    Despite having been told by the courts that sending troops into an American city is illegal, despite not having spoken to the governor and the mayor before his decision, despite the fact thay don’t want or need troops there, and despite the fact that Portland isn’t “war-ravaged” and ICE facilities are not “under siege”.

    Trump is sending those troops to incite violence, not to quell it.

  22. After a conversation with Oregon governor Tina Kotek in which she patiently explained that there was no unrest in Portland and that troops were not needed, Trump said:

    I spoke to the Governor, she was very nice. But I said, “Well wait a minute, am I watching things on television that are different from what’s happening? My people tell me different. They are literally attacking and there are fires all over the place.”

    It’s the usual diagnostic dilemma: is he being stupid here, or dishonest, or both?

    Unlike an intelligent person, Trump isn’t the kind of guy who can do online research to figure out what’s true and what’s false, so it’s quite possible that he saw something bogus on TV or social media that he stupidly believed. I know that people have been circulating video of the 2020 Portland protests and claiming that it’s current footage, so there’s a good chance that Mr. “He has MS13 tattooed on his knuckles!” saw it and fell for it.

    He’s also stupid enough to ignore what the governor was telling him about what was going on in her own state.

    However, it’s also possible that he’s deliberately playing dumb in order to excuse his decision to break the law and send troops.

    Idiotic? Malevolent? Both?

  23. Trump has been involved in several mental illness incidents meanwhile that have not made it into this thread, but here’s one worth typing up now: Medbeds. Namely, Trump posted an AI video featuring Lara Trump and himself announcing medbed health treatment and medbed cards for every citizen. The video stayed up for 12 hours until deletion.

    What is a medbed, you might ask. “Medbeds (“medical beds” or “meditation beds”) are the subject of a conspiracy theory alleging there are beds that can cure any condition.” https://en.wikipedia.org/wiki/Medbed

    The Wikipedia page has been updated for Trump’s video, “On September 27–28, 2025, an apparently AI-generated video styled as a breaking news clip from My View with Lara Trump on Fox News, claiming that a rollout of “MedBed hospitals” and “MedBed cards” was imminent, was posted to Donald Trump’s account on Truth Social.”

    This was a post by a sitting president on his official account where he announces his political assaults and tariff deals, among others. Whether the medbed video was an official promise or just a prank, the poster firmly declares himself part of the related conspiracy theory gang. And it is far from the first such online idiocy by Trump and far from the last. The guy seems to begging for removal for office, but there is nobody to do it. It is USA, baby.

  24. keiths:
    Here’s his latest. This was after he met those guys today to discuss a way out of the looming government shutdown.

    My guess is that this is so normal in Trump universe that he will not delete it. Look at all the likes. I will check back in a month.

  25. This National Security Presidential Memorandum NSPM-7 is definitely not going to be deleted. It says,

    These movements [namely Antifa] portray foundational American principles (e.g., support for law enforcement and border control) as “fascist” to justify and encourage acts of violent revolution. This “anti-fascist” lie has become the organizing rallying cry used by domestic terrorists to wage a violent assault against democratic institutions, constitutional rights, and fundamental American liberties. Common threads animating this violent conduct include anti-Americanism, anti-capitalism, and anti-Christianity; support for the overthrow of the United States Government; extremism on migration, race, and gender; and hostility towards those who hold traditional American views on family, religion, and morality.

    https://www.whitehouse.gov/presidential-actions/2025/09/countering-domestic-terrorism-and-organized-political-violence/
    If anyone of you forgot McCarthyism meanwhile, it’s back. Edicts worded like this also enabled Bolshevist-Stalinist era repressions.

  26. Illinois governor JB Pritzker, after Trump’s demented speech to the generals:

    There is something genuinely wrong with this man and the 25th amendment ought to be invoked.

    It’s one of the few things that Pritzker and Mike Johnson agree on: Trump is unwell.

  27. Video of Trump being mocked by world leaders

    From an article in Politico:

    U.S. President Donald Trump’s geographic confusion was the butt of a joke between world leaders at a summit Thursday.

    Albanian Prime Minister Edi Rama was filmed poking fun with French President Emmanuel Macron and Azerbaijan’s President Ilham Aliyev at the European Political Community meeting in Copenhagen on Thursday.

    “You should make an apology … to us because you didn’t congratulate us on the peace deal that President Trump made between Albania and Azerbaijan,” Rama told Macron, leading Aliyev to burst out laughing.

    “I am sorry for that,” Macron joked.

    Trump has repeatedly confused Armenia and Albania when talking about his efforts to resolve the long-standing tensions between Armenia and Azerbaijan.

    “I solved wars that was unsolvable. Azerbaijan and Albania, it was going on for many, many years, I had the prime ministers and presidents in my office,” he said during an appearance on Fox News last month.

    And during a joint press conference with British Prime Minister Keir Starmer, Trump said, “We settled Aber-baijan and Albania,” butchering the name of one South Caucasus country and confusing the other one entirely.

    ETA: I should add that he also recently confused Azerbaijan with Cambodia:

    Cambodia and Armenia, it was just starting, and it was a bad one.

    As Pritzker said: there is something genuinely wrong with this man.

  28. Screenshot-2025-10-03-103843

    Trump posted that yesterday on Truth Social.

    colewd to Allan, a couple of weeks ago:

    What you guys accuse Trump of is something you practice more aggressively than he does. In the case of Keiths he makes Trump look like a choir boy.

    That didn’t age well.

    Bill, what do you think of your “choir boy’s” post? Can you summon the courage to criticize him for it, like any decent person would? If you do, will it be something anodyne like “Trump isn’t always the most gracious to his opponents, but you know how politicians are”?

