Podcast Summary: The Daily Beast Podcast

Episode: Trump Mental Decline Is Accelerating: Psychologist
Host: Joanna Coles
Guest: Dr. John Gartner (Clinical Psychologist, former Assistant Professor at Johns Hopkins, practicing therapist) Date: December 22, 2025

Overview

This episode features host Joanna Coles in conversation with Dr. John Gartner, a psychologist known for his public analysis of Donald Trump’s personality and mental health. The discussion centers on Trump's recent behavior, public statements, and evidence of accelerating cognitive decline, combining insight from Gartner’s direct clinical perspective with recent news events at the White House.

Key Discussion Points

1. Monitoring Trump’s Cognitive State

• Early Mention of Testing
  • Gartner points out Trump’s own reference to repeated MOCA (cognitive) tests, indicating ongoing monitoring for dementia rather than standard screening.
    • Quote: “If you're giving it to him three times, that means you're not assessing dementia. That means you’re monitoring dementia.” (02:41, 36:47)

2. The “Angry Santa” Speech—Signs of Hypomania and Panic

• Dr. Gartner’s Analysis:
  • Despite sticking to the teleprompter, Trump delivered the speech at double his normal speed, signaling a mental status change rooted in anxiety and hypomanic behavior.
  • Quote: “He literally spoke at double the velocity and speed that he normally speaks, which is telling.” (06:20)
• Hypomania vs. Mania:
  • Trump is “on the bipolar spectrum,” not fully manic but hypomanic—evident in his outpouring of late-night social media posts (e.g., 180 Truth Social posts in one night).
  • Quote: “When he’s … I think this month, he had one night where he put out 180 Truth social posts. I mean, that’s crazy.” (06:46)
• Panic as Motivation:
  • Gartner suggests the accelerated pace stems from anxiety about losing political ground, perhaps driven by advisors’ warnings.
    • Coles: “He’s panicked.”
    • Gartner: “This was his attempt to kind of make a comeback … the anxiety stimulated his hypomania.” (07:43)
• Possible Drug Use:
  • Suggestion Trump may use Adderall before key speeches to stay focused, reflected in pressured, fast, and irritable speech.
    • Gartner: “He could have taken some Adderall beforehand, and that may be part of what we’re seeing.” (08:48)

3. Trump’s Relationship with Truth and Reality

• Types of Trump’s Lies:
  • Gartner identifies three:
    1. Bald-faced lies to deceive
    2. Lies internalized to the point he may believe them (e.g., election claims)
    3. Dementia-driven confabulations (false memories)
  • Example: The false story about Trump’s uncle teaching the Unabomber.
    • Gartner: “This is something you see a lot with people who have dementia. We call it confabulation ... he kind of merges them ... you’re not lying, you’re actually misremembering.” (11:16)
• Malignant Narcissism Overlay:
  • Trump’s chronic lying and lack of relationship to objective truth now mingle with dementia’s effects.
    • Quote: "Donald Trump is the most documented liar in all of recorded human history. And I challenge anyone to show me a close second." (10:20)
    • On self-awareness:
      • Coles: “Does he know that he’s lying, or is this his own truth?”
      • Gartner: “That’s a very nice way of putting it.” (10:50)

4. The Rob Reiner Comment—Narcissism and Cruelty

• Dehumanization and Stochastic Terrorism:
  • Trump’s statement blaming Reiner’s death on “Trump Derangement Syndrome” is described as not just cruel, but dangerous, painting opposition as deserving of harm.
    • Quote: “He implies, if you put it in sort of mob boss language, he got what was coming to him.” (14:17)
  • David Frum’s assessment (read aloud):
    • “The post is deranged, pathologically narcissistic, crude, stupid, and cruel. No adult outside a psych ward expresses such thoughts.” (16:10)
• Trump as a “Mob Boss”:
  • Gartner: “He’s a glorified mob boss … this is a case like the likes of which … very few of us have ever seen before.” (17:46, 18:23)

5. “Alcoholic’s Personality”—Insights from Susie Wiles

• Definition:
  • Explosive, irritable, unpredictable, and impulsive—traits associated with both alcoholic personalities and severe personality disorders.
  • Impact on Cabinet:
    • Staff are “walking on eggshells,” mostly trying to mollify and avoid him.
      • Gartner: “I think everyone who works in his cabinet ... are afraid of him.” (20:47)

6. Managing Trump—Caretaker Role, Distraction Tactics, and Unmanageability

• Wiles as Caretaker:
  • Wiles’ role resembles that of a caretaker, managing Trump’s moods and distractions, akin to dealing with a relative with dementia.
  • Quote: “They just kind of try to manage him ... they’re not gonna be able to cure it. They're just trying to get through the day.” (23:10)
• Distraction and Grandiosity:
  • Staff use side projects (decor, renovations) to distract Trump from impulsive or destructive ideas.
  • Trump’s efforts to erase history (renaming the Kennedy Center, White House modifications) are typical of malignant narcissism.
    • Gartner: “Malignant narcissists want to erase history ... so that the world began with them.” (27:26, 29:27)

