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Does Trump Have ADHD? My Professional Opinion

08/18/2016 03:50 pm ET
Carlo Allegri / Reuters

"He has the attention span of a 9 year-old with ADHD!"

Now that got my attention.

As a psychologist who specializes in working with children and adults with ADHD, I could not help but wonder if this assessment of Donald Trump -- spoken almost off the cuff by a man who knows him well -- actually helps explain the mystery behind much of Mr. Trump's behavior on the campaign trail.

The words were spoken by Tony Schwartz, the ghostwriter behind Donald Trump's signature book, The Art of the Deal. They came during an interview earlier this summer on the Alan Colmes Show, and followed a longer piece in the New Yorker. (The same sentiment was echoed in a somewhat snarkier tone by Kevin Drum in Mother Jones.)

To be sure, both Mr. Schwartz and Mr. Drum are writers, rather than trained psychologists, and so there opinions on this matter should be taken with a grain of salt. However, as I hope to demonstrate, many of the behaviors they describe match those that are associated with ADHD in general and Adult ADHD in particular.

Before I put on my psychologist's hat, I want to issue a very clear, and very strong disclaimer: I am not a political scientist and I am not here to endorse -- or denounce -- Donald Trump as a presidential candidate.

Who you vote for is a personal matter best left for the privacy of the voting booth. However, I do believe it is important to examine the motives and personality traits that drive anyone running for public office and especially for the office of president. With that in mind, I believe my training as a psychologist can be informative to those of us who are truly wondering what on earth makes Donald Trump tick. Not only that, but I also believe that viewing Donald Trump's behavior through the lens of Adult ADHD will add a strong dose of reality -- and perhaps even empathy -- to the ongoing firestorm surrounding his behavior as a candidate and, frankly, as a human being.

When it comes to ADHD, many people are quick to assume that they "know it when they see it." To be sure, certain aspects of ADHD do tend to manifest themselves in pretty obvious ways. However, as a clinician, I recommend that people avoid jumping to quick conclusions, which besides being wrong, often lead us to put people in a box and then wipe our hands of the issue. I cannot count the number of times a parent has come to my office convinced that his or her child has ADHD only to learn that the issue was something else altogether. So, as we delve into the mystery of Donald Trump's statements and behavior, the best strategy is to take a look at the symptoms associated with Adult ADHD.

The main features associated with Adult ADHD include difficulty paying attention, impulsiveness and problems regulating emotion. In addition, adults with ADHD often have trouble with executive functioning, which includes challenges with prioritizing and organizing tasks. These are just a few of the major indicators.

Before we go on to list other symptoms, it may be useful to explore these symptoms as they may or may not apply to Donald Trump.

One of the key criticisms leveled at Mr. Trump is that he "fails to stay on message." In other words, despite the fact that he is running for President of the United States, he is simply unable or unwilling to recognize that sticking to his talking points is his main priority as a candidate right now. To give you just a hint of how noticeable this trait is to the world, a Google search of the term "Trump can't stay on message" yields nearly 11 million results! In fact, this may be one of the very few issues on which both Trump's friends and enemies agree. How easy it would be to imagine being in the "war rooms" of both campaigns, only to see both sides scratching their heads, wondering, "Wow! What is it with this guy? How can he not stay on message?"

If we consider the notion that Trump might just have ADHD, the question becomes less mystifying. The reason Donald Trump can't stay on message is that his brain actually does not support this way of processing information. I often speak to the partners of men with ADHD. One of their chief complaints is that every new "shiny object" grabs their husband's attention.

Now imagine you are running for president when every day is overloaded with input from all sides. Wait -- he insulted me? Wait -- there's a crying baby? Wait -- we're losing the Second Amendment? In this light, it is much easier to understand why Trump would fail to stay on message. In fact, he most likely does not recognize this as a problem. From the lens of ADHD, one can imagine Trump answering back, "What do you mean, stay on message? There are hundreds of messages -- and I'm addressing them all!" To the ADHD mind, that is not a contradictory statement. That is how information is processed. And it has its advantages. For some adults with ADHD, this way of processing information allows for more spontaneous and creative ideas. Perhaps this is why many successful entrepreneurs have Adult ADHD.

For his part, Tony Schwartz, who ghost wrote The Art of the Deal, is not surprised by Trump's apparent lack of cohesion or ability to stay on message. Schwartz spent the better part of 18 months with Trump while they worked on the book, sometimes as much as 8, 10 or 12 hours a day. During that time, Schwartz quickly found that Trump had an "exceptionally short" attention span and simply "could not concentrate on the interviews."

