Something unusual is happening in American public life right now, and it goes beyond the ordinary noise of partisan politics. Sitting presidents are routinely scrutinised, criticized, and caricatured. That is nothing new. What is new is the specific and escalating nature of what credentialed medical professionals are now saying out loud, on the record, about the mental state of Donald Trump – and the fact that some of them have taken their concerns directly to the United States Congress.
The word “psychosis” is not a casual accusation. In clinical medicine, it carries weight, precision, and consequence. For a credentialed psychologist to apply it to a sitting president, publicly and repeatedly, is a significant event. Whether that psychologist is right is a separate question. But understanding what he is claiming, why he is claiming it, and what the broader medical and political record actually shows is a question that deserves a clear-eyed examination – not a partisan one.
This is not a story about whether you like or dislike Trump. It is a story about the standards of evidence, the ethics of medical commentary, the mechanics of American constitutional governance, and what happens when medicine, politics, and public accountability collide in the most visible office on earth. It is also a story that is still unfolding, with new developments arriving almost daily in May 2026.
The Psychologist Making the Claim
Dr. John D. Gartner is an American psychologist, psychotherapist, and author who served as a part-time assistant professor at Johns Hopkins University Medical School for 28 years, until 2015. He is not a fringe commentator. Gartner is a licensed psychotherapist with private practices in Baltimore and Manhattan, where he has specialized in the treatment of borderline personality disorder, bipolar disorder, and depression.
In April 2026, Gartner warned on The Daily Beast Podcast that President Donald Trump had “crossed from grandiosity into full-blown psychosis.” His specific focus was on what he called “magical thinking” – a psychological term describing a pattern in which a person treats their own beliefs and imaginings as literal truth without regard for evidence or external reality.
Gartner pointed to the president’s reported belief that Diet Coke kills cancer cells as a primary example. That claim traces back to a report by The Hill from April 15, 2026, in which Dr. Mehmet Oz – the CMS Administrator – revealed on Donald Trump Jr.’s podcast that Trump often argues diet soda “kills cancer cells.” The White House later laughed it off as a joke. Gartner did not. He stated: “It’s something that we associate with psychosis. We also associate it with young children. Freud called it ‘primary process.’ It’s kind of the most primitive type of thinking, where if you imagine it, it must be true. But this is just magical thinking. Anything that occurs to him – any stray, crazy thought – is true.”
Gartner also pointed to a series of Truth Social posts. In January 2026, Trump posted a doctored image of a Wikipedia page listing himself as the “acting president of Venezuela.” Then, in April, he posted an AI-generated image depicting himself as Jesus Christ – which he later deleted after it drew backlash even from some of his most vocal supporters. Gartner framed these as consistent with a grandiosity so extreme it had crossed into delusional thinking.
On the question of psychosis specifically, Gartner focused on Trump’s apparent need for endless praise and public adoration, arguing that the president’s grandiosity was “so extreme that not only does he want to be the pope and Jesus and the president of Venezuela and the Mullah of Iran, he wants to be all of these things at once.” He said Trump “wants the world to worship him” and wants to “erect massive monuments to praise himself.”
What Psychosis Actually Means
Before evaluating these claims, the term itself needs definition. According to DSM-5 criteria, psychosis involves hallucinations, delusions, disorganized thinking, grossly disorganized motor behavior, or negative symptoms. These criteria represent a clinical threshold – not a personality description or political judgment. Calling someone “delusional” in casual speech is one thing. Applying the DSM-5 definition of a delusion to a public figure carries an entirely different clinical and ethical weight.
Gartner has been raising these concerns for some time, previously claiming that Trump had been “showing signs of frontotemporal dementia since 2019” and later criticizing Trump’s apparent “magical thinking,” which he linked to psychosis, suggesting the president had drifted further from reality as the years progressed.
The Frontotemporal Dementia Hypothesis
Alongside the psychosis claim, Gartner and other clinicians have pointed to frontotemporal dementia (FTD) – a distinct neurological condition – as a possible framework for understanding Trump’s behavior. According to UCSF Health, FTD affects an estimated 250,000 Americans. It is not the same as Alzheimer’s disease, and it is frequently misunderstood.
The National Institute of Neurological Disorders and Stroke explains that FTD damages the brain’s frontal and temporal lobes, gradually causing difficulties with thinking and behaviors normally controlled by those regions. The National Institute on Aging identifies the hallmark symptoms as unusual behaviors, emotional problems, trouble communicating, and difficulty with work.
This form of dementia can affect judgment, empathy, language skills, and impulse control – which is precisely why Trump’s critics argue it fits a pattern they describe as escalating threats, profanities, and a tendency to ramble.
However, diagnosing someone with this condition from afar is, according to clinical experts writing in The Conversation, “not only irresponsible – it’s impossible,” and may inadvertently give Trump an “out” for offensive but intentional behavior, while increasing stigma for those who actually live with dementia.
