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A mental health professional makes a strong argument against diagnosing Trump.

'Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely.'

Donald Trump is a narcissist and everybody knows it — at least in the colloquial sense of the term.

The 45th president of the United States built his brand on being self-absorbed, self-obsessed. He's the type of man who's spent the better part of the past several decades living in a gold tower with his name emblazoned on the outside. He's put his name on everything from steaks to board games to vodka. He's a real-life Narcissus, gazing into his own reflection. He is pride, he is arrogance, he is vanity.

To untrained observers, he's the embodiment of narcissistic personality disorder. And yet, at least one man thinks that we're not giving Trump enough credit — and he's perhaps one of the most qualified people to make that assessment.


Photo by Win McNamee/Getty Images.

In a letter to The New York Times, Professor Allen Frances — who literally wrote the book the subject — offered a defense of Trump against claims that the president has narcissistic personality disorder.

The letter, titled "An Eminent Psychiatrist Demurs on Trump's Mental State," came in response to a letter the previous day signed by 33 mental health professionals who called for a lift on the American Psychiatric Association's 1973 Goldwater Rule against evaluating public figures. That letter argued that Trump suffers from a "personal myth of greatness" and "grave emotional instability" that makes him mentally unfit to serve as president.

In his letter in response, Frances explains that he personally wrote the criteria that defines narcissistic personality disorder as part of the team that wrote the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), and that Trump simply does not meet that criteria.

"He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder," wrote Frances.

Allen Frances. Photo by Angelika Warmuth/picture-alliance/dpa/AP Images.

Frances cautions that by diagnosing Trump with NPD, or any other form of mental illness, from afar, we risk further stigmatizing people who live with mental illness.

"Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither)," wrote Frances.

"Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely."

"Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers."

Psychoanalyzing Trump won't do anything to put a stop to what Frances calls "a dystopic Trumpean dark age." The solution, he argues, "is political, not psychological."

Donald Trump greets supporters after a rally in Mobile, Alabama, in 2015. Photo by Mark Wallheiser/Getty Images.

Stigma remains a big issue in the mental health and disability communities. Even if Trump does have a mental illness, it's probably not a worthwhile argument against his leadership.

David Perry, a journalist focused on disability rights, says he doesn't see any political benefit to trying to discredit Trump on the basis of perceived mental illness. To start, Perry explains, one has to work under the presumption that there are voters who are OK with someone who demonstrates questionable behavior — like lying, bragging about sexual assault, and being prone to outbursts, and all the other criticisms people have about Trump — but who would be be dissuaded from supporting that person only on the basis of mental illness.

"Does that voter exist?" Perry asks. "If so, isn't that a perfect example of using stigma — against 'crazy' people — to gain political advantage? It's possible that voter does exist, since such stigma is pretty pervasive, but I'm skeptical that Trump supporters are capable of being persuaded by anyone's internet diagnosis anyway."

Photo by Isaac Brekken/Getty Images.

Mental illness affects people all around us. That doesn't make them, as Trump might call them, "bad hombres."

"So I get it. ... We're going to speculate," says Perry. "But every person I know who has a mental disability finds that speculation painful, because it suggests that you might expect them to behave like Trump due to their diagnosis. So that matters to me."

Mental illness is nothing to be ashamed of. According to the National Alliance on Mental Illness, roughly 1 in 5 U.S. adults experience mental illness in any given year. That's more than 43 million people. The problem, though, when it comes to mental illness, is that shame and stigma prevent many people from seeking care in a timely fashion. The truth is that when treated — whether that's with talk therapy, medication, exercise, diet, or something else — most forms of mental illness are pretty manageable.

Stigma makes seeking help a scarier process than it needs to be, so can we all agree not to add to it by trying to diagnose Trump from afar?

Photo by Chip Somodevilla/Getty Images.

Courtesy of Elaine Ahn

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There’s also a feeling that the current state of pop culture is lacking as well. Nobody listens to new music anymore and unless you’re into superheroes, it seems like creativity is seriously missing from the silver screen.

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Wylee Mitchell is a senior at Nevada Connections Academy who started a t-shirt company to raise awareness for mental health.

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Teens of today live in a totally different world than the one their parents grew up in. Not only do young people have access to technologies that previous generations barely dreamed of, but they're also constantly bombarded with information from the news and media.

Today’s youth are also living through a pandemic that has created an extra layer of difficulty to an already challenging age—and it has taken a toll on their mental health.

