Back in 2006, when George W. Bush was still president, Duke University Medical Center professor of psychiatry Dr. Jonathan Davidson published a study that reviewed biographical sources for the first 37 presidents (from 1776 to 1974), and expert psychiatrists concluded that half suffered from mental illness, 27 percent while still in office. Twenty-four percent met the diagnostic criteria for depression at some point in their lives, including most famously Abraham Lincoln and Calvin Coolidge. Richard Nixon was treated for many years for stress by psychiatrist Dr. Arnold Hutschnecker, and was severely depressed after leaving office. The psychiatrist who treated Nixon after Watergate has confirmed this to me. “Who wouldn’t be?” he said.
The key to all these cases was either a physician making an in-person assessment and coming up with a diagnostic impression and treatment plan or at least the president or those close to him recognizing the problem. What makes the current pundit-media attack on President Trump’s mental health most disturbing is that those leading the charge are either non-psychiatrists, or else have never examined the president, such as psychiatrist Dr. Bandy Lee of Yale, who traveled to Washington last month to brief twelve Democratic and one Republican lawmakers on President Trump’s supposed mental instability.
Dr. Lee’s claims come across as partisan meanness, and they undermine the integrity of the medical profession at a time when we are already spending too little actual face time with our patients. Philadelphia psychiatrist Dr. Claire Pouncey, writing in the prestigious New England Journal of Medicine, supported the actions of Dr. Lee, along with the book of essays she published, The Dangerous Case of Donald Trump. But Dr. Jeffrey Lieberman, chairman of the Department of Psychiatry at Columbia University, writing a response in the New England Journal of Medicine, called Pouncey and Lee’s actions “a misguided and dangerous morality.”
On Tuesday, the American Psychiatric Association reaffirmed its adherence to the so-called Goldwater Rule, which stipulates that member psychiatrists should not publicly discuss the mental health of a public figure, leader, or candidate. This rule is wise, protects our integrity as physicians, and continues to apply here.