Since the end of Trump’s previous term, however, American society has become more polarized — and so has the psychiatric community. According to Bandy Lee, her conclusions were initially in line with the medical consensus among experts, including Republican supporters. That reality has changed:

“We had a medical consensus — including among Republican psychiatrists (they simply declined to contribute to our book, even though they agreed on the analysis). Now, with politics influencing or pressuring just about every field, we see a number of mental health professionals deviating from the former consensus. The APA provided a convenient exit ramp by falsely calling evasion of our societal ethical responsibility (to protect society) ‘ethical,’ through its distortion of the ‘Goldwater rule’ with the first Trump presidency — this is what it means to be politically biased.”

Originality or illness?

Boris Zlotin, an American inventor, entrepreneur, and instructor in creative thinking, sees Trump primarily as an innovator. He even wrote a book titled Inventor Trump that cites various examples of the divisive president’s creativity.

For instance, in 1976, when the Trump the real estate mogul began renovating the old Commodore Hotel, he immediately changed its address. The building was listed on the less prestigious 42nd Street, but the developer took advantage of the fact that part of the structure also faced Lexington Avenue. That trick allowed him to raise the property’s future value.

Another example is Executive Order 13837, issued in 2018, which allowed the administration to exert pressure on labor unions. Trump limited the amount of time employees could spend on union activities not connected with their direct job duties.

“And what about his recent claim that import tariffs would allow the elimination of the income tax? It’s the most hated tax in America. His approval rating jumped 2% right away, while the Democrats’ dropped by the same amount,” Zlotin continues.

“What he and Vance did with Zelensky in the Oval Office — I gave them a standing ovation. And when Trump imposed tariffs, all the countries lined up to talk to him. If he had arranged those meetings through normal diplomatic channels, it would’ve taken months.”

Zlotin owns an extensive collection of MAGA caps. But like many intellectual Trump supporters, he distances himself from the broader base of the president’s electorate:

“That Trump lies — well, who besides us even notices? Don’t take anything he says seriously. Look at what he does. He behaves boldly, he plays to win. He doesn’t care about anyone except American voters. And he understands and knows the American middle class perfectly. What he says doesn’t seem dumb or unhinged to these people.”

Of course, the fact that Trump has won two out of the past three U.S. presidential elections may seem like a point in favor of Zlotin’s argument that the president is doing just fine cognitively speaking — at least in his supporters’ eyes. But to Bandy Lee, it is a sign that Trump’s derangement is spreading. She outlines the process in her 2024 book, The Psychology of Trump Contagion:

“Now, we are imperiled not just by an unstable individual having sole command over thousands of thermonuclear arsenals that could destroy the planet many times over, but by a contagion of symptoms all over the nation and the world, such that much of the population has lost the ability to see that anything is wrong.”

That conclusion, however, is open to debate. In 2020, a team of researchers in Colorado conducted a study examining how Trump’s supporters and opponents perceive his personality. They hypothesized that “participants who voted for Trump would rate his personality as less dysfunctional than those who did not.” The results were surprising.

The 265 participants were given SCATI questionnaires — a tool used to screen for 14 major personality disorders. The test includes 70 statements such as “I find the suffering of people or animals amusing,” with responses ranging from “strongly disagree” to “strongly agree.” Participants watched Trump campaign ads and were then asked to complete the survey as if answering on his behalf.

Unexpectedly, both Republicans and Democrats rated Trump high in traits associated with sadistic, narcissistic, antisocial, and passive-aggressive personality disorders. The difference was in how they interpreted the results — some saw it as a warning sign, while others still saw no reason not to support him.