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.

578 thoughts on “Trump and mental illness

  1. petrushka: Show me your facts.

    You mean facts you like, such as the fact that a judge in Finland just declared that sex by an adult with a ten year old girl isn’t really rape. Knowing that this is a fact for you, anybody can tell that you’re not a facts kind of person. You’re a MAGA/Qanon Trump cult propaganda brainwash immersion type of person.

  2. Flint:

    There will probably be a point reached where hiding the files is more politically damaging than publishing them.

    I hope so. For now, every day the coverup continues is evidence that whatever is still hidden is worse than what has already been revealed plus the political penalty of continuing the coverup. It must be pretty bad.

    ETA: The latest scam is that the DOJ has released a list of all the names that appear in the files, without explaining why each person was mentioned. No distinction between someone who was intimately involved with Epstein versus someone who was tangentially mentioned.

    The DOJ is desperately trying to seem transparent without actually being transparent. What a bunch of sleazy people.

  3. A Sky News article says that these people are on the list:

    Barack Obama, Margaret Thatcher, Mick Jagger, Elvis Presley, Marilyn Monroe, George Clooney, Beyoncé, Cher and Janis Joplin.

  4. keiths,

    “Cher” may be in because there are a few bits in French. “Chère Madame/Cher Monsieur”, or ironic usages – “trop cher to talk on my US phone”; “bisoussss mon cher”. Whatever else these files show, basic competence is not among them.

  5. Allan:

    “Cher” may be in because there are a few bits in French. “Chère Madame/Cher Monsieur”, or ironic usages – “trop cher to talk on my US phone”; “bisoussss mon cher”.

    What? You’re part of the coverup now? Cher is guilty as hell.

    Not to mention Elvis and Janis Joplin, who have returned from the grave to abuse underage girls. Reverse necrophilia.

  6. keiths:
    A Sky News article says that these people are on the list:

    Barack Obama, Margaret Thatcher, Mick Jagger, Elvis Presley, Marilyn Monroe, George Clooney, Beyoncé, Cher and Janis Joplin.

    Can you explain why they are on the list?

    A pretty simple reason.

  7. petrushka:

    Can you explain why they are on the list?

    As I said, it’s because their names appear in the files, according to the DOJ.

    Do you understand why releasing the list, with no explanation of the contexts in which each name appears, was a sleazy move by the DOJ and part of the continued coverup?

  8. On a slightly different topic, Trump’s efforts to “prevent non-citizens from voting” is nothing of the sort. Non-citizen voting has never been a problem. But if Home Depot parking lots are good ICE hunting grounds, imagine how target-rich a line of hispanic-American citizens will look to ICE. Most likely, a lot of those voters won’t take the risk, and will stay home. Needless to say, most of them vote Democrat. Just the threat of having ICE present to “preserve election integrity” could well swing a dozen or more districts to Republicans. And that damage has already been done, insofar as the threat of ICE presence has been made public on podcasts, social media, mailers etc.

  9. keiths:
    Allan:

    What? You’re part of the coverup now? Cher is guilty as hell.

    Not to mention Elvis and Janis Joplin, who have returned from the grave to abuse underage girls. Reverse necrophilia.

    Heh!

    A friend has got deep into this. She’s been spamming me with stuff she finds utterly compelling and horrifying, but I find totally unconvincing. She thinks the conspiracists she used to laugh at have been proved right: the Rothschilds (more broadly, the Jews) really do run the show; sinister cabals of ‘elites’ and celebrities eat babies and drink blood, Epstein and Bill Gates plotted the pandemic, any mention of pizza is a reference to child sex… I try and reason, debunk each notion one by one, but it’s on to the next one.

    This list of names is the latest – anyone on it is guilty as hell. But when you look, it’s mundane. “Managed to score Springsteen tix for my brother” and Bruce Springsteen is elbows-deep in it. As are people who died when Epstein was about 10.

    There is definitely a switch that flips when someone buys into conspiracism; a way of looking at evidence that I find completely alien. What’s particularly odd is that, knowing me, stubborn as a mule when it comes to poorly-supported claims, she thinks I’ll find any of it persuasive!

  10. Flint:

    Non-citizen voting has never been a problem.

    I asked Claude to dig up some statistics:

    Based on comprehensive research and state audits, noncitizen voting is extraordinarily rare. Here are the key statistics:

    Recent State Audits (2024-2025)

    Georgia’s comprehensive audit of 8.2 million registered voters uncovered 20 noncitizens who registered to vote, including nine instances when noncitizens actually cast a ballot.

    Michigan’s review found 16 credible cases of noncitizen voting in the 2024 general election out of 5.7 million votes cast — that’s 0.00028% of total votes.

    Iowa’s audit of 2.3 million voters revealed 87 instances where individuals cast ballots and later self-reported as noncitizens.

    Historical Data

    The Heritage Foundation’s own database — maintained by the conservative organization specifically to document voter fraud — shows just 68 total cases of noncitizen voting going back to the 1980s, less than 5% of all fraud cases in their database.