    How would you have reacted if Biden had called Republicans “THE PARTY OF HATE, EVIL, AND SATAN”?

    For once, could you not dodge the question? Tell us honestly how you would have reacted.

  29. jeffries-trump-2028

    That photo is real, as verified by Snopes and reported in the press. Those are ‘Trump 2028’ hats sitting on Trump’s desk during negotiations with Democratic leaders.

    From an article in The Independent:

    “When he tried to hand you that Trump 2028 hat, what was your reaction?” Phillip asked Jeffries Tuesday evening.

    “Well, actually, he did not try to hand Leader Schumer and I the Trump 2028 hat. They just randomly appeared in the middle of the meeting on the desk,” said Jeffries. “It was the strangest thing ever.”

    There was then an awkward moment involving Vice President JD Vance.

    “I just looked at the hat, looked at JD Vance, who was seated to my left, and said, ‘Don’t you got a problem with this?’ and he said, ‘No comment,’” Jeffries revealed. “And that was the end of it.”

    Bill, how would you have reacted if Obama had put ‘Obama 2016’ hats on the Resolute Desk during negotiations with Republicans? How would the entire Republican party and right-wing media ecosystem have reacted? Are you familiar with the term ‘double standard’?

    Do you believe that your Dear Leader actually wants to “preserve, protect and defend the Constitution of the United States”, as he swore on Inauguration Day? How do you feel about the Constitution? Something worth upholding, or just an annoying hindrance to your Dear Leader’s authoritarian ambitions?

  30. I’d like to remind those who are interested in the standards of mental health illness that people who benefit form those standards set.
    1. A kid who is shy now has been labeled as a mental patient with generalized anxiety disorder.
    I’m not saying few kids of this group may use some help. But if you group shyness as a metal disorder, you can sell drugs… a lot if you know how…

  31. There are new poll numbers out indicating that almost half(!) of voters in swing congressional districts support impeaching Donald Trump. 49%. That’s massive, and it’s another indication of why Republicans are panicking and trying to gerrymander in order to steal the 2026 election.

    The pollster is Lake Research Partners. They’re Democrat-leaning, so I was a little skeptical of the numbers, but they have a solid reputation, and here’s what really boosted my confidence in the poll: they measured Trump’s job approval, and it came out at 56% disapprove, which is right in line with the major pollsters. First number is approval, second is disapproval:

    Pew Research           40% 58%
    Gallup                        40% 56%
    Quinnipiac University 38% 54%
    Economist/YouGov    43% 54%
    Morning Consult        46% 52%

    The fact that the approval numbers match with the major pollsters suggests that the Lake Research sample isn’t biased, which lends credence to the impeachment numbers.

  32. keiths: Do you believe that your Dear Leader actually wants to “preserve, protect and defend the Constitution of the United States”, as he swore on Inauguration Day?

    Did he swear? His hand was not on the Bible and there are some interesting theories and perhaps even legal implications to it, ranging from Second Coming of Christ to 25th Amendment.

  33. Erik:

    Did he swear? His hand was not on the Bible and there are some interesting theories and perhaps even legal implications to it.

    Though it’s traditional, the Bible is optional. The Constitution simply says:

    Before he enter on the Execution of his Office, he shall take the following Oath or Affirmation:– I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States, and will to the best of my Ability, preserve, protect and defend the Constitution of the United States.

    The “so help me God” that is tacked onto the end is also optional, like the Bible.

  34. A federal judge has issued a temporary injunction against Trump’s military invasion of Portland. Her ruling (and she’s a Trump appointee, by the way) is pretty brutal. She writes:

    Here, this Court concludes that the President did not have a “colorable basis” to invoke § 12406(3) to federalize the National Guard because the situation on the ground belied an inability of federal law enforcement officers to execute federal law. The President’s determination was simply untethered to the facts. [emphasis added]

    “Untethered to the facts”, Bill. You got suckered again.

  35. Another excerpt from the ruling:

    In this case, and unlike in Newsom II, Plaintiffs [the State of Oregon] provide substantial evidence that the protests at the Portland ICE facility were not significantly violent or disruptive in the days—or even weeks—leading up to the President’s directive on September 27, 2025. The record evidence establishes that while disruption outside the Portland ICE facility peaked in June of 2025, federal and local law enforcement officers were able to “quell . . . the disorder.” Newsom II, 141 F.4th at 1051 (quoting Sterling, 278 U.S. at 399–400). As of September 27, 2025, it had been months since there was any sustained level of violent or disruptive protest activity in Portland. During this time frame, there were sporadic events requiring either PPB monitoring or federal law enforcement intervention, but overall, the protests were small and uneventful.

    The protests were “small and uneventful”, as the judge (a Trump appointee) ruled. Now let’s look at Trump’s characterization of the situation. He said that Portland was “war-ravaged”, a “war zone”, “like WWII”, “like living in hell”. He said “Many people have been badly hurt, and even killed,” “It’s anarchy out there,” “People in Portland are literally attacking and there are fires all over the place.”

    All of that is false. The mayor and the governor told Trump that it’s false, and he sent troops anyway. Now a Trump judge has told him the same thing.

    Trump’s response? Since the judge ruled that he can’t send the Oregon National Guard into Portland, he’s sending the California National Guard instead.

    To tamp down non-existent chaos. It’s a pure personal power grab. Trump doesn’t care about the people of Portland. He cares about Trump.

    Do you support this, Bill? Will you run away from this question, like you’ve run away from the questions I raised above?

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