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President Donald Trump claims to love his country and wants to defend its Constitution. Yet, his recent behaviors and comments, especially instigating his followers to violently attack Congress on Jan. 6, counteracts that. The president’s mental functioning has long troubled many people and is now obviously dysfunctional and dangerous for America. It’s been “the elephant in the room,” a situation where one does not talk about what one sees or knows.

Now, that elephant is rampaging. The violent insurrection, deaths in the halls of Congress and resulting national shame are Trump’s legacy. His positive achievements are muted.

As a retired psychologist, I cannot diagnose anyone’s mental health, but I can use my psychology experience and the Diagnostic and Statistical Manual (DSM-5) to suggest that Trump’s bizarre comments and dysfunctional behaviors are similar to those of people identified with antisocial and narcissistic personality disorders as well as delusional disorders.

Trump’s personality disorders are evidenced by his manipulative schemes, exaggerated self-importance, entitlement, arrogance and inability to sympathize. History reminds us that citizens of nations with similarly personality disordered leaders never fare well. Losing this election appears to have greatly increased Trump’s dysfunctional actions. His life experiences seem to have made him psychologically unable to accept or admit to losing or “being a loser” in anything.

Nothing, including vote counting accuracy or judicial decisions, can ever make him believe that he lost this election. He convinced his followers of this as well as related conspiracies, evoking memories of cult leaders and their followers’ tragic endings (e.g., Jonestown, Guyana, 1978). Sadly, accepting the lie that Trump won the election feels right to those fearing the loss of someone who champions their causes or view it as a political steppingstone.

Most people get over severe losses after processing the recognized stages of grief — denial, anger, bargaining, depression and acceptance. Those who lose that which is dearest to them often have long stays in the anger or depression stages but very rarely remain in the denial stage, as has Trump. His extreme grief over losing power and control makes him unable to manage his actual loss and suggests that he has developed a delusional disorder. He has even browbeaten Republican officials to revise actual results to fit his thought process.

DSM-5’s criteria for this diagnosis requires the delusion lasts at least a month, schizophrenia is absent and aside from the delusion, other behaviors are not overly strange or the result of substances or medical conditions. Subtypes of delusional disorders, grandiose, believing that one has unusual talents and persecutory, believing one is being conspired against or cheated on, seem relevant.

“Alternate facts,” inflammatory tweets, strained international relationships and denying COVID-19’s lethality are hallmarks of Trump’s administration. While our economy looked great and Republican goals were achieved, those with the wherewithal to check the president’s bizarre behaviors and comments didn’t interfere.

Now, there’s no doubt that Trump’s biased, erratic, self-serving, tyrannical decisions and encouragement of violence are dangerous to our nation. America is paying the price for this president’s dysfunctional mental health.

Diane W. Mufson is a retired psychologist and a regular contributor to The Herald-Dispatch opinion page. Her email is dwmufson@comcast.net