Should Political Anxiety Disorder Be a Diagnosis?
Political anxiety has become a dominant theme in our culture.
Updated December 7, 2025 | Reviewed by Abigail Fagan
There is a long history of using mental health diagnoses to act out political agendas. This storied history includes diagnosing women who complained of sexual assault as mentally ill (Bourke, 2012); using patients with intellectual disabilities as part of inhumane experiments (Iacono & Carling-Jenkins, 2012); and using conversion therapy to alter the orientation of homosexual patients (Haldeman, 1994). In the United States, in the current political climate, terms signifying mental illness as well as intellectual disabilities are bandied about as weapons in partisan warfare. It is perilous to characterize people with different political beliefs as somehow dumb, evil, or mentally ill.
“Trump derangement syndrome” has been coined as a way of labeling people who are frightened by the agendas of this president as irrational (Goldberg, 2015). “Derangement” implies that the individuals who hold these fears do so with little basis in reality, suggesting that their fears are irrational. After Donald Trump’s loss in the 2020 election, the same term, “Trump derangement syndrome,” was used to label Trump's followers for their inability to accept his election loss (Avlon, 2020). The term has now returned to its original use as a pejorative term for people who are afraid of President Trump .
Concepts from Cognitive Behavioral Therapy (CBT) may be useful in combating the depressogenic feelings that follow from political anxiety . Early in my career as a psychologist, I (EB) was taught the three questions one should ask to help patients work on changing their thinking to accurately appraise and manage fears. I am applying them to some of the fears expressed by people who are struggling with fears and depressive feelings regarding the current political situation:
Of course, the question of distortion may depend on the person’s actual circumstances. The level of true threat can be different depending on the person. Concerns may vary depending on the state in which one lives as well as the demographics of the person who is anxious. The individual situation will have to be taken into account when considering whether thoughts are rational or not.
Some Features Associated With Political Anxiety
When a new diagnosis is identified, people often feel relief in having a name for what they experience and often embrace it in a “that’s it!” kind of way. In the case of “Trump derangement syndrome,” this “diagnosis” is only used for the sake of mockery, and is not endorsed by those seen as having it.
“Political anxiety disorder” may feel more genuine to some people. In addition to fears, whether distorted or realistic, there are other characteristics of this condition, making it worth coining as a diagnosis. It has features that I have not seen before in my more than 30-year career as a licensed psychologist, and entire life as an American, including the following:
If there is political anxiety, what can be done about it? Does it fall in the purview of other anxiety disorders or does it deserve its own unique category? What is the treatment?
With the amount of ambient anxiety in our current world, helping patients and their families manage and cope, despite societal threats, is essential. I am certain that mental health providers need to be a force in helping people handle the political worries of our time so that everyone remains an effective member of our community.
Andrade, G., & Redondo, M. C. (2022). Is conversion therapy ethical? A renewed discussion in the context of legal efforts to ban it. Ethics, Medicine and Public Health, 20, 100732.
Avlon, John (December 16, 2020). "'Trump derangement syndrome' has taken on a new twist" . CNN. Archived from the original on June 16, 2022.
Bourke, J. (2012). Sexual Violence, Bodily Pain, and Trauma: A History. Theory, Culture & Society, 29(3), 25-51.
Coppins, M. (May 28, 2018). "Trump's Right-Hand Troll" . The Atlantic . Archived from the original on November 9, 2020.
Goldberg, Esther (August 17, 2015). "Trump Derangement Syndrome" . The American Spectator . Archived from the original on February 24, 2021.
Haldeman, D. C. (1994). The practice and ethics of sexual orientation conversion therapy. Journal of Consulting and Clinical Psychology, 62(2), 1994, 221-227.
Iacono, T. & Carling-Jenkins, R. (2012), Medical research ethics history and human rights intellectual Disabilities. Journal of Intellectual Disability Research, 56: 1122-1132.
Vargas, A. (2024). What does ‘FAFO’ Mean? Parade.com. November 22, 2024.
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Elisa Bronfman, Ph.D., is a teacher of graduate students, interns, fellows and residents, a clinician working with children, adults and families, and a Senior Psychologist at Boston Children's Hospital. Johanna D. Sagarin, Ph.D., is currently an assistant professor of practice at Assumption University and psychologist in private practice.
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