Donald Trump, Republicans Gala, NY
Former President Donald J. Trump, enters the 111th New York Young Republicans Gala in New York, NY, December 9, 2023. Photo credit: © Sarah Yenesel/EFE via ZUMA Press

It is entirely fair that President Joe Biden’s age is a campaign issue. But we also need to talk about Donald Trump’s various mental disorders.

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We periodically point out that Donald Trump is seriously mentally ill. From being a pathological liar to a textbook example of malignant narcissism, the former president displays a cluster of disorders that, in other circumstances, might not get him institutionalized, but would definitely justify some form of treatment. 

So why aren’t we talking about that?

The GOP seems intent on making President Joe Biden’s age an issue in the upcoming election (although Trump is only four years younger), and that is perfectly appropriate in light of the fact that the incumbent would be 86 at the end of a second term.

It is important that experts — rather than Fox News pundits, who interpret every one of Biden’s verbal slips as a sign of advanced dementia — weigh in on this topic. After all, being president is a stressful and highly demanding job, so is it possible for an octogenarian to do it well? That is a valid question, and it seems as though voters deserve an answer. 

But they should also know whether one of the candidates is very likely completely nuts. 

Yet, while Biden’s age is fair game, not just in the right-wing mediaverse but also among mainstream news outlets, Trump’s mental health, or lack thereof, is largely a taboo topic, even though it is a much bigger problem. 

Most reporters don’t have a problem with mentioning Biden’s age (and it bears repeating that it’s a perfectly legitimate concern as long as their conclusions are supported by facts). Yet the same journalists fail to spell it out for their audiences when Trump does or says something that is completely insane apart from labeling some of his most outrageous speeches “rants” or saying the former president is “unhinged.” But those are buzzwords and not a serious attempt to spell out that Trump is, to put it in layman’s terms, crazy.

A big part of the reason why the former president’s mental health is not more of a topic of conversation is the so-called Goldwater Rule of the American Psychiatric Association’s (APA) Principles of Medical Ethics. It states that “it is unethical for a psychiatrist to offer a professional opinion [about someone’s mental health] unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

That might seem fair in most circumstances, but it is arguably even less ethical to allow a seriously mentally ill person to become president — in particular if that mental illness could negatively impact their performance, which it arguably did during Trump’s first term.

After all, there are exceptions to the attorney-client privilege; e.g., a lawyer is allowed to divulge relevant information if doing so prevents death or serious injury.

Another part of the problem is that, as a society, we do not talk much about mental health, and these disorders are not as easy to diagnose as physical ailments. 

If an X-ray reveals a fracture, the bone is broken; a biopsy showing malignant cells is clear evidence of cancer. In these cases, no doctors are going to disagree with another doctor’s diagnosis. 

It’s somewhat different with mental illness, especially in mild or mainly benign cases which might be open to some interpretation or differences of opinion. 

For example, it takes a special kind of person — specifically, someone with a very high opinion of him or herself — to decide that he or she wants to be president of the United States. Therefore, every commander in chief probably has a narcissistic streak. 

However, there is nothing mild or benign about Trump’s narcissism. 

Trump, a Textbook Case. Look Him Up!

The Mayo Clinic website lists 13 symptoms for narcissistic personality disorder plus another eight that describe how narcissists react to criticism. 

Keep in mind that displaying any number of these can make you a narcissist, but we challenge anybody to look at this list of 21 symptoms and find even a handful that don’t apply to Trump. 

It’s an impossible task for any fair-minded person. 

That’s precisely the reason why the former president’s mental health must be part of the national conversation. Voters need to know what someone suffering from this disorder (and others) is capable of in a position of power, just as they need to know whether an 82-year-old (or a 78-year-old, for that matter), can handle the rigors of the presidency for four years. 

And it’s not just his malignant narcissism and compulsive lying. Look up the APA’s symptoms for “sociopathy,” and it is difficult not to think of Trump.

But who is actually looking up the definitions of “malignant narcissism” or “sociopathy?” Clearly not enough people. 

And this is where it would help if mental health professionals spoke out. They could point out that Trump is a poster child for several serious disorders. And then, responsible journalists could cite these opinions when they write about the former president’s latest rant or spate of lies. 

In fact, most stories about him should include that information, e.g.,

“Former President Donald Trump, who experts say is mentally ill,…”

‘“As per usual, Trump, a diagnosed compulsive liar, did not stick to the truth in his remarks…”

“As a result of his malignant narcissism and sociopathy, Trump did tremendous damage during his first term, and experts say he has only gotten worse since then.” 

Granted, it would have been better to have had these conversations eight years ago. Take his narcissism, for example. People like Trump need adulation and attention like ordinary people need oxygen. 

Now, you probably could not have headed off the adulation from his most fervent supporters, but you could have deprived the former president of much of the attention he craves so much.

Instead, media executives with an eye on the bottom line showered him with billions of dollars of free airtime, which constituted one of the worst cases of journalistic malpractice in history.

Now, we can’t do anything about what happened eight years ago, but it is high time for experts to weigh in on Trump’s mental state and how it would jeopardize the United States should he be elected again.


  • Klaus Marre

    Klaus Marre is a writer, editor, former congressional reporter, and director of the WhoWhatWhy Mentor Apprentice Program. Follow him on Twitter @KlausMarre.

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