For a third time this week, Donald Trump went on an unhinged social media attack targeting the daughter of the judge in his upcoming hush money trial. In the most recent post he called her out by name. It fits Trump’s megalomania to see him think he is exempt from the laws and rules that would apply to everyone else. He must be loathe to accept that a judge has more power than he does. Trump’s lawyers may have told him that a judge has the authority to put him in jail for contempt but he either doesn’t believe Judge Merchan or any other judge would dare do this or this defiance is a result of a mental disorder.

One of the signs of both delusional psychosis and of dementia is impaired judgment. It possible someone can be suffering from both at the same time.

As a retired therapist who never had significant clinical experience working with people with dementia I worked with many who had delusional psychosis. It has only since I retired 10 years ago and moved to a continuing care retirement community that I have I observed dozens friends and aquaintances as they moved though the various stages of dementia.

I have seen or been told about a few of them lapsing into episodes of paranoia and psychosis (read article.)

I have seen them move from being able to live independently to needing to live in one of our memory care neighborhoods.

I am also a member of a group of 50 residents who have regular training by our security professionals in conducting searches of our buildings and our sprawling 25 acre campus for residents with dementia who have wandered off. We all carry walkie-talkies as we look for large colored ducks hiden by the security team. They are devious in where they put the ducks so it is a challenge to find them.

Of course Trump, who is protected by the Secret Service, is unlikely to wander outside of Mar-a-Lago in his pajamas or underwear, although it is possible the Secret Service could find a befuddled Trump wandering around the mansion in the middle of the night not knowing where he was of what he was doing. Of course if this happens it will be covered up.

Those like Dr. John Gartner who in a group of interviews with Salon’s Chauncey DeVega ( for example:”Hastening his deterioration”: Dr. John Gartner on impact of court trials on “Trump’s fragile brain” “He is cognitively weak and closer than you might think to being completely disabled”) have ticked off examples from Trump’s spoken words which suggest he is along the slippery downslide of dementia what we don’t know, and may not know for years, is what behaviors those close to him during unguarded moments have observed. It is possible Melania and his adult children have seen more and more signs of memory impairment. It is also quite possible, perhaps likely, that his lawyers have seen this.

If Trump is in the early stages of dementia there are people who have seen more evidence of this than what we see when he’s on TV.

If this is true, they aren’t talking, but if they truly care about his well-being they have to live with themselves if he descends into full-blown dementia within the next year. There are no treatments available but there is medical intervention that can be helpful (See WebMD).

Previous Stressline blogs here.