Proper FTD diagnosis is complex and cannot rely on observation alone. A multidisciplinary clinical team must examine the person’s personal and medical history – including information from family members – followed by neurological examinations, formal cognitive testing, and brain imaging such as MRI or PET scans to identify structural and functional changes in the brain. None of that has been done publicly.
The Late-Night Posting Pattern
One of Gartner’s more specific behavioral claims centers on Trump’s social media habits. Trump is frequently online throughout the night, sharing rapid successions of messages including false claims and inflammatory attacks, punctuated by AI-generated imagery and videos. Gartner stated: “First of all, he’s up at all hours of the night, all night… posting all of these lies and crazy stuff. The pace of it – that someone would be up all night tweeting in and of itself is a clinical indicator of some kind of either mania or sundowning, and I think in his case it’s actually a combination of both.”
“Sundowning” is a term more commonly associated with forms of dementia, where confusion and agitation worsen later in the day. Mania, by contrast, sits in the bipolar spectrum and is characterized by decreased need for sleep, racing thoughts, and impulsive behavior.
Gartner has also drawn a clear distinction between age-related cognitive decline and what he is describing. He has argued that “his clinical condition matters more than his age,” clarifying that while normal aging involves standard cognitive decline, Trump’s behaviors reflect “signs of dementia” – which is, in his view, “very, very different.”
When 36 Doctors Went to Congress
Gartner is not the only clinical voice in this conversation. The debate reached a formal institutional threshold on April 30, 2026. On that date, a group of 36 leading physicians and other doctors with expertise in mental health issued a statement calling for President Trump’s immediate, lawful removal from office for medical reasons, declaring that his mental instability, combined with his sole and unchecked authority to launch nuclear weapons, makes him “a clear and present danger to the safety of all Americans.”
The statement was formally submitted to the U.S. Senate on April 30, 2026, by Democratic Senators Sheldon Whitehouse and Jack Reed, both of Rhode Island, giving it official legislative standing.
According to the official Congressional Record, the group includes neurologists, forensic psychiatrists, general psychiatrists, and other physicians with experience in the diagnosis of cognitive disorders and in evaluating dangerousness to self and others. The roster includes clinicians from Harvard, Columbia, Tufts, and George Washington University, along with Eric Chivian, a co-founder of International Physicians for the Prevention of Nuclear War – an organization that won the Nobel Peace Prize in 1985.
The group is explicit that it has not examined the president in person and is not offering a formal clinical diagnosis. Its assessment is based on public behavior and statements, which the signers argue are sufficient to raise serious red flags about fitness.
Their statement notes: “It is our professional opinion, based on previous and ongoing assessments, that Donald Trump’s mental state since our 2024 statement has deteriorated even further.”
The physicians urged invocation of the 25th Amendment, a constitutional mechanism that allows the vice president and a majority of Cabinet secretaries to declare a president unable to perform his duties. If invoked, the vice president would assume presidential powers unless Trump contested the move, which would then require Congress to decide the outcome. No president has ever been removed through the 25th Amendment.
For additional background on Trump-related health debates that have emerged across his second term, see our earlier coverage of cognitive fitness concerns in 2026.
The Goldwater Rule: Why This Is Ethically Contested
The medical community is not unified behind these claims. A longstanding professional norm directly governs this kind of commentary, and it is one that many of the doctors involved are knowingly setting aside.
The Goldwater Rule is a statement of professional ethics first issued by the American Psychiatric Association (APA) in 1973. It prohibits psychiatrists from professionally diagnosing someone they have not personally evaluated. The APA’s Ethics Committee affirmed and even expanded the rule beyond diagnosis to cover almost all psychiatric opinion in 2017, amid widespread public discussion of Trump’s mental health during his first term.
The rule is codified in Section 7.3 of the Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry, and states that “it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
There is a meaningful distinction worth noting here. Gartner is a psychologist, not a psychiatrist – a difference that matters professionally. The American Psychological Association, representing psychologists rather than psychiatrists, does not maintain an equivalent formal rule. Its ethical code permits public statements on observable behaviors or general psychological principles derived from publicly available information, provided they are grounded in professional knowledge and avoid unsubstantiated claims. This gives Gartner slightly more ethical runway than a psychiatrist would have – but it does not eliminate the clinical credibility concerns that come with diagnosing anyone without direct examination.
There is a clear difference between evidence-based reporting grounded in disclosed medical information and speculative diagnosis based on observation from a distance. Medical professionals have long recognized this boundary. Ethical guidelines warn against diagnosing individuals without examination, in part because doing so undermines trust in both medicine and the media.
What the Cognitive Tests Actually Show
Trump has repeatedly cited his performance on cognitive tests as evidence that concerns about his mental state are unfounded. According to records reviewed by Wikipedia’s Montreal Cognitive Assessment entry, Trump scored 30 out of 30 on the MoCA on both his January 2018 and April 2025 assessments. A score of 26 or higher on the MoCA is considered normal. A perfect score is the highest result possible.
