When family members express concern about a loved one’s wellbeing, it typically remains a private matter handled behind closed doors. However, when that family member happens to be the President of the United States, such concerns inevitably become part of the national conversation. Recent statements from within the Trump family circle have sparked renewed debate about presidential fitness and the intersection of personal health with public responsibility.
These concerns, voiced by someone with both intimate family knowledge and professional psychological training, represent more than typical political criticism. They reflect a growing dialogue about cognitive health, presidential capacity, and the responsibility of both medical professionals and family members when they observe troubling changes in behavior and mental acuity.
The Source: A Complex Family Dynamic
Mary Trump occupies a unique position in American political discourse – she is simultaneously a trained clinical psychologist and the niece of the sitting president. Her perspective carries weight not only because of her professional background but also due to her intimate knowledge of family dynamics and behavioral patterns spanning decades.
Mary Trump, who is the daughter of Donald Trump’s deceased brother Fred, has been a prolific critic of the former president. Her 2020 bestselling book “Too Much and Never Enough: How My Family Created The World’s Most Dangerous Man” provided unprecedented insights into the Trump family’s psychological dynamics and their impact on Donald Trump’s personality development.
However, the relationship between Mary and her uncle is far from harmonious. She filed an inheritance lawsuit against him in 2020, which was subsequently dismissed by a judge. This contentious history adds complexity to her current observations and raises questions about potential bias in her assessments. Critics have suggested that personal grievances might color her professional observations, while supporters argue that her insider knowledge provides unique insights unavailable to outside observers.
The Trump family’s response to Mary’s psychological assessments has been consistently dismissive. In a statement previously shared with Newsweek, the Trump campaign said: “Trump Derangement Syndrome is a serious issue and some people like her [Mary Trump] need to get checked out.” This response reflects the broader political polarization surrounding discussions of presidential mental health.
Professional Background and Credentials
Mary Trump’s observations carry additional weight due to her academic and professional credentials in psychology. She has openly admitted she didn’t spend long in the profession, never taught at a university, and wasn’t a prominent scholar. However, her clinical training provides her with frameworks for understanding behavior patterns and psychological development that distinguish her commentary from typical political criticism.
Her psychological analysis of her uncle draws on both professional knowledge and personal observation. Mary believes the future president’s personality was shaped by his father — her grandfather Fred Trump, whom she describes as a high-functioning sociopath. This perspective, while controversial, reflects her attempt to apply psychological principles to understand behavioral patterns within her family system.
The intersection of personal knowledge and professional training creates both opportunities and challenges for Mary Trump’s assessments. While her psychological background provides analytical tools, her family involvement potentially compromises the objectivity typically expected in clinical evaluations. This duality makes her observations simultaneously more insightful and more problematic than traditional political commentary.
Current Observations and Specific Concerns
Mary Trump’s recent statements focus on observable behavioral changes that she attributes to cognitive decline. Opening a Substack blog post titled “The Republican Candidate Knows Nothing,” the psychologist wrote, “Donald had yet another banner week on the campaign trail. Between cutting his Pennsylvania town hall short to listen to songs from Cats and Shrek for 39 minutes, to his rambling, incoherent performance at the Economic Club of Chicago, it’s hard to see how anybody thinks my uncle is still tethered to reality.”
Her concerns extend beyond isolated incidents to broader patterns of behavior and communication. In recent video commentaries, she has documented what she perceives as increasing frequency of concerning behaviors. Mary, the daughter of Donald’s older brother Fred Trump Jr, accused the president of showing signs of “cognitive decline” as well as “clearly emotional and psychological decline.”
One particular incident that drew Mary Trump’s attention involved the president’s unexpected appearance on the White House roof while speaking to journalists. “There he was on the roof of the White House in the middle of a Tuesday afternoon doing what exactly. Nobody knows. I don’t believe he knows,” Mary commented about the bizarre episode. She interpreted this behavior as evidence of declining impulse control and judgment.
Additionally, Mary then drew attention to reports that Transportation Secretary Sean Duffy is preparing to unveil plans to construct a nuclear reactor on the moon, speculating that Donald’s mention of nuclear missiles while atop the White House roof might have been connected to this initiative. She views such policy initiatives as evidence of compromised decision-making capabilities.
The Pattern of Behavioral Changes
According to Mary Trump’s analysis, the concerning behaviors represent an escalating pattern rather than isolated incidents. “This is nothing new. Donald has practically always bristled when anybody has the audacity to push back at him or to suggest that he is not the one with sole authority over everything,” Mary said in a video on her YouTube channel earlier this month.
However, she argues that the intensity and frequency of these behaviors have increased significantly. “If he is not the one who is always right, but it’s getting worse. It’s getting worse in part because he’s getting worse,” she added. “Untreated psychiatric disorders do not get better and they do not stay the same; they deteriorate.”
Her observations extend to communication patterns and factual accuracy. Mary also slammed her uncle when he claimed that former President Joe Biden hired Jerome Powell as the head of the Federal Reserve when it was Trump. She interprets such factual errors as potential indicators of memory problems or confusion about basic governmental functions.