7. Impulse Control and Memory Decline

• Unfiltered, Impulsive Decisions:
  • Sudden nighttime demolition of the East Wing illustrates lack of impulse control and process.
  • Cabinet staff allegedly used a “25” text chain as code to note moments Trump appeared most unhinged, referencing the 25th Amendment. (32:34, 33:34)
• Memory Confusion:
  • Examples where Trump refers to Barron as “Melania’s son” or mixes up staff names (e.g., “Susie Trump” instead of Susie Wiles) signal personal relationship disintegration, a hallmark of advancing dementia. (44:21)

8. Family Dynamics and Personal Impact

• Living with a Malignant Narcissist:
  • Gartner describes the likely emotional environment for Melania and the Trump family as “a nightmare,” noting Melania’s ongoing absence and open antipathy.
    • Quote: “To know Donald Trump is to hate him. That's the natural human reaction to someone so vile.” (34:04)
• Transgenerational Patterns:
  • Trump’s upbringing under a “malignant” father (“crook, racist, KKK member”) helps explain but not excuse the personality developments seen across generations. (42:49)

9. Prognosis: Steepening Decline

• Acceleration of Cognitive Deterioration:
  • Gartner warns that Trump is “on the cusp of needing 24-hour care” and won’t finish his term “compos mentis.”
    • Quote: “There’s no way he’s going to make it to the end of his term compos mentis … the progress starts to catch up, it starts to get faster and faster till finally, at some point, they really fall off a cognitive cliff.” (36:47)
• Monitoring with the MOCA:
  • Trump’s repeated mention of passing cognitive tests is, in Gartner’s view, inadvertent confirmation of ongoing, worried surveillance by his doctors. (02:41, 36:47)

10. Sleep Patterns and Mania

• Sleep Deficits as Symptom and Lifelong Condition:
  • Chronic lack of sleep is linked both to Trump’s lifelong hypomanic temperament (common among high achievers) but also now exacerbates his impulsive, erratic behaviors. (38:41, 39:49)

Notable Quotes & Memorable Moments

• On cognitive testing frequency:

  “If you're giving it to him three times, that means you're not assessing dementia. That means you're monitoring dementia.” – Dr. John Gartner (02:41)

• On hypomania and manic posting:

  “He had one night where he put out 180 truth social posts. I mean, that's crazy … the quantity is telling us something about one aspect of his mental illness, which is being on the bipolar spectrum.” – Dr. John Gartner (06:46)

• On the Reiner comment and mob boss attitude:

  “He implies, if you put it in mob boss language, he got what was coming to him.” – Dr. John Gartner (14:17)

• On staff’s secret code for Trump’s outbursts:

  “There used to be a text chain … [they’d] just text to each other, 25. You know, that was code for: he’s at it again.” – Dr. John Gartner (33:34)

• On family relationships:

  “To know Donald Trump is to hate him. That’s the natural human reaction to someone so vile.” – Dr. John Gartner (34:04)

• On prognosis and progression:

  “If we were to chart this rate of deterioration... there’s no way he’s going to make it to the end of his term compos mentis... the progress starts to get faster and faster till finally ... they really fall off a cognitive cliff.” – Dr. John Gartner (36:47)

• On the potential for 2026:

  Coles: “Any predictions for 2026?”
  Gartner: “Only that it’ll be worse than 2025.” (46:43)

Important Timestamps

• Discussion kicks off / Trump’s cognitive monitoring discussed: 02:41
• Analysis of “Angry Santa” speech & hypomania: 06:20–08:34
• Types of Trump’s lies, confabulation explained: 11:16–13:26
• Analysis of Rob Reiner death comment: 14:17–16:18
• Staff management & “alcoholic’s personality”: 18:38–21:55
• Unmanageable nature, care strategies: 23:10–27:26
• Grandiosity & White House modifications: 27:26–29:27
• Impulse control & “25th Amendment” code: 32:34–33:31
• Family & marriage dynamics: 34:04–36:47
• Deterioration rate and prognosis: 36:47–38:41
• Sleep issues, mania: 38:41–39:49
• Final predictions for the future: 46:43

Tone Notes

• The episode sustains a sharp, clinical yet conversational tone—colloquial, sometimes darkly humorous, with vivid psychological analogies (e.g. “Grinch,” “mob boss”).
• Gartner’s analysis is blunt but accessible, interweaving psychiatric terminology with real-world examples and wry, memorable phrasing.

Summary

If you missed this episode, you’ll gain a comprehensive picture of Trump’s increasingly unstable mental state as seen through the lens of clinical psychopathology and recent White House events. Dr. Gartner provides a unifying theory: that Trump’s lifelong traits—malignant narcissism, hypomania—are now compounded by pronounced, accelerating dementia. This combination leads to a chaotic environment troubling for those around Trump, increasingly evident even to the public. Staff manage him more like a patient than a leader, while his policies and statements become ever more impulsive and confabulatory. Prognosis: the decline will likely steepen—and the collateral damage may be significant.