These symptoms (distress and impairment) are a critical element to a mental health diagnosis. Not only is this aspect misunderstood with regards to the President, but for those who suffer from mental health ailments in general (perhaps more importantly). Dr. Frances eloquently (and succinctly) clarifies this in his letter to the New York Times:
FEB. 14, 2017
To the Editor:
Fevered media speculation about Donald Trump’s psychological motivations and psychiatric diagnosis has recently encouraged mental health professionals to disregard the usual ethical constraints against diagnosing public figures at a distance. They have sponsored several petitions and a Feb. 14 letter to The New York Times suggesting that Mr. Trump is incapable, on psychiatric grounds, of serving as president.
Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. 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.
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).
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.
His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.
ALLEN FRANCES
Coronado, Calif.
The writer, professor emeritus of psychiatry and behavioral sciences at Duke University Medical College, was chairman of the task force that wrote the Diagnostic and Statistical Manual of Mental Disorders IV (D.S.M.-IV).
How's that for a long title?
I just finished listening to an episode of one of my top, go-to podcasts: the Enormocast. The Enormocast is focused on climbing. It definitely covers areas most non-climbers won't have any clue as to what being discussed. Yet, to paraphrase its host Chris Kalous, there really isn't anything else to talk about! And even if so, why would anyone even want to talk about something other than climbing? The beauty of Chris is that while talking about only climbing, he manages to cover a lot of other really interesting human aspects within the context of climbing. And he does it quite well.
While this episode with big wall climber Cheyne Lempe is about a big wall expedition to the extremely remote and cold Baffin Island, it's really about a lot more that just the climbing. It touches on journeys, generalized anxiety (as a medical affliction), and quite a few other thought-provoking topics.
I too have generalized anxiety. It’s not been all that long that I’ve been able to name it specifically, but as Cheyne touched upon, it’s been something that’s been part of my journey and growth pretty much my whole life. It’s only recently that I’ve begun to see how it has been at play in the past. Sometimes with mental health disorders, people tend to take a negative view, e.g. “I suffer from x.” I don’t quite see it that way. For me, anxiety can be both my greatest curse and greatest gift. As I’ve become friends with anxiety, gotten to know it better, and really have owned it, I’ve seen how I’ve let it channel me into the abyss of despair and paralysis. But I’ve also seen how it has helped me achieve incredible commanding heights. Much of this is about your brain and how it’s wired. Anxiety people have minds that think a lot… to the point of potentially harmful overthinking! I can use my brain to scare and talk myself out of everyday actions that otherwise could give me immense benefit. Or I can learn to flip the downward spiral and use my mind with all of its thoughts and ideas to spin them into great creations.
One of my favorite observations: A hammer is a tool. In and of itself, it’s neutral. It’s what you use it for that has impact (yeah, bad pun!). You can use a hammer to build a home for someone who really needs a good, safe shelter. Or you can use it to bash their skull in. Same hammer, different outcomes. One good, one bad. The hammer is neither.
If you're interested, check out the www.enormocast.com!