Arthur Lazarus, MD, MBA
5 min readAug 5, 2020

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Trump’s Delusions Are Bad For Our Health

You feelin’ alright? I’m not feelin’ too good myself.

I see red and my stomach churns at the mere sight of Trump on TV, whether speaking at a rally or providing an update on the coronavirus pandemic.

“Turn it off,” my wife implores from the other room, while she patiently does her arts and crafts or plays “Candy Crush” on her i-phone.

But I can’t turn it off. I remain glued to the television, fixated on Trump, intrigued by his demeanor and outlandish remarks, which clearly put him in an alternate reality. You see, I feel compelled to analyze Trump as I did thousands of patients in my psychiatric practice before I retired. Old habits die hard, even at the expense of my personal health.

Trump-Talk Hypertension

Columbia University physician Dr. Andrew Bomback is a nephrologist and expert in hypertension. After the 2016 presidential election, he saw four consecutive patients with blood pressure readings above normal. None of them had previously been diagnosed with hypertension.

Dr. Bomback wrote: “Each [patient] blamed our recent banter about Donald Trump for their pressure being elevated, citing either anger or anxiety or depression or some combination of these feelings. It seemed that we’d stumbled upon a new form of white coat hypertension, in which blood pressure was rising not in response to being in a doctor’s office but rather to having a discussion about Trump in that doctor’s office. The difference between the conventional form of white coat hypertension and ‘Trump talk hypertension,’ I worry, is that my patients continue these political conversations and tend these same emotions outside my office, when no doctors are around.”

I don’t think anyone has literally dropped dead due to Trump’s machinations, but his lies and distortions do stir the psyche and soma. Certainly, his policy agenda — to repeal the Affordable Care Act, ransack the environment, incite public violence, undercut public education, downplay the coronavirus pandemic, and undermine conditions that promote health in America — endangers the health of all Americans and exacerbates health disparities. Trump’s rejection of science and willingness to spread the virus for political gain defy all logic and reason.

Departure from Reality

Trump’s actions go beyond those of a malignant narcissist, the diagnosis most often invoked to explain his psychopathology. He is clearly delusional, according to the standard definition of a delusion: “a fixed false belief that is resistant to reason or confrontation with actual fact.”

Here are just a few of Trump’s beliefs that part with reality. Many deal with the coronavirus:

· COVID-19 will “disappear

· The coronavirus is “receding

· Schools should reopen because children are “virtually immune” to COVID-19

· Coronavirus testing artificially inflates the number of cases of COVID-19

· The World Health Organization miscalculated the coronavirus death rate

· COVID-19 was bioengineered a Chinese laboratory

· China deliberately spread the coronavirus to the United States

· Hydrochloroquine is effective against COVID-19

· The economy is stronger than ever

· The United States is the highest-taxed country in the world

· Racial protestors are looters and “terrorists

· The Obama administration is responsible for skyrocketing health insurance

· The media reports fake news and propagates it

· The Russian bounty story is either fake news or unimportant to national security

· Russia (Putin) did not interfere with the 2016 Presidential election

· The Mexican government forces immigrants into the United States

· Universal mail-in voting will be inaccurate and fraudulent

Technically, narcissistic beliefs are not delusional. But Trump’s way of thinking blurs the line between reality and fantasy and should be considered delusional. It is delusional because his perspective is so irrationally nonsensical.

For example, Trump believes he’s smarter and better than everyone else. He never admits he’s wrong, and staunchly believes that bad outcomes are never his fault (and good outcomes are always his doing). And Trump falsely accuses others whose beliefs are not aligned with his.

Convincing someone they’re wrong about something by offering alternative untruths is known as gaslighting. It’s Trump’s way of damaging someone’s credibility when he feels attacked or wrongly blamed. Trump turns the tables on people by psychologically manipulating them to the point where they question their own sanity. In fact, it is Trump’s sanity that’s in question.

Health Impact

According to behavioral health ethicists at the University of Pennsylvania, there are data to suggest that Trump’s delusions are indeed bad for our health. Suicidal ideation increased in individuals shortly after he was elected, as evidenced by a dramatic spike in traffic in the Crisis Text Line. Therapists interviewed by the Philadelphia Inquirer reported increased distress, anxiety, and depression in patients, family members, and colleagues. Physicians other than the kidney doctor, Dr. Bomback, reported that patients were having physical symptoms of anxiety such as insomnia, hypertension, chest tightness and gastrointestinal distress.

Most of these symptoms can be explained by the effects of toxic stress created and perpetuated by Trump’s unpredictable and bizarre behavior. Prolonged and continuous exposure to high levels of stress has a negative impact on overall health, contributing to heart disease, diabetes, substance abuse, and depression.

Terms like “Trump Anxiety Disorder” and “Trump Hypertensive Unexplained Disorder” have been coined to describe the detrimental effects of Trump-related stress on broad segments of the American population, from young adults to women, to racial and LGBTQ communities. In short, Trump’s delusional thinking has put millions of American’s health at risk.

A Bleak Future

Approximately 83% of Americans say the future of our nation is a significant source of stress, according to the American Psychological Association’s (APA) most recent survey report, Stress in AmericaTM 2020: Stress in The Time of COVID-19, Volume Two. The previous high was 69%, reported in 2018 as part of APA’s annual Stress in America survey. More than 7 in 10 (72%) Americans say that this is the lowest point in the country’s history that they can remember.

People fear they will not survive another four years under Trump’s rule. A 2007 study uncovered an unimaginable health crisis among the people of Turkmenistan, which was ruled for 21 years by a dictator under a policy of secrecy and denial. The same misfortune probably awaits Americans should Trump serve another term.

The Penn ethicists observed: “President Trump has infused stress and uncertainty into virtually every facet of American life…Sadly, researchers now have an opportunity to conduct a natural experiment and examine the health effects of toxic stress emanating from an abusive US President. Our hunch is their findings will be deeply disturbing.”

No doubt.

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