In 2017, twenty-seven psychiatrists and mental health professionals broke their profession’s long standing ‘Goldwater rule’ against diagnosing public figures from afar. They published a book titled The Dangerous Case of Donald Trump, and in it, they wrote a sentence that should have stopped the world cold:
‘Trump is now the most powerful head of state in the world, and one of the most impulsive , arrogant, ignorant, disorganised, chaotic, nihilistic , self-contradictory , self-important and self-serving. He has his finger on the triggers of a thousand or more of the most powerful thermonuclear weapons in the world. That means he could kill more people in a few seconds than any dictator in past history has been able to kill during his entire years in power’
That was nine years ago. Today, that warning is no longer prophecy, it is the reality.
The man who sits in the White House governs not by deliberation or diplomacy, but by impulsive digital barks fired into the atmosphere every few minutes, often forgetting what he himself said an hour earlier.
He has embraced AI-generated deepfakes as a routine tool of political communication , blurring reality into propaganda. In his most recent foray AI kitsch, (April 12) while attacking Pope Leo XIV as ‘weak on crime’, Trump cast himself as a digital messiah. Yet, beneath this surreal veneer of virtual omnipotence, the world cannot afford to forget that the same man holds, in his trembling hand, the nuclear codes of the most powerful military the world has ever known.
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I’m not here to repeat the obvious labels of ‘mad’ or ‘deranged’ that already saturate the airwaves. Stating he is ‘crazy’ is just describing the scenery. I am here to connect the dots and raise a warning: we aren’t headed for chaos—we are headed for catastrophe, and we are standing on the edge of something much worse than a personality flaw.
The Unprecedented Triple Threat
History offers echoes of erratic leaders: Caligula’s cruelty, Nixon’s calculated ‘madman’ bluff, the Cold War’s existential brinkmanship. But none of those parallels capture the lethal novelty of today. What makes this moment peculiar is the fusion of three elements:
- A president whose cognitive decline and emotional instability are now widely acknowledged, even by former allies, and increasingly by members of his own party.
- The speed of AI and social media , which allows a single delusional or enraged thought to circle the globe in seconds, triggering markets, and rattling allies and adversaries alike.
- The absence of any filter- no diplomatic cable to revise, no national security advisor to intercept, no adult in the room to say ‘ Sir, you cannot tweet that’.
The result is a structurally incoherent foreign policy that mystifies the entire global stage. And beyond the bombs and threats of war, there is another casualty: the collective peace of mind of billions who go to bed wondering if tomorrow will bring a trade war, a military confrontation or an inexplicable reversal, all because one man woke up in an uncouth mood and recklessly started scrolling his screen.
The Evolving Regional Inferno
We have already seen what this president’s mental state, combined with his unconditional acquiescence to Benjamin Netanyahu and Israel’s lobby in Washington, has produced.
The genocide in Gaza happened because of US weapons and diplomatic cover flowing without pause. Now the same president is openly threatening to obliterate Iran within hours, and all this not through careful diplomatic channels, but through profane, erratic and often contradictory social media outbursts.
His threats about ending civilisation , his obscene demands to open strategic waterways, his messianic AI generated postings – all of this is public, and all of it is terrifying. This incoherent impulse-driven governance is nothing less than a direct enabler of mass death. And the world watches in horror.
In the last two weeks , the Iran war has frozen into a stalemate that looks increasingly like a strategic defeat for the United States. A fragile ceasefire , repeatedly extended, now has ‘no time frame’, a clear admission that Trump’s promised victory has not arrived as Iran still blocks the strait of Hormuz. Trump is trapped: renewing the war risks catastrophic casualties and economic pain across the board. So he does nothing, hoping the problem will solve itself. Meanwhile Israel quietly pushes for chaos, not only in Iran but the whole region, knowing that a weaker and distracted America is easier to drag into a wider war.
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The Iranian Psychiatrists’ Letter
It is worth noting that the alarm is no longer confined to American professionals. On 7 April 2026, the Iranian Psychological Society published an open letter to their US counterparts calling for a formal , scientific examination of Trump’s behavioural patterns, which they say pose a direct threat to global peace. They pointed to his ‘ hostile rhetoric, extreme attention- seeking trait, lack of empathy and narcissism, impulsivity and delusional thoughts, disconnecting from reality , disregarding others’ rights , threats and insults toward other nations, contradictions, and antisocial and inhuman behaviour’. They further stated that Trump ‘ is not bound by any rules, and like a psychopath, has led the world into a pit of fire and destruction’. They concluded with a powerful statement: ‘Regardless of geographical borders, we share a common responsibility to uphold the mental health of humanity and contribute to global peace and justice’.
This should not be read as a political statement from an adversarial state. It is a professional plea from mental health experts who recognise that the psychological stability of world leaders directly affects the fate of us all.
The Moral Question the World Cannot Escape.
If this man’s madness only affected his own country, we might look away and say ‘ This is America’s problem’. But his decisions , or whims, can level a city, start a war, and shatter global alliances. Every nation on earth now has a stake in the mental state of the American president.
This brings us to the concept the United Nations adopted in 2005 : The Responsibility to Protect, ( or R2P). R2P holds that sovereignty is not absolute. When a state manifestly fails to protect its own people from mass atrocities – or as here, actively enables them elsewhere – the international community has a moral , and in extreme cases, a legal duty to intervene.
Though the legal reality is clear, and there is no mechanism for the world to step in and say: ‘This president is too dangerous to remain at the helm’ , yet, the absence of a legal mechanism does not erase the moral imperative. The world has a duty to speak, loudly, clearly and without hesitation.
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What Speaking Looks Like
Speaking means every foreign leader, every international organization , every major newspaper, every professional body of psychiatrists and psychologists, every religious authority and every ordinary citizen on every continent saying the same thing:
‘The president of the United States is not mentally fit to command a nuclear arsenal. His behaviour is erratic, his memory is failing, and his impulsive use of social media and AI -generated disinformation is a direct threat to global peace. We demand that those with constitutional power to remove him- the Vice president and the cabinet invoke the 25th Amendment . And if they will not, we demand the American people vote him out of office before it is too late’ .
This is not interference in American democracy. This is self-defence by the rest of the world, because we live in the unprecedented dangers of governing by tweet, AI and cognitive decline. No nation has a right to hold the world hostage to its internal failures.
The 2017 Book was a Warning. 2026 Is the Reckoning
Those twenty-seven psychiatrists were ridiculed and marginalised for breaking their professional norms. They were told they were being hysterical, that they should stay in their lane, and that a president’s mental health was not their concern. But they were right.
As the world navigates this volatile climate, the primary threat is no longer just the prospect of reckless action, but the equally grave danger of reckless inaction. This is the true peril of the Trump era. Rather than looking away, the international community must undertake the urgent task of refusing to normalize the situation.
It is time to speak the truth—that a mentally deteriorating man now holds ultimate power, enabling current atrocities while openly courting catastrophic new wars.
Because if we look away, and the unthinkable happens, we will have no one to blame but ourselves.
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The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.
