Psychotherapist Jonathan Alpert wrote a piece in the Wall Street Journal telling us what most of us already knew: Trump Derangement Syndrome is actually a real thing.
He was not trying to make a political point, but rather to explain that in his practice, about 75% of his patients are experiencing an obsession with Donald Trump that is warping their lives.
Is “Trump derangement syndrome” real? No serious mental-health professional would render such a partisan and derogatory diagnosis. Yet I’ve seen it in my own psychotherapy practice. Patients across the political spectrum have brought Donald Trump into therapy not to discuss policy but to process obsession, rage and dread. Their distress is symptomatic, not ideological.
Clinically, the presentation aligns with anxiety and obsessive-compulsive disorders: persistent intrusive thoughts, emotional dysregulation and impaired functioning. Patients describe sleepless nights, compulsive news checking and physical agitation. Many confess they can’t stop thinking about Donald Trump even when they try. They interpret his every move as a threat to democracy and to their own safety and control.
Call it “obsessive political preoccupation”—an obsessive-compulsive spectrum presentation in which a political figure becomes the focal point for intrusive thoughts, heightened arousal and compulsive monitoring.
I initially viewed this as an ideological reaction, an understandable response to a polarizing figure. But over time the symptoms took on a more clinical shape. What once looked like outrage now presents as a fixation that distorts perception and consumes attention.
One patient told me she couldn’t enjoy a family vacation because “it felt wrong to relax while Trump was still out there.” Others report panic attacks or trouble sleeping after seeing him in the news. Their anxiety has outgrown politics and become a way of being.
At the group level, the pattern functions like a culture-bound syndrome, a condition shaped by shared social triggers within a specific context. From a diagnostic standpoint, it overlaps with obsessive-compulsive disorder, generalized anxiety disorder and trauma-related syndromes. While not a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, it reflects the same symptom patterns and behavioral mechanisms used to define emerging conditions. By that measure, this presentation merits serious consideration.
TDS is not a diagnosis in the classic sense, but rather a description of a phenomenon where people begin organizing and understanding their lives around a boogyman who happens to be Donald Trump. Trump becomes the eye of the hurricane, around which all their fears, troubles, and disappointments seem to center.
Unfortunately, TDS is real.
Psychotherapist Jonathan Alpert: “People are obsessed with Trump… they’re hyper fixated on Trump… to be that fixated on a figure on a person uh it’s simply not healthy.”pic.twitter.com/tduT1WcdQr
— RNC Research (@RNCResearch) November 15, 2025
TDS is hardly a revelation to any of us who have been the victims of people whose obsession is the evils of Donald Trump. Many, or most of us, have been ostracized from some version of polite society for making the mildest comment about agreeing with Trump about anything. There is no rational conversation to be had, just as having a conversation with somebody who believes that some version of Critical Theory can interpret everything in life.
Try to have a conversation with somebody dedicated to gender ideology. It is impossible. We exist in two different universes.
Alpert is not trying to make a political point about whether Trump is a good or bad president. Instead, the issue is that the obsession with all things Trump is distorting lives, communities, and our ability to function as a country. On the most basic and personal level, if you can’t enjoy a vacation because somebody—anybody—else walks the earth and is able to speak, the problem isn’t him, but you, and it’s important to regain the ability to smell the grass.
When the Nazis were taking over Europe, Americans could walk and chew gum at the same time. You can mobilize to fight what you consider evil and then go to a movie to relax, right? When the organizing principle of your life is one thing and one thing only, something is wrong.
Alpert wrote a subsequent piece for The New York Post about the reaction to his Wall Street Journal article, in which he points out that the reaction to his original essay proved his point.
I asked if Trump Derangement Syndrome is real: I got the death threats in reply proving it is https://t.co/NYbUO5G5eh pic.twitter.com/hvZ8r8W7WO
— NY Post Opinion (@NYPostOpinion) December 2, 2025
Alpert got to experience TDS in real time.
Last month, when I published a column asking “Is ‘Trump Derangement Syndrome’ Real?” in the Wall Street Journal, I expected it to spark lively debate.
I didn’t anticipate a live demonstration of the very pathology I’d described.
My column outlined a pattern I see in my psychotherapy practice every week.
I call it “obsessive political preoccupation,” a presentation that resembles an obsessive-compulsive pattern in which one political figure becomes the center of intrusive thoughts, heightened arousal, and compulsive monitoring that takes over a person’s mental bandwidth. …
As soon as my column was posted online, the response illustrated my point with almost clinical precision.
Many of the loudest critics merely reacted to my use of the term “TDS,” not to my explanation.
Their retorts, immediate and emotional, displayed the very pattern I described: impulsive, catastrophic thinking driven by feeling rather than reflection.
In trying to disprove the phenomenon, they demonstrated it dramatically.
Two days later, I discussed the piece live on Fox News, and the reaction intensified.
The segment was calm and clinical.
But once the clips hit social media, they were stripped of context, paired with heated captions, and fed into outrage feeds.
The surge of emotional messages I received was immediate and relentless.
Some accused me of defending a fascist.
Others called me a “pedophile protector,” and one self-identified therapist suggested I must be a pedophile myself.
Several messages, including voicemails, wished me dead.
These weren’t fringe accounts, but people who publicly describe themselves as compassionate, trauma-informed, or dedicated to mental health work.
Their reaction is exactly what concerns me as a clinician.
I got to see this last year, when a Minnesota state senator casually signed onto a bill that classified Trump Derangement Syndrome. It was not really intended to make it a legal classification—there was no way it would become law, obviously—but rather to needle his colleagues about their own obsession with Trump.
He wasn’t the chief author. He just attached his name to it as something of a joke. After having been called horrible names such as “Nazi,” “fascist,” and “white supremacist,” he didn’t worry about offending his colleagues with a bit of a jibe.
He got death threats. The phones rang off the hook, and the emails were vicious. My wife got to see it all. It became her life for a bit, dealing with all the hate. You would think that he had called Democrats “bitter clingers” or “deplorables.”
The critics who condemned the piece re-enacted the pattern in real time.
Their outrage became their evidence.
Their feelings became their argument.
They proved my point more clearly than anything I could have written — and that’s why we need to talk about these symptoms openly.
Our society encourages people to “trust their truth,” to follow every impulse and to label ordinary discomfort as harm.
Too many in my profession have encouraged this view
They now celebrate it — when directed at the “right” targets.
I see the consequences daily, as a patient tells me she’s stopped speaking to her father because he “voted the wrong way,” or a couple avoids family gatherings because a relative supports Trump.
These are educated adults who have adopted the idea that emotional discomfort equals danger.
There is nothing wrong with dedicating some of your bandwidth to fighting for your beliefs. In fact, that is, if done properly, good citizenship. I respect people who use their time and effort to fight for their values, as long as they do it thoughtfully. Even if I think they are wrong, even tragically so.
But raw emotion is now valued over rational thought, and the evidence that one is moral seems to be irrationality itself. The more irrational you are, the more “passionate” you are about justice. Smashing the Magna Carta and throwing soup at paintings is, for some people, morally persuasive.
TDS is ruining lives, undermining society, and destroying social trust. Everybody, especially those who suffer from it, has their lives degraded.
Arguing with somebody suffering from TDS is like trying to reason with a schizophrenic. There is no common frame of reference. Where does one begin?
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