Speculations about the mental health of U.S. presidents is not new and they have sometimes been justified. After he left office, it was learned that during the Watergate crisis Richard Nixon was depressed, drinking excessively and taking Valium, and talking to portraits of former presidents in the White House. President Reagan was diagnosed with Alzheimer’s disease after his second term, but it is assumed that he was afflicted with the progressive illness while he was still in office. All presidents have probably been called “crazy” in the colloquial sense by their political enemies. And some presidents have suffered from real mental illnesses, especially depression. For example, President Lincoln had a history of severe depression which was called melancholia in his era.
Mental illness, as in the case of Lincoln’s depression, can be a strength and does not necessarily preclude one from being an effective president. However, this is not the prevailing view with regard to those who speculate that Trump has a mental illness. Claims that Trump is mentally ill and therefore unfit for office are ubiquitous. The frequency and nature of these claims are unprecedented for a U.S. president in modern history and perhaps ever. There have been calls for Trump to be administered a neuropsychiatric evaluation, involuntarily if need be, and for the 25th amendment to be invoked. In this article, I review speculations about President Trump’s mental health, share my views of these speculations, and propose what, if anything, can be done about this situation.
Trump engendered controversy long before he announced his candidacy for president which, in turn, has helped fuel speculations about his mental health. Such speculations escalated during his presidential campaign and especially when he was elected. A network of mental health professionals formed the Duty to Warn group which is described on its web site as “an association of mental health professionals and other concerned citizens who advocate Trump’s removal under the 25th Amendment on the grounds that he is psychologically unfit.” Psychologist Dr. John M. Grohol has noted, however, that a petition created by this group leaves a lot to be desired. The petition called for signatures from mental health professionals who agreed that Trump was “psychologically incapable of competently discharging the duties of President of the United States.” Dr. Grohol pointed out, however that not all of the individuals who signed the petition were mental health professionals and there was no way to verify the signatures on the petition. My multiple attempts to contact the creator of the petition, psychologist John D. Gartner, to address the invalidity of this petition, were not answered.
Two books have significantly contributed to speculations that Trump is mentally ill. The first book is The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President edited by Yale psychiatrist Dr. Bandy Lee and published in October 2017. In this book, mental health professionals and other authors propose various and sometimes contradictory opinions about Trump’s behavior and mental status. For example, authors speculate Trump may have delusional disorder, dementia, narcissism, and sociopathy. The book has been a bestseller on Amazon and The New York Times because, I suggest, it has confirmed biases many have that indeed Trump is mentally ill.
The second book, journalist Michael Wolff’s Fire and Fury: Inside the Trump White House, was published in January of 2018 and made the question of Trump’s mental health and fitness for office an international story. In his book, Wolff provides accounts from White House staff that include descriptions of Trump as “a moron,” “a little child,” and “an idiot surrounded by clowns.” This book has also been a bestseller on Amazon and The New York Times. Wolff’s book confirms for some readers that Trump is unstable and therefore unfit for office. Other readers have criticized the book for being not factual. Some of the quotes in the book have been denied by the people who Wolff attributed to them. Wolff also admits he did not interview Vice President Pence or anyone in the president’s cabinet for his book. Even if we accept claims about Trump’s mental health in the book, none of them were made by mental health professionals.
The media is replete with speculations about Trump’s mental health. Cable news consistently covers the topic with political pundits who have little or no education in mental health and/or no training in the field. When mental health professionals weigh in, a majority of them tend to agree with the prevailing view that Trump has narcissistic personality disorder and that he is mentally ill. On social media, I’ve seen laypersons as well as mental health professionals describe Trump as having just about every condition or diagnosis imaginable from being a cocaine addict to delusional to a narcissist and even having brain damage.
The main reason it is dubious to say Trump has a mental illness is because there is simply a lack of adequate clinical evidence to support this claim. There are various reasons mental health professionals and laypersons make such claims. Many people are ignorant about what mental illness is and what mental illness is not. It is also common to use a word like “crazy” in informal conversation without really meaning mentally ill.
Another reason people insist Trump and others are mentally ill despite insufficient evidence is because they want it to be true. Labeling someone as mentally ill confirms one’s bias that there is something wrong about that person whether it’s true or not. It fills the need for an explanation of what one deems as behavior that is deviant from cultural and social norms. This error runs the risk of stigmatizing people who have a real mental illness. Mislabeling a person as mentally ill also distracts from factors that are relevant to an individual’s behavior. In the case of Trump, doing so may distract from his criminality and the need for political, rather than medical, action in order to bring about change.
We all have biases. I am anti-Trump, yet I see no basis to say Trump definitely has a mental illness. Maybe Trump has a mental illness. Maybe he doesn’t. My view is we do not know for certain without, first, conducting a thorough in-person mental health evaluation. We could speculate. But I don’t think this serves a useful purpose. Granted, Trump acts in ways that I consider aberrant, corrupt, inappropriate, obnoxious, and racist, just to mention some. Sure, he has issues. But to diagnose him with a mental illness is another story. The Goldwater rule set forth by the American Psychiatric Association (APA) in 1973 and affirmed in a recent statement from the professional organization, calls for “physician members of the APA to refrain from publicly issuing professional medical opinions about individuals that they have not personally evaluated in a professional setting or context.” I contend, however, that even if one assesses Trump from afar, there is no basis to conclude that he has mental illness.