According to Mental Health America, nearly 14% of youths ages 12 to 17 experienced a major depressive episode in the past year. In a September 2020 survey of high schoolers by Active Minds, nearly 75% of respondents reported an increase in stress, anxiety, sadness and isolation during the first six months of the pandemic. And in a Pearson and Connections Academy survey of US parents, 66% said their child felt anxious or depressed during the pandemic.

However, the pandemic has only exacerbated youth mental health issues that were already happening before COVID-19.

“Many people associate our current mental health crisis with the pandemic,” says Morgan Champion, the head of counseling services for Connections Academy Schools. “In fact, the youth mental health crisis was alarming and on the rise before the pandemic. Today, the alarm continues.”

Mental Health America reports that most people who take the organization’s online mental health screening test are under 18. According to the American Psychiatric Association, about 50% of cases of mental illness begin by age 14, and the tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

Such statistics demand attention and action, which is why experts say destigmatizing mental health and talking about it is so important.

“Today we see more people talking about mental health openly—in a way that is more akin to physical health,” says Champion. She adds that mental health support for young people is being more widely promoted, and kids and teens have greater access to resources, from their school counselors to support organizations.

Parents are encouraging this support too. More than two-thirds of American parents believe children should be introduced to wellness and mental health awareness in primary or middle school, according to a new Global Learner Survey from Pearson. Since early intervention is key to helping young people manage their mental health, these changes are positive developments.

In addition, more and more people in the public eye are sharing their personal mental health experiences as well, which can help inspire young people to open up and seek out the help they need.

“Many celebrities and influencers have come forward with their mental health stories, which can normalize the conversation, and is helpful for younger generations to understand that they are not alone,” says Champion.

That’s one reason Connections Academy is hosting a series of virtual Emotional Fitness talks with Olympic athletes who are alums of the virtual school during Mental Health Awareness Month. These talks are free, open to the public and include relatable topics such as success and failure, leadership, empowerment and authenticity. For instance, on May 18, Olympic women’s ice hockey player Lyndsey Fry will speak on finding your own style of confidence, and on May 25, Olympic figure skater Karen Chen will share advice for keeping calm under pressure.

Family support plays a huge role as well. While the pandemic has been challenging in and of itself, it has actually helped families identify mental health struggles as they’ve spent more time together.

“Parents gained greater insight into their child’s behavior and moods, how they interact with peers and teachers,” says Champion. “For many parents this was eye-opening and revealed the need to focus on mental health.”

It’s not always easy to tell if a teen is dealing with normal emotional ups and downs or if they need extra help, but there are some warning signs caregivers can watch for.

“Being attuned to your child’s mood, affect, school performance, and relationships with friends or significant others can help you gauge whether you are dealing with teenage normalcy or something bigger,” Champion says. Depending on a child’s age, parents should be looking for the following signs, which may be co-occurring:

  • Perpetual depressed mood
  • Rocky friend relationships
  • Spending a lot of time alone and refusing to participate in daily activities
  • Too much or not enough sleep
  • Not eating a regular diet
  • Intense fear or anxiety
  • Drug or alcohol use
  • Suicidal ideation (talking about being a burden or giving away possessions) or plans

“You know your child best. If you are unsure if your child is having a rough time or if there is something more serious going on, it is best to reach out to a counselor or doctor to be sure,” says Champion. “Always err on the side of caution.”

If it appears a student does need help, what next? Talking to a school counselor can be a good first step, since they are easily accessible and free to visit.

“Just getting students to talk about their struggles with a trusted adult is huge,” says Champion. “When I meet with students and/or their families, I work with them to help identify the issues they are facing. I listen and recommend next steps, such as referring families to mental health resources in their local areas.”

Just as parents would take their child to a doctor for a sprained ankle, they shouldn’t be afraid to ask for help if a child is struggling mentally or emotionally. Parents also need to realize that they may not be able to help them on their own, no matter how much love and support they have to offer.

“That is a hard concept to accept when parents can feel solely responsible for their child’s welfare and well-being,” says Champion. “The adage still stands—it takes a village to raise a child. Be sure you are surrounding yourself and your child with a great support system to help tackle life’s many challenges.”

That village can include everyone from close family to local community members to public figures. Helping young people learn to manage their mental health is a gift we can all contribute to, one that will serve them for a lifetime.

Join athletes, Connections Academy and Upworthy for candid discussions on mental health during Mental Health Awareness Month. Learn more and find resources here.

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