Is Trump Experiencing Drug-Induced Mania?

How do you tell if this president is in his right mind?

1. Incapacitated

One of the drugs President Trump is currently taking is Dexamethasone. DXM is a corticosteroid, meaning that it replaces a hormone produced by the adrenal gland.

DXM is used to reduce swelling and is commonly prescribed for a number of conditions: It’s used in the treatment of various forms of arthritis, asthma, and even certain cancer treatments. Its use is both common and safe.

Like almost all drugs, DXM has potential side effects. All of them are minor. One of these minor side effects is mania.

Here’s the abstract from a 2001 study on these effects:

Results: Symptoms of hypomania, mania, depression, and psychosis occur during corticosteroid therapy as do cognitive changes, particularly deficits in verbal or declarative memory. Psychiatric symptoms appear to be dose-dependent and generally occur during the first few weeks of therapy. Patients who must remain on corticosteroids may benefit from pharmacotherapeutic approaches, such as lithium and the new antipsychotic medications.

Conclusion: Mood and cognitive changes with corticosteroids appear to be common but generally mild and reversible side effects.

With that in mind, consider the following:

Please understand that I am not asking this to be a wise-ass, but as a genuine and serious question:

If Donald Trump was experiencing DXM-induced mania, how would we know?

I say this because any of those actions above might seem bizarre or manic in a normal person. But they all fit within the known parameters of Trump’s cognitive profile.

Is the balcony salute any stranger than the Lafayette Square Bible photo op?

Is claiming that COVID is “far less lethal” than “the Flu” any more bizarre than claiming that he’s done more for African-Americans than any president except—“possibly”—Lincoln?

I don’t know.

But here’s the thing: If the president’s judgment is not functioning at its normal level and all we’re talking about are superficial campaign optics and misleading tweets, then fine.

I mean: It’s not really fine. There are people who work in the White House who will be exposed to the virus unnecessarily. Dealing with this exposure will cause at least some minor hardships—and possibly real suffering and danger. Spreading more misinformation about COVID will continue to stoke conspiracy theories, divide the public, and make it harder for America to deal with the virus. It might cost a few lives and make the economic recovery somewhat harder.

So, you know, not “fine.” But also, not cataclysmic and not appreciably different from the trajectory we were already on.

What concerns me is this: What happens if there is a world event during this period that requires a decision by America? How sure are we that Donald Trump is—right now, today—in full control of his faculties?

Even by his own standards?

I would not want to be living in Taiwan right now.


2. The Bottom

Never believe an individual poll.

A single poll can be an outlier. You get a bad sample. The survey period reflects some turbo news event. The house model of the electorate is off. The MOE is big enough to dilute the poll’s value.

A dozen things can go wrong to reduce the usefulness of a single poll.

But you can believe in the polling average. Not as gospel truth, not as a report from the future, but as a fairly accurate portrait of the state of play as of a couple days ago.

All of which is to say that I don’t believe the new CNN poll showing Biden +16. The sample is only a thousand likely voters. And I have a hard time believing that 16 points is possible in the current environment.

I don’t believe the USC poll from Monday showing Biden +12. The sample is bigger—4,836 likely voters. But it’s a longitudinal survey, meaning that they’re polling the same group over and over. So if their original sample wasn’t good, then the results will be skewed.

While we’re at it, I don’t believe the NBC/WSJ poll from the weekend showing Biden +14. That sample is only 800 registered voters.

You see where I’m going with this.

I don’t believe any of these polls, but in the aggregate I believe that something is happening, right now, in the race. Look at the polling average over the last 14 days:

What’s going on? A few possibilities.

(1) Post-debate bump. Usually, debates don’t matter. When they do matter, the winning candidate can get a small, temporary boost in the polls that usually dissipates within a couple weeks.

(2) COVID uncertainty. It’s possible that the movement is related to Trump’s COVID diagnosis. Historically, voters freak out about potential health issues for candidates. Maybe this is voters getting nervous about Trump, but after he’s healthy again—thoughts and prayers!—the numbers will revert.

(3) Late break against the incumbent. Again, historically speaking undecided voters eventually break against the sitting president—especially if the president’s approval rating is sitting close to 40 percent. If the POTUS hasn’t given them a reason to vote for him after 204 weeks, they’re not going to flip in the last month. Those voters eventually decide they want change.

I can see both sides on each of these scenarios—and they’re not mutually exclusive. It could be some combination of all three. Or something else, even.

What matters most here, though, is whether or not this moment is transitory.

If it’s just the debate, then we’ll tick back to Biden +6/+7 at some point in the next 14 days.

If it’s the late-break, then the shift is permanent and the gap between the candidates will probably increase grow.

And it it’s related to Trump’s COVID diagnosis? Then, again, I can see it either way. Uncharted territory.


3. Hikikomori

I’ve long been fascinated by Japan’s “Lost Decade,” which turned out to be something much bigger. This is the story of Japan’s Gen-X, the generation that was left behind:

The doors open only once. That’s how people often describe Japan’s hidebound hiring system, in which college students have their best shot at landing a coveted salaried position in the year approaching graduation. Those who successfully navigate the arduous corporate recruiting process will be rewarded with a secure place on the corporate ladder, along with regular raises and promotions. The rest are largely condemned to flit from one low-paying job to the next, with little avenue for advancement and zero job security.

The divide was solidifying when I finished college in 2000. It had been a decade since Japan’s bubble economy had collapsed, and employers drastically scaled back new hires to protect older workers. The labor market had entered an “ice age,” according to media reports.

Having watched my older brother struggle to establish himself in a career, I chose to emigrate to the U.S. to pursue my interest in journalism. Over the years, I read stories about the travails of the so-called lost generation. Faced with limited job prospects, many ended up single and childless. Japan’s 2015 census revealed there were 3.4 million people in their 40s and 50s who had not married and lived with their parents.

Read the whole thing.