The problem is not the score. The problem is what the test actually measures. The Montreal Cognitive Assessment is designed as a screening tool for mild cognitive impairment and dementia – not an intelligence test, not a psychiatric evaluation, and not a comprehensive neurological workup.
As reporting from The Daily Beast noted, the MoCA is “not an IQ test but a screening designed to detect early signs of Alzheimer’s or dementia.” Gartner himself has pointed out that if Trump has been administered the test three or more times, the frequency of testing is itself a clinical signal – suggesting the physicians involved may be tracking something rather than simply confirming routine health.
The MoCA can help rule out some forms of cognitive impairment, but cannot by itself prove lifelong cognitive fitness or measure complex executive functions. It is most useful as a screening step that can prompt further neuropsychological testing if concerns arise.
Read More: Trump’s Viral Speech Prompts Online Debate Over His Cognitive Fitness
What the Public Actually Thinks
Whatever the clinical picture is, public opinion has shifted markedly. A growing share of Americans question Trump’s mental acuity for the presidency. According to a Washington Post-ABC News-Ipsos poll conducted in late April 2026, 59% of U.S. respondents said Trump does not have the mental sharpness to lead, with 55% saying he was not in good enough physical health to serve effectively. Both figures are slightly more negative than they were in February and significantly more negative than last September.
A Reuters-Ipsos poll from February 2026, reported by CNN, showed that 61% of Americans agreed that Trump had “become erratic with age.” Even 30% of Republicans agreed with that sentiment.
Trump, who turned 80 on June 14, 2026, traveled to Walter Reed Medical Center in late May for a physical exam. It was his third physical examination at the facility since the start of his second term.
Dr. Jeffrey Kuhlman, who served as a White House physician for more than a decade under Presidents Obama, Bush, and Clinton, said: “I think concern for the president’s physical health is probably at an all-time high, and I think advanced physical age is the No. 1 concern.”
The White House Position
The administration’s response has been consistent and categorical. The White House has stated that Trump “is the sharpest and most accessible President in American history and remains in excellent health.”
When reached for comment on Gartner’s assessments, the White House criticized him directly. Assistant Press Secretary Liz Huston called The Daily Beast “a left-wing mouthpiece” and said: “Anyone pathetic enough to defend Biden’s mental state – while being labeled as unethical by their peers – has zero credibility.”
There is no independent medical evidence in the public record confirming Gartner’s claims of psychosis or dementia-like decline. His assessment is based on Trump’s posts, speeches, and reported projects, viewed through his own clinical and political lens.
Gartner has openly described himself as a member of “The Resistance” against Donald Trump – a disclosure that critics argue compromises his objectivity and that supporters cite as the primary reason to dismiss his clinical commentary entirely.
Read More: The Trump Phone Just Released. Critics Have a Lot to Say
What This Means for You – and for the Country
This story resists easy resolution, and any honest accounting of it has to hold that complexity rather than collapse it into a verdict.
On one side: a credentialed former Johns Hopkins psychologist is publicly claiming the sitting president of the United States shows signs of psychosis and frontotemporal dementia. He is not alone. A group of 36 physicians from major research institutions placed that concern formally into the Congressional Record in April 2026, calling for Trump’s removal under the 25th Amendment on medical grounds. Meanwhile, public polling shows that a clear majority of Americans – and nearly a third of Republicans – now express doubt about Trump’s mental fitness.
On the other side: no independent clinical diagnosis has been made. No brain imaging, no comprehensive neuropsychological battery, no face-to-face examination. Trump has scored a perfect 30 out of 30 on the MoCA on multiple occasions, including in April 2025. His physician has declared him fully fit to serve. The primary voice driving the “trump psychosis” narrative has openly declared himself a member of the political opposition, which raises questions of bias that cannot simply be set aside.
The health of political leaders is a legitimate public concern. There is a meaningful difference between evidence-based reporting grounded in disclosed medical information and speculative diagnosis based on observation from a distance. The Goldwater Rule exists precisely because the absence of a direct clinical examination does not simply introduce uncertainty – it makes formal diagnosis impossible by definition.
What this moment genuinely calls for is something that has not yet happened: full, independent, and transparent neurological evaluation by clinicians with no stake in the political outcome, with results made available to the public. That standard should apply to any president at any age. As the April 2026 physicians’ statement made plain, the United States has no formal, independent system for evaluating whether any sitting president is mentally fit to control nuclear weapons. That structural gap has become impossible to ignore.
Disclaimer: The information provided here is for educational and informational purposes only and is not a substitute for professional psychological, psychiatric, or mental health advice, diagnosis, or treatment. Always seek the guidance of a licensed mental health professional, therapist, psychologist, or psychiatrist with any questions or concerns about your emotional well-being or mental health conditions. Never ignore professional advice or delay seeking support because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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