The issue threatened to derail the project until they came up with a work-around that allowed Schwartz to listen in on Trump's phone calls with clients and business partners. Rather than actually engaging Trump in a series of questions and answers that demanded a lot of thought and introspection, it was easier to get a handle on his business philosophy by acting as a fly on the wall as he worked.

Beyond difficulty setting priorities, adults with ADHD struggle with impulse control, impatience, mood swings and outbursts of anger. Certainly one of the signature elements of the Trump campaign has been the impression that he is given to angry outbursts at those whom he perceives to be attacking him. Is this yet another sign that the real driver behind Trump's behavior is ADHD?

Some might argue that the "angry public face" of Donald Trump is really just a reflection of the pressures of the campaign trail. However, Schwartz believes that the Donald Trump we see on television and twitter is actually a reflection of his core personality -- which, in turn, may simply be a reflection of a man struggling with Adult ADHD.

When he was working on the book with Trump, Schwartz's opinion of Trump's business strategy was to "bully, push, demand." To Trump, Schwartz felt, "it doesn't matter whether it has any basis in the law, doesn't matter whether it's reasonable. Intimidate. And if you say it loud enough and long enough, people will go along."

This certainly appeared to be the way Trump operated during the primary campaign and, as Schwartz noted in his interview, Trump himself told him that when it comes to his personality, "nothing much has changed since he was seven years old." This is illustrative for diagnostic purposes. To assess whether an adult has ADHD, the common symptoms must be present before the age of twelve.

Yet another symptom adults with ADHD demonstrate is a constant attraction -- if not addiction -- to excitement. They crave adrenaline highs. This need for excitement has a positive and negative side. Positive excitement can come from such things as visiting a new city or engaging in relatively benign adrenaline-rush activities. It's easy to imagine that building a skyscraper -- and certainly dozens of them -- can bring with it a positive adrenaline rush that can also have a positive effect on the world by creating jobs and improving cities. On the other hand, one could easily argue that deciding "how great it would be" to become president -- despite lacking any experience in the realm of politics or statecraft -- can end up being an example of "negative excitement" associated with ADHD.

Another issue for adults with ADHD is that they tend to fall into the trap of overpromising. People with ADHD are often so convinced that the next new thing will "save the day" that they are willing to promise anything and everything just to continue to follow their new obsession. Often their enthusiasm and charm win people over, especially their spouses, co-workers and bosses. Unfortunately, this invariably leads to crushing disappointment for the very people they are intending to please.

This was one of Schwartz's concerns as well. Based on his time working with Trump, he is convinced that Trump will ultimately disappoint his followers. Schwartz sincerely believes that Trump "truly doesn't care about you. He truly doesn't have your best interests at heart."

As a therapist, I would disagree with this assessment on one very particular point. Not having clinical experience with people who ADHD, Schwartz is assuming that Trump is purposely out to bamboozle his followers, the voting public and who knows, maybe even the whole world.

I am willing to see it a different way. I believe that if it is true that Donald Trump struggles with ADHD, he actually believes he can deliver. He actually intends to see this thing through, and may not even become aware that what he intends to achieve is impossible. Or, he may lose interest prior to that point -- and truly not understand why people could be upset at his actions. Such is the ever-changing, ever-racing mind of a person with, let's say, untreated ADHD.

Now, before anyone is tempted to confirm the diagnosis, it is important to note that almost everyone will experience symptoms of ADHD at some point in their lives. What, then, moves the needle from an annoyance or personality quirk to a full-blown diagnosis? Two things: First, can these symptoms be traced back to childhood, pretty much without interruption. Second: are the symptoms so severe that they cause ongoing problems in one or more areas of a person's life?

Until now, the fast-paced, frenetic world of New York City and global real estate, reality TV, and generally having multi-billions of dollars at his disposal have served Donald Trump well. It could be having ADHD actually contributed to his success, given the circumstances of his life and environment.

The question now, from a clinical standpoint, is whether Donald Trump has finally hit the wall. Has he finally come up against a moment where his underlying ADHD is going to betray him and lead him to one of the most colossal failures in the history of presidential politics? Or, perhaps, if he wins, to a chaotic and unfocused presidency? I will have to leave the answer to that question to current pundits and future historians.

However, there is one thing I do know: Whether he wins or loses, Donald Trump could very well benefit by having an ADHD specialist at his side.

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  • Kevin Drum's article in Mother Jones
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    Dr. George Sachs is the founder and director of the Sachs Center in Manhattan, specializing in the testing and treatment of ADHD in adults and children. Dr. Sachs offers a holistic approach to ADHD treatment, which includes neurofeedback, therapy, ADD coaching and medication. He is a frequent contributor to the Huffington Post and other media outlets.

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