My name is Philip, and I have TDS. I have had it for years. I have it so badly that I read the news every morning, I check the polls, I have opinions about the federal funds rate, and I once wrote an entire essay about the legal record of the forty-seventh president. The symptoms are severe and, I am told, incurable. I am here to tell you that I do not want a cure. I am proud to have TDS, and I think you should be too.

Let me be honest about the term, because honesty is the whole point of this essay. Trump Derangement Syndrome was not invented by a quack. It was invented by a psychiatrist, Charles Krauthammer, who in 2003 coined the phrase “Bush derangement syndrome” to describe “the acute onset of paranoia in otherwise normal people in reaction to the policies, the presidency, nay, the very existence of George W. Bush” (Wikipedia, 2026). Krauthammer was a serious man, and his observation was real. There is such a thing as irrational political obsession. There are people who cannot distinguish between legitimate policy disagreement and signs of psychic pathology in their opponents. The syndrome exists. The only question is who has it.

The first recorded case of TDS, properly so called, was diagnosed in August 2015 by Esther Goldberg in The American Spectator, and here is the part that should make you smile: she applied it not to liberals but to “Ruling Class Republicans” who were dismissive of the candidate (Wikipedia, 2026). The term began as a way to describe Republicans who found Trump contemptible. It was only later, once the diagnosis proved useful, that it was reassigned to everyone else. That is the first clue that the syndrome is less a medical condition than a rhetorical one. Real diseases do not get reassigned to whoever is inconvenient.

The second clue is the treatment. In March 2025, a group of Minnesota Senate Republicans introduced a bill to classify TDS as a mental illness and write it into state law, using Krauthammer’s exact wording about Bush (Wikipedia, 2026). In May 2025, Representative Warren Davidson of Ohio introduced a bill requiring the National Institutes of Health to study the syndrome and report annually to Congress, on the theory that TDS “has divided families, the country, and led to nationwide violence” (Wikipedia, 2026). I am not a doctor, but I have read enough of the DSM to know that a condition is not usually diagnosed by statute. You do not legislate a disease into existence. You observe it, or you do not. The fact that the diagnosis requires a bill is the diagnosis.

The third clue is the patient list. The syndrome has been diagnosed in, among others: a federal judge who ruled against the administration; four Republican senators who voted to end a tariff emergency; the former White House communications director, after he left the job; the former chief of staff, after he described the president accurately; Elon Musk, after he and the president had a falling out; and Bruce Springsteen, for the crime of touring (Wikipedia, 2026). The most recent case, diagnosed on April 2, 2026, involved the president describing Springsteen as a “dried up prune” with “a horrible and incurable case of Trump Derangement Syndrom” (Wikipedia, 2026). I want to pause here and note the spelling. The man who diagnosed the syndrome misspelled the syndrome. That is either the most deranged thing in this essay or the most honest.

So let me tell you what my TDS actually consists of, because I think you deserve the full clinical picture.

I read the news. I read it in the morning, with coffee, and I have done so for years. I read the court opinions and the poll numbers and the budget projections. I read the transcript of the phone call in which a president asked a secretary of state to find 11,780 votes. I read the indictment and the verdict and the appellate briefs. I read that a jury found a former president guilty of thirty-four felonies, and I believed the jury. I read that the Supreme Court struck down the tariff program, and I believed the Court. I read that the war in Iran has cost eighteen American lives and seven hundred and fifty-six wounded, and I believed the Pentagon. I read that the Strait of Hormuz is down to six ships a day, and I believed the shipping data. I read that the president called the war “small potatoes,” and I believed my ears.

I check the polls. I check them the way other people check the weather, because I live in the same country the polls describe. I have watched the president’s approval rating fall to levels not seen in modern polling, and I have watched his own party’s senators run from him in the ratings the way you would run from a man holding a lit firework. I have watched the generic ballot move six points against the party in power, and I have watched the forecasters move Texas and Iowa into the toss-up column. I do not check the polls because I enjoy them. I check them because I am a citizen, and citizens are allowed to look at the scoreboard.

I worry. I worry about the war, which is in its seventh month with no end in sight. I worry about the economy, which is growing at 1.5 percent with inflation above target and a Federal Reserve considering a rate hike. I worry about the inspectors general who were fired in a late-night purge, and the generals who were purged for telling the truth, and the judges who are being called deranged for doing their jobs. I worry about the fact that the largest protest in American history was answered with an AI-generated video of the president wearing a crown. I worry about all of it, and I am told that worrying about it is a symptom.

Here is the honest part. If the symptom is paying attention, then the syndrome is not a disease. It is citizenship. The people who diagnosed me with TDS are not wrong that I am alarmed. They are wrong that the alarm is irrational. Every one of my symptoms is a documented fact. The verdict is in the record. The war is in the shipping data. The polls are in the averages. The only way to look at all of it and not be alarmed is to stop looking, and the people who have stopped looking are the ones who should worry about their own diagnosis.

The great irony of TDS is that the term was coined by a psychiatrist who understood exactly what he was describing, and it has been deployed ever since by people who do not. Krauthammer’s syndrome was the inability to distinguish legitimate policy differences from pathology. The modern usage has inverted it. Now the diagnosis is applied to anyone who can distinguish a legitimate policy difference from a national emergency. The man who calls a war “small potatoes” is not deranged. The people who notice the war are. The man who posts a video of himself wearing a crown is not deranged. The people who find the crown alarming are. The diagnosis has become a mirror, and the people holding it up are looking at themselves.

There is a better tradition, and it is worth remembering. In July 2018, the columnist Eric Zorn wrote in the Chicago Tribune that the true TDS was “the delusion suffered by those who still think he’s going to make this country a better place for average people” (Wikipedia, 2026). John Avlon, the CNN analyst, extended the diagnosis to include the positive delusions: the people who cannot accept that their candidate lost an election, who believe the courts are all corrupt, who trust the man who misspells the syndrome. Adam Gopnik called it “Deranged Trump Self-Delusion,” the president’s “daily spasm of narcissistic gratification and episodic vanity” (Wikipedia, 2026). These are the real cases. The people who cannot see the record are the ones with the condition. The rest of us are just reading the news.

So yes. I have TDS. I have it proudly, the way you would proudly have a fever if the fever were the only thing telling you the house was on fire. I have it because I read the verdict and believed it. I have it because I watched the war and counted the cost. I have it because I looked at the crown and saw the crack. I have it because I am a citizen of a republic, and citizens are supposed to be alarmed when the republic is in danger. The diagnosis is the compliment. The cure would be the disease.

The thermometer is in the brain, and the reading is normal. The patient is fine. It is the room that is on fire.

Sources

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