Is “Trump Derangement Syndrome” a Real Mental Condition?

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Many clinicians, political commentators and members of the public have speculated upon the mental health of President Donald Trump. Indeed, over 70,000 people self-identifying as "mental health professionals" have signeda petition declaring that "Trump is mentally ill and must be removed." In sociological terms, the ‘medical gaze’ has been hitherto focused on President Trump, and to a lesser extent his ardent supporters.

However, in recent months many have been questioning the direction of this ‘medical gaze.' In fact, more and more people are suggesting that this ‘medical gaze’ should be reversed and refocused on President Trump’s most embittered and partisan opponents. Some have even suggested that these opponents are experiencing a specific mental condition, which has been labelled ‘Trump Derangement Syndrome' (TDS).

What does DSM 5 say about ‘Trump Derangement Syndrome?'

Mental illnesses are officially classified in a dense and dry book published by the American Psychiatric Association (APA) known as the Diagnostic and Statistical Manual-version 5 (DSM-5). This book contains 947 pages and lists hundreds of mental disorders; TDS is nowhere to be seen in DSM-5. Similarly, a review of scholarly databases such as MEDLINE and Google Scholar reveal no academic papers on this alleged syndrome. Officially at least, TDS is not a real, diagnosable or treatable mental disorder.

That said, medical anthropologists and critical sociologists have convincingly argued that DSM-5 is a flawed document. Indeed, social scientists have long recognized that there are numerous ‘folk categories’ of mental disorders that are considered real conditions by the general public, even though they are not recognized as such in the DSM. These include categories such as ‘burnout’ or ‘nervous breakdown.'

As such, lack of official recognition does not mean that TDS is not a real mental condition.

Lay Understandings of ‘Trump Derangement Syndrome’

There is no shared lay understanding of TDS, mainly because it is a folk category rather than a professional category. As such, there is currently much armchair speculation about the nature and existence of TDS, without consensus.

The name itself explicitly suggests a ‘syndrome,' which the Oxford English Dictionary defines as "a characteristic combination of opinions, emotions, or behavior." Several commentators have run with this, putting forth suggestions about opinions, emotions and behaviors characterizing TDS.

Shared amongst these is a notion that the everyday activities of President Trump trigger some people into distorted opinions, extreme emotions and hysterical behaviors. Well-known writer Bernard Goldberg gives supposed behavioral examples of TDS among Trump’s political opponents, including fainting, vomiting, students retreating to ‘safe spaces’ and others demanding ‘therapy dogs.' Political commentator Justin Raimondo focuses on opinions, language and cognition, writing in the LA Times that "sufferers speak a distinctive language consisting of hyperbole [leading to] a constant state of hysteria… the afflicted lose touch with reality."

Such forms of highly emotional reaction could be something akin to the fainting and screaming characterizing American Beatlemania in the 1960s. Unlike the Beatles however, the extreme emotional reaction alleged to characterize TDS is not based on adoration and admiration, but on fear and loathing.

Contrariwise, many others ridicule the notion that TDS is anything but a malicious slur term used to discredit and delegitimize criticism of President Trump. For example, CNN’s Chris Cillizza speaks for many when he states that "the truth is that TDS is just the preferred nomenclature of Trump defenders who view those who oppose him and his policies as nothing more than blind hatred." Likewise, Adam Gopnik writes that "our problem is not TDS, our problem is Deranged Trump Self-Delusion."

In other words, there are polarized opinions about the nature, reality and existence of TDS.

Conclusion

The wider public may be unaware that psychiatrists and social scientists spend considerable time and energy behind closed doors pondering over the existence and reality of mental conditions. This has led the APA to revise the DSM five times since 1952, considerably expanding the list of official mental disorders with each revision. As far as I am aware, few psychiatrists are currently arguing that DSM-6 should contain TDS as a mental disorder.

That said, in its official definition of mental disorder, the DSM-5 states that "a mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior… mental disorders are usually associated with significant distress in social, occupational, or other important activities."

Many have argued that some people have been seriously disturbed and distressed by the policies, speech, behavior and tweets of President Trump, so much so that it has affected their cognitive, affective and behavioral functioning. Such people may need mental health support. As such, further research is necessary to investigate the extreme reactions toward President Trump, in the same way that researchers investigate other extreme social phenomena such as Beatlemania or the like. This will shed light on the reality of this emerging folk category that has been labelled by many as ‘Trump Derangement Syndrome.'

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