Mental health experts: Biden far exceeds Trump in psychiatric fitness

Mental health experts: Biden far exceeds Trump in psychiatric fitness
Gage Skidmore

Most Americans would agree that the President of the United States should be a normal, honorable, and effective leader of the country.  Republican Senator Lindsey Graham has said this about Joe Biden: “He is as good a man as God created” and “He is the nicest person I’ve ever met in politics.” In contrast, Graham has said this about Donald Trump: “I think he’s a kook. I think he’s crazy. I think he’s unfit for office.” The stark differences between Biden and Trump are revealed in these strong comments.


Much has been written about Donald Trump’s psychiatric disturbance. We have published several pieces ourselves. His personality pathology—narcissistic and antisocial—is severe, malignant, and dangerous. Its visibility in Trump’s presidency has been front and center. Its impact is seen in his divisiveness, his chaos, and his vindictiveness.  Its impact is seen in his attacks on the rule of law, the Constitution, and democracy itself.

Today, we want to discuss Joe Biden’s mental health. It has been largely ignored in the mass media. No mental health professional has spoken out about Biden’s psychiatric status. We believe it is important to make a statement now since the presidential election is only weeks away.

Joe Biden has been nationally visible during the past 12 years. He has been a two-term Vice President and is now the Democratic nominee for President. Biden was a long-time Senator and has also been a candidate for President in the distant past. As such, all of us have had access to hundreds of Biden’s statements, tweets, speeches, audio recordings, videotapes, interviews, and other collateral data.

In the field of psychiatry, “normality” can be defined as the absence of pathology. If a person presents with few or no psychiatric symptoms and his or her daily life is conducted without interruption, we can safely determine that there is no psychopathology—no psychiatric disorder.

As mental health professionals, we look for evidence of a psychiatric condition that might undermine a person’s ability to be a fit president. A psychotic illness is a prime example. This is a major mental illness that includes hallucinations and/or delusions—clear breaks with reality. A second category would be a severe personality disorder—where the personality pathology is so pronounced and dramatic that it renders the person impaired and disrupted. A third category is severe cognitive dysfunction—due to dementia or other degenerative neurological disease. A final category to consider would be severe alcohol or substance abuse.

Everyone knows that Joe Biden has suffered terrible losses in his life. It is true that he has shown resilience and a remarkable capacity to recover from tragedy. His experience of grief has been in the normal range and not a psychiatric disorder.

Biden had one episode of plagiarism in 1965 as a first-year law student.  Another allegation of plagiarism was levied against him during the 1988 presidential campaign. He has apologized for the law school incident.

Biden’s verbal blunders during the early Democratic debates were initially feared to be due to dementia. Even Democrats began to question his mental acuity. “Biden is either near senile or actually senile” was heard more than once. But Biden has a longstanding problem with stuttering, dating back to childhood. He still uses various techniques to overcome his stuttering, especially in public forums. In our opinion, Biden’s verbal stumbling is directly related to his speech impediment—not to serious cognitive decline. Biden’s town hall performance on the evening of September 10, 2020, proves that his cognitive abilities and mental sharpness are intact. His thinking was logical, orderly, and well-organized.

Biden had two surgeries for two brain aneurysms in 1988. In 2019, his brain surgeon, Neal Kassel, MD, stated that Biden “is every bit as sharp as he was 31 years ago. I can tell you with absolute certainty that he had no brain damage.”

Last year, Biden’s primary care physician, Kevin O’Connor, MD, released a three-page summary in which Biden was described as “healthy” and “vigorous.” Biden is taking blood thinners and medications for acid reflux, cholesterol, and seasonal allergies.

As best we can tell, Joe Biden does not show evidence of a psychiatric condition. There is no evidence in the public domain that he has a major mental illness. There is no evidence that he has a severe personality disorder. There is no evidence that alcohol or substance abuse is a problem. There is no evidence of serious cognitive dysfunction. In looking at the public record, Biden is described as decent, warm, empathetic, compassionate, competent, moral, and a strong public servant.  His only diagnosis is chronic stuttering.

Going forward, we believe it would be a prudent policy for all nominees for president to routinely sit for a thorough neuropsychiatric evaluation. Such a fitness for duty evaluation would detect potentially disqualifying major mental illness, severe personality pathology, and/or significant cognitive decline.

In sum, it is our opinion that Joe Biden falls in the normal range of mental health. He is psychiatrically healthy and fit. In contrast, it is undeniable that Donald Trump has narcissistic and antisocial personality pathology–and it is severe and malignant. Not one psychiatrist or clinical psychologist has stood up for Trump or pronounced him normal and fit.

Simply put: One candidate is normal. The other candidate has a severe psychiatric condition.

Alan D. Blotcky, PhD, is a clinical psychologist in private practice in Birmingham, Alabama.

Seth D. Norrholm, PhD, is a faculty member at Wayne State University School of Medicine.

John M. Talmadge, MD, is a psychiatrist in private practice in Dallas, Texas.

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