Donald Trump: Historical Context

Two introductory notes are warranted.

First, Dr. Zebra started this website in 1999 out of a concern that Americans too oftened assumed that their president was making decisions in full health and with healthy thinking processes. Donald Trump, who had a severe and largely unrecognized illness that happened to be psychiatric, epitomizes the stakes involved by that concern. Dr. Zebra puts Trump's illness in historical context here → SEE BELOW

Second, in compiling Trump's medical entries, Dr. Zebra has had to contend with Trump's charitably described "aggressively unreliable" nature 1, using an approach outlined here → MORE

Personality disorder (introduction)
Trump's mental status has generated analyses and opinions from his co-workers MORE, from mental health professionals MORE including his niece (Dr. Mary L. Trump), and from Dr. Zebra, who was driven by the events of 2020 to significantly revise his diagnosis SEE BELOW.

The current assessments (January 2021) from Dr. Trump and Dr. Zebra are below. Update 2023 -- Trump's post-presidency legal embroilments solidify the diagnostic discussion that follows.

The story of Donald Trump cannot be told with a mere recitation of facts. Not only are they overwhelming in quantity, but his course has been so singular in American history that no framework exists on which the facts can be organized. This page may help.

Historical Comparisons

Donald Trump is the sickest individual ever to inhabit the White House -- sicker even than stroke-crippled Woodrow Wilson, to whom it is instructive to compare him.

Wilson ...

  • had an acute physical illness ...
  • that led to a chronic psychiatric illness ...
  • that went untreated ...
  • by his incompetent military physician,
    • who placed loyalty to a man above duty to the nation.
It has been argued that strong competent leadership from a psychiatrically intact Wilson might have averted the man-made global catastrophe that was World War II, in which 400,000 Americans died.

Trump, by contrast ...

  • had a chronic psychiatric illness ...
  • that led to an acute physical illness (covid-19) ...
  • that was treated aggressively ...
  • by a team of skilled physicians, led by a military physician,
    • who placed loyalty to a man above duty to the nation.
It is easily argued that strong, competent leadership from a psychiatrically intact Trump could have averted the national catastrophe of 400,000+ American dead and a shattered economy -- just look at the successful curtailment of covid-19 in well-run democracies like South Korea, Taiwan, Germany, New Zealand, etc.

The biggest difference between Wilson and Trump is the public's knowledge of their illnesses. Wilson's physical illness and unsuitability for the presidency would have been immediately perceptible to the public, certainly leading to calls for his resignation, had he not hidden himself in strict isolation for months. Trump's psychiatric illness, on the other hand, was aggressively public, though generally not perceived as illness, even through an impeachment trial and a bipartisan vote to remove him from office.

But Is It a Disease?

Initially, Dr. Zebra resisted giving Trump a formal psychiatric diagnosis. The reason: Despite Trump's clearly abnormal, unfeeling, narcissistic personality traits, he did not suffer harm as a result of these traits -- he was elected president! One cannot claim anything is a disease if the patient does not suffer by having it, no matter if compatriots, investors, or the public suffer.

Others agreed with this common-sense stance in 2017:

[Dr.] Allen Frances wrote the criteria for narcissistic personality disorder used in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and he doesn't think Trump qualifies. In Twilight of American Sanity 2 Frances says the diagnosis requires the patient to experience significant distress because of his condition. But throughout his life, Trump "has been generously rewarded for his Trumpism, not impaired by it," Frances writes. "[If] Trump is a threat to the United States, and to the world, [it would be] not because he is clinically mad, but because he is very bad." 3 (Also 4)

Making a Diagnosis

America's 2020 covid calamity changed the above calculus. The epidemic created conditions in which Trump's con-man genius could not cover his ineptitude as an executive (one cannot con a virus). However, instead of rising to the epidemic's challenges, as a psychiatrically intact Trump could have done merely by listening to experts in his government, Trump was locked into the only behavior permitted by the unbreakable grip of his personality: a single-minded focus on his own short-term interests 5 6.

This pathologically restricted focus caused him to mismanage the epidemic and, consequently, suffer extraordinary self-harm:

  • Infecting himself and his family with a potentially fatal disease,
  • Losing his job in a failed re-election bid and, with that loss, earning the hated label of "Loser,"
  • Conducting and/or championing illegal methods to subvert the election ...
  • ... causing his party to lose control of the Senate ...
  • ... culminating in the Capitol riot of Jan. 6, 2021, resulting in a general revulsion that itself precipitated:
    • Loss of his Twitter account and, therefore, his public voice,
    • Pariah status that eviscerates his business "brand" and finances,
    • An unprecedented second impeachment that could bar him from future elected office,
    • Demolition of his future reputation in history,
    • Legal threats to his future in multiple jurisdictions,
    • Evaporation of any goodwill that might have mitigated the above threats.
... all that in less than four months. Distress indeed.

And so, for Donald Trump, what would have been classified as merely an irksome personality trait before covid, became diagnosable as a personality disease: Despite ongoing avoidable distress to himself as the epidemic burned, he could not break from his psychiatric chains and adapt.


We can pity Trump for his mental handicaps, but they do not absolve him of his total responsibility for the covid-19 conflagration in the United States, nor shield him from charges of criminality and worse. Fundamentally, Trump's irredeemable focus on his own self-interests creates a tunnel vision that renders him largely blind and, therefore, situationally unaware. As part of his illness, he does not recognize this blindness. And so, Trump fails to rise even to the level of poor Warren Harding, who at least understood that he was not mentally up to the demands of the Presidency.

The question now is whether the United States, which has been revealed to have its own blindness in failing to constrain a medically unfit president, can institute safeguards to contain the damage that another medically unfit president might someday cause. Goodness knows, we almost did not survive this one.

Cited Sources
  1. Kruse, Michael. The Mystery of Mary Trump. (Published November/December 2017. Downloaded on 2019-12-06.) Available on the web:
  2. Frances, Allen. Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump. New York: William Morrow, 2017.
  3. Lozada, Carlos. Is Trump mentally ill? Or is America? Psychiatrists weigh in. (Published 22 Sept. 2017. Downloaded on 2017-09-23.) Available on the web:
  4. Frances, Allen. I helped write the manual for diagnosing mental illness. Donald Trump doesn't meet the criteria. (Published Sept. 6, 2017. Downloaded on 2019-12-25.) Available on the web:
  5. Parker, Ashley; Rucker, Philip. One question still dogs Trump: Why not try harder to solve the coronavirus crisis?. Washington Post. 2020 July 27.   Available on the web at:
  6. Parker, Ashley; Rucker, Philip; Dawsey, Josh. Trump the victim: President complains in private about the pandemic hurting him. Washington Post. 2020 July 10.   Available on the web at:

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