TDS is Not a Mental Illness

Minnesota State Senators introduced a bill to amend the definition of Mental Illness to include “Trump Derangement Syndrome”. The bill is SF2589, read March 17, 2025, and referred to Health and Human Services committee.

No surprise the authors of the bill all have an “R” after their name. It also comes as no surprise there are a few on the House side who happen to have an “R” after their name declaring they will take up the bill in the House, when it comes to them. Or, if it comes to the House. Knowing as close to nothing as possible about the makeup and inclinations of the Minnesota legislature, I can’t even hazard a guess on this bill’s chances of making it out of committee much less to the House.

The parts of the bill that jump out –

Minnesota Statutes 2024, section 245.462, subdivision 20, is amended to read:

Subd. 20.

Mental illness.

(a) “Mental illness” means Trump Derangement Syndrome or an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior that is detailed in a diagnostic codes list published by the commissioner, and that seriously limits a person’s capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, and recreation.

And –

Subd. 28.

Trump Derangement Syndrome. 

“Trump Derangement Syndrome” means the acute onset of paranoia in otherwise normal persons that is in reaction to the policies and presidencies of President Donald J. Trump. Symptoms may include Trump-induced general hysteria, which produces an inability to distinguish between legitimate policy differences and signs of psychic pathology in President Donald J. Trump’s behavior. This may be expressed by:

(1) verbal expressions of intense hostility toward President Donald J. Trump; and (2) overt acts of aggression and violence against anyone supporting President Donald J. Trump or anything that symbolizes President Donald J. Trump.

This link will take the curious to the text of the bill.

Regardless of what happens with this bill there is actual, serious justification for considering TDS as a Personality Disorder, but it not a Mental Illness. There is a difference between a Mental Illness and a Personality Disorder and by definition, TDS would more appropriately be categorized as one of the latter. In short, a Personality Disorder is a pervasive pattern of behavior, not considered to be organic in origin; a Mental Illness is a dysfunction in the brain, a structural, chemical or hormonal imbalance that impacts behavior, thought and function. In short, a Personality Disorder is acquired and a choice, a Mental Illness is biological.

Granted, TDS may manifest more readily in those with other, co-occurring Mental Illnesses hence the argument for a genetic component or predisposition for Personality Disorder. Regardless of the category under which TDS falls the real-world results, particularly for the rest of us, are the same.  Many therapists struggle or even flat-out refuse to treat those with certain Personality Disorders because they cannot be “cured” without a strong willingness on the part of the patient to change, which seldom exists.

This is in contrast to a Mental Illness, a biological dis-ease. Individuals so afflicted can be very difficult to live with but talk and behavioral therapy and psychopharmaceuticals can help manage symptoms and manifestations negatively impacting their lives. These individuals generally experience significant improvement due to a strong willingness to change or modify their behavior, thoughts, and interactions with others; they understand, or come to, they are not at fault, it is not merely a matter of perspective or choice. It is no different than diabetes in that a part of their biology is not working as intended.

The American Psychiatric Association Diagnostic and Statistical Manual, the infamous DSM-5, makes clear the distinction between Mental Illness and Personality Disorder but includes both as “mental disorders”, i.e., dysfunctions that negatively impact an individual’s life. And, because very few in modern society live completely separate from everyone else, others are also negatively impacted by one individual’s experience. So, understanding what can and cannot be helped, what is a matter of choice, and what is biologically driven matters.

Those said to be suffering from TDS negatively impact their own lives but more to the point cause significant distress in those with whom they come in contact. The blame for their distress is caused by others, Trump and MAGA-people, and they are not the problem. They take no responsibility for either their behavior or the negative consequences their behavior inflicts on others. That is the hallmark of a Personality Disorder, a choice of behaviors for which there is no personal accountability.

Calling Trump Derangement Syndrome a Mental Illness almost gives these noxious individuals a pass. We can joke “they can’t help themselves” but the simple truth is, they can. TDS is the literal definition of an environmentally acquired pattern of behavior that is pervasive and inflexible, causing distress or impairment in functioning.

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