    The American Immigration Council’s analysis found only 10 cases involving undocumented immigrants since the 1980s.

    Research by New York University’s Brennan Center for Justice shows the rate of noncitizen voting is about 0.0001 percent nationwide.

    The SAVE Act (just passed by the House but unlikely to pass in the Senate) requires proof of citizenship for voter registration, and it has upwards of 80% support among Americans, far too many of whom have bought Trump and the the Republicans’ lies about non-citizen voting. In fact, it would make elections far less fair, which is fine with Republicans but not with people who actually care about democracy.

  11. Allan:

    A friend has got deep into this. She’s been spamming me with stuff she finds utterly compelling and horrifying, but I find totally unconvincing. She thinks the conspiracists have been proved right… There is definitely a switch that flips when someone buys into conspiracism; a way of looking at evidence that I find completely alien.

    Did you know her before she took her conspiratorial turn? Any idea what flipped her switch?

  12. keiths:
    Allan:

    Did you know her before she took her conspiratorial turn? Any idea what flipped her switch?

    Yes, we go back a while – 10 years maybe. She’d shown vague hints of conspiracist sympathies – thought the existence of Watergate proved that conspiracies were real, which I argued a confusion of terms – ‘conspiracies’ can obviously exist but ‘conspiracy theorists’ still be full of shit. But nothing remotely like this, and I’d always made my skepticism clear. Don’t know what changed for her; we’re not in constant contact.

  13. Seen on Twitter:

    MAGA be like:

    “Just because he cheated on all 3 wives, has 30 sexual assault accusers, bragged about going backstage at Ms Teen USA while they were changing, grab them by the p@ssy, was found guilty of rape in a civil trial, best friends with the worlds biggest sex trafficker of children, won’t release all the files to stay in accordance with the law he signed 30 days ago and happened to transfer Maxwell to a country club prison, why would you think he has anything to do with this? Do you have TDS or something?”

  14. A couple of tidbits from Harry Enten’s latest:

    Trump is 39 points underwater on his handling of the Epstein case, with 70% of Americans disapproving.

    Only 55% of Republicans approve.

    Google searches for Epstein are up an astonishing 900% over the last month, and the top associated person being searched is Trump.

  15. From the latest Economist/YouGov poll, the percentage of people who think Trump is

    Racist
    47% yes, 24% no

    Dangerous
    50% yes, 20% no

    Corrupt
    49% yes, 23% no

    Divisive
    41% yes, 15% no

    Cruel
    46% yes, 22% no

    Out-of-touch
    43% yes, 20% no

  16. On Truth Social:

    Based on a thorough, detailed, and complete review of the ridiculous, poorly written, and extraordinarily anti-American decision on Tariffs issued yesterday, after MANY months of contemplation, by the United States Supreme Court, please let this statement serve to represent that I, as President of the United States of America, will be, effective immediately, raising the 10% Worldwide Tariff on Countries, many of which have been “ripping” the U.S. off for decades, without retribution (until I came along!), to the fully allowed, and legally tested, 15% level. During the next short number of months, the Trump Administration will determine and issue the new and legally permissible Tariffs, which will continue our extraordinarily successful process of Making America Great Again – GREATER THAN EVER BEFORE!!! Thank you for your attention to this matter. President DONALD J. TRUMP

    Screenshot 2026 02 21 101521 (Custom)

  17. Donald is finding it hard to cope:

    Any Country that wants to “play games” with the ridiculous supreme court decision, especially those that have “Ripped Off” the U.S.A. for years, and even decades, will be met with a much higher Tariff, and worse, than that which they just recently agreed to. BUYER BEWARE!!! Thank you for your attention to this matter. President DONALD J. TRUMP

    And:

    As President, I do not have to go back to Congress to get approval of Tariffs. It has already been gotten, in many forms, a long time ago! They were also just reaffirmed by the ridiculous and poorly crafted supreme court decision! President DJT

  18. More failure to cope at today’s Angel Families event:

    It just amazes me that there’s not more support out there. It’s just — we actually have a silent support. I think it’s silent. I think it’s a — well, that’s how I won. I got probably 85 million votes. They say 78 million, 79 million. They cheated in this election, too. It was just too big to rig. Too big to rig. But they cheated like hell. They can’t win on policy.

    First he admits that his support sucks. Then the narcissistic defense mechanism kicks in and he claims that the support is there, it’s just “silent”. Sure, Donald.

    Watch this part of the video and see how utterly defeated the man looks and sounds.

    Later in the same speech:

    And I had to go through, and I still do, fake stories, fake polls. I mean, I had polls for the election that showed I was going to get swamped and I won in a landslide. They were fake polls because polls are tough. You know, when you get a fake poll, I get them today. I saw one today that I’m at 40%. 40%. I’m not at 40%. I’m at much higher than that. I mean, I’d love to run against anybody for — the real polls say you kill everybody. It wouldn’t even be close, but you go through the fake polls, you go through the fake stories.

