Yes, he’s been this way for years. But now he’s crossed the line from personality to neurological impairment.
Let’s start with the personality, well-captured in this description of narcissistic personality disorder:
“People with narcissistic personality disorder have a greatly inflated sense of their own importance. They seek validation and flattery, believe themselves to be special and unique, and lack empathy.” - Zawn Villines / Medical News Today December 2025
While I’m against medicalizing unpleasant personalities as “disorders”, this description does appear to fit Trump to a T - as far as it goes. But it doesn’t go far enough these days. He’s more grandiose than ever and less connected to the real world. Which has got me to wondering if there’s something neurological going on, possibility frontotemporal dementia (FTD). Although FTD typically afflicts people younger than Trump, he seems to fit the symptom pattern: infantile, disinhibited, impulsive, grandiose and deluded.
For the purpose of this post, I’ll just focus on the grandiosity. From an AI Overview:
Dementia grandiosity refers to grandiose delusions, false beliefs where a person with dementia thinks they are more important, powerful, or talented than they actually are, such as believing they have special abilities...They [may believe] they can end world wars, are royalty, or have unique knowledge, persisting despite contrary evidence.
What it looks like
Beliefs of exceptional power or unique talent.
Overstating accomplishments or telling untrue stories.
Exaggerated sense of entitlement.
Yeah, the old Trump was grandiose but he also seemed more in control,more on top of his game, more strategic.
It feels like he’s becoming a child again, a very bad child. Maybe it’s time to consider the 25th Amendment.