The psychological principle underlying Mary Trump’s analysis is that mental health conditions, when untreated, tend to worsen over time. “Also he’s under more, more and more stress because of the very situations he himself is creating on the world stage. He is unraveling and he knows it,” she warned.
Public Speaking and Cognitive Function
One area of particular concern for Mary Trump involves her uncle’s public speaking performances and their potential indication of cognitive changes. Mary Trump then proceeded to write that her uncle’s recent interview with Bloomberg also exhibited the decline of his mental faculties. “If the town hall was the best example so far of his cognitive decline, the interview with Bloomberg Editor-in-Chief John Micklethwait at the Economic Club of Chicago was perhaps the best example I’ve seen of an interlocutor revealing both Donald’s inability to handle pushback and his stunning ignorance.”
Her analysis suggests that high-pressure interview situations may be particularly revealing of cognitive changes. When faced with challenging questions or pushback from interviewers, she argues, underlying cognitive difficulties become more apparent. Analyzing Donald Trump’s performance in the interview, Mary Trump wrote that her uncle “came out of every exchange looking like a complete fool whose lack of knowledge was surpassed only by his contemptuousness.”
These observations align with broader concerns raised by other observers about changes in presidential communication patterns. Trump is set to turn 80 before his current term is out, and his condition is clearly not improving: his speech is increasingly incoherent, he often makes crude jokes at inappropriate moments (like when he mimed oral sex with a microphone), and he frequently resorts to profanity.
The Broader Context of Presidential Health
Mary Trump’s concerns occur within a broader national conversation about presidential health and fitness for office. When he was running against President Joe Biden, 81, before the latter dropped out of the race on July 21 and endorsed Vice President Kamala Harris, 59, to be his successor, the former president’s allies frequently criticized Biden’s age and cognitive state. However, Trump, 78, is now the oldest person to ever be nominated for president by a major U.S. political party and has increasingly faced questions about his own physical and mental fitness for office.
This context highlights the political dimensions of health discussions while also acknowledging legitimate concerns about cognitive capacity in leadership roles. At 79 years, 1 month and 24 days old, Donald Trump, the 47th and previously 45th president of the United States, is the oldest person in American history to be inaugurated as president for the second time.
The age factor adds complexity to Mary Trump’s observations. While age alone does not determine cognitive capacity, it does increase statistical risk for various forms of cognitive decline. Should he serve as president until August 15, 2028, he would be the oldest sitting President in American history. On January 20, 2029, the end of his second term, he would be 82 years, seven months, and six days old.
Professional and Ethical Considerations
Mary Trump’s public commentary raises important questions about professional ethics and the responsibilities of mental health professionals when observing concerning behaviors in public figures. The American Psychiatric Association’s Goldwater Rule generally prohibits psychiatrists from offering professional opinions about public figures they haven’t personally examined.
Still, Mary Trump can hardly be seen as an impartial researcher. She herself has acknowledged being deeply hurt by the family and struggling for years with the resulting psychological trauma. This personal history complicates the interpretation of her professional observations and raises questions about potential bias in her assessments.
However, the Goldwater Rule does not apply to analyses of public speech like those carried out by The New York Times and STAT. This distinction allows for some form of behavioral analysis based on publicly observable information, though it doesn’t resolve questions about professional objectivity when personal relationships are involved.
The ethical dilemma becomes particularly complex when family members with professional training observe concerning changes. The competing obligations of family loyalty, professional responsibility, and public interest create tensions that don’t have clear resolution within existing ethical frameworks.
Expert Opinions and Professional Assessment
Mary Trump’s concerns are not isolated within the mental health community. Dr. Lee taught for 17 years at the Yale School of Medicine, authored a textbook on violence prevention, worked on U.S. prison reform, and served as a UN consultant on countering violence against children. Since 2017, she has focused on Trump’s mental health, publishing three books and numerous articles on the subject.
Bandy Lee says she first noticed signs of neurocognitive issues in Donald Trump back in 2017, and that the president’s condition has steadily declined since then. In 2024, the World Mental Health Coalition, which Dr. Lee chairs, issued a statement signed by fifty prominent forensic psychiatrists, neuropsychologists, and dementia experts.
Other experts have also weighed in on observable behaviors. Harry Segal, senior lecturer in the Psychology Department and in the Psychiatry Department at Weill Cornell Medicine, says Trump’s awkward display at his rally was another clear sign of mental decline.
Segal says: “What’s alarming is how the rate of Trump’s bizarre speech and political decisions have been increasing. He gave an answer about childcare to the Economic Club of New York so incoherent that even his supporters were concerned. Last week he got cognitively lost in a rally and began to talk about the ‘eight circles’ that Biden filled up with journalists. No one on his staff has been able to explain the reference.”
Physical Health Indicators
The concerns about mental health occur alongside documented physical health issues that may contribute to cognitive function. In July 2025, Karoline Leavitt, the White House press secretary, stated that Trump had been diagnosed with chronic venous insufficiency. Trump’s physician, Sean Barbabella, wrote in a statement that bruising on Trump’s right hand was attributed to his use of aspirin and frequent hand-shaking.