    In the clip, he sounds like he might burst into tears at any moment.

    Keep in mind that this is all happening at an event for people who have lost loved ones, and Trump is throwing a pity part for himself. What an insensitive, weak and whiny oaf.

  19. Trump today on Truth Social:

    When you watch Low IQ Ilhan Omar and Rashida Tlaib, as they screamed uncontrollably last night at the very elegant State of the Union, such an important and beautiful event, they had the bulging, bloodshot eyes of crazy people, LUNATICS, mentally deranged and sick who, frankly, look like they should be institutionalized. When people can behave like that, and knowing that they are Crooked and Corrupt Politicians, so bad for our Country, we should send them back from where they came — as fast as possible. [Yeah! Send Tlaib back to the US, where she came from!] They can only damage the United States of America, they can do nothing to help it. They should actually get on a boat with Trump Deranged Robert De Niro, another sick and demented person with, I believe, an extremely Low IQ, who has absolutely no idea what he is doing or saying — some of which is seriously CRIMINAL! When I watched him break down in tears last night, much like a child would do, I realized that he may be even sicker than Crazy Rosie O’Donnell, who is right now in Ireland trying to figure out how to come back into our beautiful United States. The only difference between De Niro and Rosie is that she is probably somewhat smarter than him, which isn’t saying much. The good news is that America is now Bigger, Better, Richer, and Stronger than ever before, and it’s driving them absolutely crazy! PRESIDENT DONALD J. TRUMP

    Narcissists can’t abide criticism, which makes it so easy to get under their skin. Trump has no idea how ridiculous and weak he looks for posting something like that.

  20. keiths,

    Body shaming and disability shaming aren’t normally my thing, but RFK has exactly the face someone with his condition needs to have. #sorrynotsorry

  21. Trump on Truth Social, reminding us why we have the 25th Amendment:

    Iran, which is being beat to HELL, has apologized and surrendered to its Middle East neighbors, and promised that it will not shoot at them anymore. This promise was only made because of the relentless U.S. and Israeli attack. They were looking to take over and rule the Middle East. It is the first time that Iran has ever lost, in thousands of years, to surrounding Middle Eastern Countries. They have said, “Thank you President Trump.” I have said, “You’re welcome!” Iran is no longer the “Bully of the Middle East,” they are, instead, “THE LOSER OF THE MIDDLE EAST,” and will be for many decades until they surrender or, more likely, completely collapse! Today Iran will be hit very hard! Under serious consideration for complete destruction and certain death, because of Iran’s bad behavior, are areas and groups of people that were not considered for targeting up until this moment in time. Thank you for your attention to this matter! President DONALD J. TRUMP

  22. keiths:
    Trump on Truth Social, reminding us why we have the 25th Amendment:

    The 25th Amendment is basically as irrelevant as the emoluments clause, or the 14th Amendment. Those who would apply the 25th Amendment were selected as cabinet members were the sorts who would never even think such a thing. Trump could have a stroke and become mentally disabled, and those around him would simply take care this his condition (as with Biden, by the way) didn’t leak. The power wielded by the VP and every cabinet member derives from Trump. The Biden case is a good example – enough top people were aware of his deterioration for a couple of years, but not one of them was willing to risk their own turf by saying so. Instead, they acted in his name and didn’t allow him to conduct a press briefing for all that time. So nobody outside the White House was really aware of his condition until they couldn’t sweep him under the rug at the debate.

    So who, exactly, would invoke the 25th Amendment to dump Trump? Hegseth? Bondi? Patel? Nutlick? Such people have power because they are incompetent and they know it, and they know that Trump relies on it. If Vance were to take over as President, he’d appoint his own cabinet (and some of the Trump folk would face criminal sanctions). So the Trump people may be third-rate hacks, but aren’t so stupid as to risk their power (and their grift) rocking the boat.

  23. In The New Republic:

    The Wall Street Journal has reported that Trump has developed a strong affinity for the American shoe brand Florsheim, and has bought a pair for Vice President JD Vance, Secretary of State Marco Rubio, Transportation Secretary Sean Duffy, Defense Secretary Pete Hegseth, Commerce Secretary Howard Lutnick, communications director Steven Cheung, deputy chief of staff James Blair, and speechwriter Ross Worthington. Even those not in his Cabinet, such as Fox News host Sean Hannity, Senator Lindsey Graham, and Tucker Carlson, have been gifted a pair. They are around $145.

    “Did you get the shoes?” he’d ask them.

    “All the boys have them,” one female White House official told the WSJ. “It’s hysterical because everybody’s afraid not to wear them,” said another.

    Rubio and Vance got their Florsheims after an Oval Office meeting last year. “Marco, JD, you guys have s—y shoes,” Trump said before getting a Florsheim catalog and asking them their shoe sizes.

  24. keiths,

    Waiting for them to adopt gimme caps at dignified occasions, shitty combovers, and ties below the waist.

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