the many 'armchair diagnoses' of donald trump

no matter who will be sworn in as u.s. president in january 2021, there will be plenty of scrutiny into the health of the commander-in-chief. both donald trump and joe biden are well into their 70s and plenty of ink has been spilled over how old is too old to be president. there is genuine anxiety over the physical and mental health of someone with such vast power.even before being elected president, trump’s public appearances frequently sparked fevered speculation as many of his habits and verbal and physical mannerisms were closely assessed by those with — and without — medical experience. and the speculation never really went away during his four years at the helm of the u.s.part of this can be attributed to the white house’s less-than-clear messaging about his overall health. at least one of his former physicians has suggested the upbeat, account of trump’s health in 2015 was dictated by, well, trump. the white house has never released the reason for his sudden trip to walter reed in november 2019. and in the early day’s of his covid-19 diagnosis, the team of doctors at walter reed national military medical center were criticized for stumbling over key pieces of information such as the timing of tests and the severity of trump’s symptoms.while it makes sense for medical experts, journalists and the public to ask questions and demand clear answers about a leader’s physical and mental state, many doctors and psychiatrists have refused to publicly comment since they aren’t directly treating him.still, that hasn’t stopped speculation around possible ailments and disorders potentially plaguing the u.s. president.

personality disorders

during his previous presidential campaign, trump’s behaviour led to suggestions about the soundness of his personality. the headline of a 2015 vanity fair article was indicative of the fascination with what goes on in the president’s head: “is donald trump actually a narcissist? therapists weigh in!” developmental psychologist howard gardner, a professor at harvard graduate school of education, told the magazine trump was a case of “textbook narcissistic personality disorder.” in 2019, lance m. dodes, md, a former assistant clinical professor of psychiatry at harvard medical school, described trump as “essentially a predator” and a “successful sociopath” in an interview.the american psychiatric association’s president maria a. oquendo wrote in august 2016, amid the presidential campaign’s “outright vitriol,” that “the goldwater rule” prohibits psychiatrists from offering opinions on someone they have not personally evaluated. the rule is based on a very public misfire during the 1964 presidential election when a magazine polled 12,356 psychiatrists on whether candidate sen. barry goldwater was psychologically fit to be president.“simply put, breaking the goldwater rule is irresponsible, potentially stigmatizing, and definitely unethical,” she wrote.arthur caplan, a bioethicist at new york university’s langone medical center, asked npr, “how can anyone give an in-depth character analysis on psychological or mental health grounds without knowing or examining the person at all?” others have suggested it’s a particularly poor idea to try and psychoanalyze trump from afar as it trivializes mental illness.

dementia

in 2017, msnbc host joe scarborough said trump’s behaviour reminded him of his own mother’s decade-long struggle with alzheimer’s disease.scarborough wasn’t alone in speculating about the president’s cognitive state. in january 2018, more than 70 mental health professionals signed a letter to the president’s then chief physician ronny l. jackson asking him to perform psychiatric testing as part of the president’s annual physical examination, given his age. “your examination should include an evaluation of the 71-year old president’s neurological health, including cognitive and mental health functions,” the letter stated, pointing to increasing concerns over such things as trump’s “declining faculties for complex thought, rambling speech, difficulty completing a thought,” episodes of slurred speech and decreased fine motor coordination.

mini-strokes

in september, trump fired back at speculation suggesting he had experienced a series of mini-strokes. he brought up the topic on twitter first: “now they are trying to say that your favourite president, me, went to walter reed medical center, having suffered a series of mini-strokes.”

though trump didn’t say who “they” were in the tweet, he later singled out matt drudge of the drudge report after the site linked to a story from the hill, referencing mini-strokes.joe lockhart, a political commentator who questioned on twitter whether the president had had a stroke, was later slammed in a statement from trump’s re-election campaign.

parkinson’s or another neurological condition

in mid-october, richard e. cytowic, a professor of neurology at george washington university, wrote a piece in psychology today cautioning against speculation on the president’s health from people without medical experience. he also noted that neurologists typically rely on direct observation and called attention to trump’s forward-listing stance: “while most frequently observed in parkinson’s disease, the bent posture so evident in trump may also be seen in alzheimer’s dementia, movement disorders of the basal ganglia, and as the side effect of certain medications.” cytowic describes the president’s posture, jerking movements and manner of walking as “concerning.”“it is true that individuals who have balance and gait issues similar to those observed in trump can have degenerative brain disease in the frontal lobes, such as fronto-temporal dementia or pick’s disease,” he wrote. “of course, it may be that trump has none of these conditions, which only argues for having greater and more reliable disclosure as opposed to compulsory nondisclosure agreements.”regardless of who wins the election, as long as the world grapples with a global pandemic and political leaders in their 70s, it’s unlikely that the health speculation will stop any time soon.monika warzecha is the home page editor at healthing.cadon’t miss the latest on covid-19, reopening and life. subscribe to healthing’s daily newsletter covid life.