After publishing my Wall Street Journal opinion piece, “Is ‘Trump Derangement Syndrome’ Real” I received a storm of responses that revealed more than disagreement. Many messages were angry or fearful, and a few crossed into threats, but the takeaway was clear: political feelings are no longer just opinions, they are a constant emotional state for a large share of Americans.
The intensity surprised me less than the speed with which disagreement turned into fury. People treated a clinical question like a political charge, and that reaction mirrored what I see in sessions every week. This pattern isn’t limited to any one class or place; it cuts across neighborhoods, jobs and education.
In my practices in Manhattan and Washington, D.C., the emotional heat around Donald Trump hasn’t cooled. If anything, it has crystallized into a steady background agitation that people carry into work and family life. Politics has stopped being a set of positions and started to function like an identity tag you wear 24/7.
I want to be clear about one clinical point I made then: “Trump Derangement Syndrome,” or TDS, is not a legitimate psychiatric diagnosis. People are suffering from anxiety, obsessive thinking, sleeplessness and relationship strain, and those symptoms deserve care and attention. Labeling those responses as a political diagnosis does not help recovery or clarify treatment.
What I see in practice has familiar features of obsessive worry: nightly scrolling that replaces sleep, repetitive checking of headlines, intrusive thoughts that are hard to silence. Patients describe the physical restlessness that follows hours of news consumption and the social narrowing that happens when politics dictates who they will spend time with. These are real stressors that shape daily choices.
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This pattern becomes self-reinforcing because outrage supplies a clear villain and moral certainty. When life feels messy, casting someone as the source of all harm simplifies things and spares people from doing the harder work of self-examination. That psychological payoff helps explain why the anger persists long after specific stories fade from the headlines.
Trump did not invent grievance or anxiety, but he has been an extraordinarily effective focus for both. Long after any one scandal passes, the emotional architecture remains: suspicion, alertness, readiness to mobilize. Once a political figure becomes the main object of intrusive thought, the mind stays primed for confrontation.
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Our cultural incentives make this worse. Media and social platforms reward strong feelings and fast judgment, and the louder voice often gets the most attention. Calm analysis is treated as timidity, and pulling back can be framed as complicity rather than prudence.
The consequences reach beyond opinion. People change where they go, who they date, which family dinners they attend and even where they travel, based on political comfort zones. Workplaces become battlegrounds, friendships fray, and many patients report a weary resignation from being constantly “on alert.”
From a conservative perspective, this is a civic problem as much as a clinical one: a democracy needs citizens who can tolerate disagreement and recover perspective. Emotional regulation is not surrender to the other side; it’s a skill that preserves relationships and keeps public debate functional. We’re better off when arguments are about policy and ideas, not about who can sustain the loudest moral fury.
None of this asks anyone to stop caring or to abandon convictions. It asks people to recognize when political preoccupation is doing real harm to their sleep, their families and their sense of agency. Treatment and simple boundaries can reduce the constant churn without requiring political capitulation.
The question now is whether Americans will let politics take up permanent residence inside their heads. At some point, a society has to decide whether permanent outrage is a way to live.