Between December 2024 and March 2025, bruises were spotted on multiple occasions on Trump’s hands which generated speculation about his health. While these physical symptoms don’t directly indicate cognitive problems, they contribute to broader health concerns and may affect overall functioning.
The intersection of physical and mental health becomes particularly relevant in discussions of presidential fitness. Trump’s age, weight, lifestyle, and history of heart disease raised questions about his physical health. These factors can potentially impact cognitive function and overall capacity to handle the demands of presidential responsibilities.
Media Coverage and Public Response
The discussion of presidential mental health has become a significant media story, with coverage ranging from serious medical analysis to political commentary. Concerns about President Donald Trump’s health continue to swirl after the president struggled to understand a reporter’s question during a meeting with European Union President Ursula von der Leyen at his Turnberry golf course in Scotland.
Specific incidents receive detailed coverage and analysis. “Should Israel be doing more to allow food in Gaza?” asked the reporter. “Say it,” Trump responded while gesturing to the woman. The reporter then reasked her question, which the president did not seem to hear once again, forcing him to ask someone sitting next to him, “What is she saying?”
Such incidents generate speculation about hearing difficulties, attention problems, or other potential health issues. The media coverage creates a feedback loop where observable behaviors receive intense scrutiny, potentially amplifying concerns while also raising questions about the appropriate boundaries of health-related reporting.
Political and Constitutional Implications
The broader implications of these health concerns extend beyond personal wellness to questions of constitutional governance and political stability. Mary Trump wrote that Trump had taken the Montreal Cognitive Assessment (MoCA), under the advice of then-White House doctor and now-Congressman Ronny Jackson, while he was in office.
The use of cognitive assessments raises questions about what constitutes adequate health screening for presidential candidates and sitting presidents. While such tests can provide objective measures of cognitive function, they also become political tools in partisan debates about fitness for office.
Mary Trump wrote that her uncle’s recent behavior during a Pennsylvania town hall and an interview with Bloomberg editor-in-chief John Micklethwait are signs of his “cognitive decline”. These professional assessments, even when conducted by family members, contribute to political discourse about leadership capacity and democratic governance.
The Challenge of Objective Assessment
One of the fundamental challenges in evaluating these concerns involves the difficulty of obtaining objective, non-partisan assessment of presidential health. Donald Trump is showing all the signs of suffering from dementia. If this were a neighbor, a parent, or a family friend, we would be having serious conversations with them, and with themselves, that there is a problem, just as Biden’s supporters did for him.
The comparison to how families handle similar concerns in private settings highlights the unique challenges of addressing such issues in the political sphere. Normal family interventions and medical consultations become complicated by political considerations, public scrutiny, and the enormous stakes involved in presidential decision-making.
Once you have seen that Donald Trump is confabulating, it cannot be unseen — and all sorts of other mildly disturbing incidents suddenly fall into place. This observation points to the challenge of interpreting behaviors once concern has been raised – every action becomes potentially significant evidence of decline.
Future Implications and Ongoing Concerns
Mary Trump’s assessment concludes with warnings about the trajectory of these concerns. “We need to make sure that Donald Trump loses badly. We know what we’re fighting for and against,” In a statement previously shared with Newsweek the Trump campaign said: “Trump Derangement Syndrome is a serious issue and some people like her [Mary Trump] need to get checked out.”
The polarized response to these concerns reflects broader challenges in addressing presidential health issues in a politically divided environment. Mary Trump ended her blog post by urging Americans to keep “shining a light” on “Donald’s increasing, and increasingly serious, deficiencies” and not get demoralized by this year’s presidential race being so close between the former president and Harris, the Democratic nominee.
Conclusion: Balancing Family, Professional, and Public Interests
The concerns raised by Mary Trump represent a unique convergence of family dynamics, professional expertise, and public responsibility. Her observations, while controversial and politically charged, reflect broader questions about how societies should address potential cognitive decline in their leaders.
“The truth of the matter is that Donald Trump has been “failing the cognitive test” for a very long time,” Mary Trump wrote in the Substack. “He’s been failing other tests as well: He’s a failure as a human being – he has no empathy; he is a failure as a moral being – he is amoral.”
These assessments go beyond simple cognitive evaluation to encompass broader questions about character, judgment, and leadership capacity. While the personal and political motivations behind such statements can be debated, they contribute to important national conversations about presidential fitness and the intersection of personal health with public service.
The ongoing nature of these concerns, combined with the upcoming electoral considerations and constitutional questions about presidential capacity, ensures that discussions of presidential mental health will remain a significant aspect of American political discourse. Whether Mary Trump’s observations prove prescient or politically motivated, they have succeeded in keeping these critical questions at the forefront of public attention during a crucial period in American democracy.
Adrian Hawthorne is a celebrated author and dedicated archivist who finds inspiration in the hidden stories of the past. Educated at Oxford, he now works at the National Archives, where preserving history fuels his evocative writing. Balancing archival precision with creative storytelling, Adrian founded the Hawthorne Institute of Literary Arts to mentor emerging writers and honor the timeless art of narrative.