One of the earliest and most underreported warning signs of certain forms of dementia is not memory loss. It is disinhibition — a deterioration of impulse control, judgment, and social restraint that often manifests as reckless behavior, inappropriate speech, and diminished concern for consequences. By the time forgetfulness becomes obvious, the disease process is often well underway.
That framework matters because it closely tracks what President Donald Trump has been displaying with increasing frequency.
In the wee hours of Tuesday morning, Trump posted private messages from confused European leaders, publicly criticized the United Kingdom’s national security posture, and shared a fabricated image depicting the United States in control of Greenland, Canada, Venezuela, and Cuba. This was the sitting president of the United States conducting foreign policy online, overnight, as allies scrambled to contain diplomatic fallout from his threats to “take” Greenland.
Trump has always treated impulse as a strength. He boasts about “going with his gut,” rejecting filters, and saying what others will not. That posture is central to his political identity, and voters knowingly rewarded it, including in his most recent election. What stands out now is a shift beyond performative bluntness. Leaking private diplomatic communications, antagonizing allies without leverage, and circulating fantasy maps of territorial expansion suggest behavior detached from strategy and indifferent to consequence. The posture looks less controlled and less purposeful than before.
I am not a medical professional, but I have watched close friends and family endure the slow, painful experience of cognitive decline. Disinhibition is familiar to anyone who has lived through it. The tell is not temperament, but change from baseline. Trump’s baseline has never been calm or conventional. During his first term, chaos still met resistance. Advisers intervened. Messages were delayed or softened. Impulses were redirected or quietly shelved. What stands out now is the disappearance of that friction. The midnight posting spree did not apply pressure or extract leverage. It exposed a presidency operating without restraint.
That shift helps explain why concern is coming from voices that once defended or accommodated Trump. Sen. Ruben Gallego described Trump as “insane” on CNN. Mick Mulvaney, Trump’s former acting chief of staff and one of his most reliable institutional defenders during the first term, expressed bafflement at the Greenland fixation and said he would urge the administration to abandon it entirely. Conservative British broadcaster Andrew Neil warned that the United States is beginning to resemble an adversary rather than an ally. Even Trump’s own former deputy spokesperson, Sarah Matthews, believes Trump’s pursuit of Greenland is “mentally ill” and “deranged.” And CNN medical analyst Dr. Jonathan Reiner has called for a bipartisan congressional inquiry into Trump’s mental fitness, citing the behavioral pattern rather than ideology.
These reactions reflect a shared difficulty explaining the conduct through familiar political lenses. Conservatives raised questions about Joe Biden’s mental fitness years before it became unavoidable, with figures like Brit Hume describing him as senile in real time. The language struck many as harsh at the time, and the terminology imprecise, but the underlying judgment proved accurate as Biden’s decline became undeniable. That episode set a standard for scrutiny. Trump’s behavior now warrants the same application of it.
Grievance has long shaped Trump’s behavior. His fixation on the 2020 election, anger over criminal investigations, and instinct for escalation remain constant. What has changed is the degree to which those impulses now appear untethered from outcome. Actions that weaken alliances, undercut stated objectives, and generate chaos without payoff suggest something beyond anger or strategy at work.
Disinhibition offers a framework that fits the observable pattern.
The dynamic echoes The Madness of King George, the 1994 film about King George III and the slow recognition of his mental deterioration. The story focuses on how a ruler’s changing behavior is absorbed, explained, and accommodated by the institutions around him until it can no longer be managed. Power delays recognition. Familiarity prolongs denial.
Clinically, disinhibition often appears before memory loss, particularly in frontotemporal dementia. Individuals may seem energetic, confident, even dominant. What erodes first is judgment. Filters weaken. Social norms lose force. Behavior becomes impulsive, inappropriate, and unconcerned with consequence. That framework does not establish a diagnosis. It explains why behavior changes in ways that feel abrupt and destabilizing.
Trump himself has intensified attention on the issue. In recent weeks, he has repeatedly and unpromptedly defended his cognitive fitness, boasting about mental sharpness and tests no one was publicly challenging. Clinicians recognize this pattern. People respond defensively to doubts that have already begun to surface.
The press approaches this moment carrying the weight of its own recent failure. Coverage of Joe Biden’s cognitive decline relied too heavily on deference and too little on observable evidence until the problem became impossible to ignore, —though I wrote about it earlier than most of my peers. That experience damaged credibility and encouraged excessive caution. The result is hesitation at the precise moment clarity is required.
Scrutiny applied late loses value. Scrutiny applied early preserves it.
Trump’s recent behavior presents a coherent and escalating pattern. The loss of restraint is public, persistent, and increasingly disconnected from consequence. Disinhibition is a clinical concept, not a political insult, and it describes how judgment can fail before memory does.
The danger lies not only in the behavior itself, but in the absence of any visible response to it. Advisers remain quiet. Party leaders defer. Congressional oversight is dormant. The presidency is operating as if impulse carries authority and escalation requires no check.
That condition leaves the country exposed. Not to norm violations, but to a system that no longer knows how to respond when restraint erodes in real time.
This is an opinion piece. The views expressed in this article are those of just the author.