Age is one thing, when it comes to leadership — sanity is another 

A special counsel’s comment about Joe Biden’s age has triggered an energetic debate about the president’s mental acuity compared to that of GOP presumptive nominee Donald Trump. Veteran columnist Walter Shapiro (who doesn’t reveal his own age) says Biden’s decision to run for reelection “may prove to be the most self-indulgent act by a Democrat president in modern history.” 

So far in this campaign year, Biden’s age is getting much more attention than his record as one of America’s most effective presidents — so effective that Trump often tries to take credit for Biden’s accomplishments. “THIS IS THE TRUMP STOCK MARKET,” Trump trumpeted recently on his social media site as the stock market reached unprecedented heights. 

Biden has presided over recovery from the pandemic (all the jobs lost from COVID were regained by 2022) with an economy stronger than any other country’s. America’s infrastructure is finally being repaired, and the nation is making unprecedented investments in clean energy and resilience to climate change. The wealth of Black and Hispanic families grew 61 and 47 percent, respectively, between 2019 and 2022, and 31 percent among white families. 

The worst thing we can say about Biden’s performance is that he doesn’t brag about it enough. 

When it comes to personal qualities, age is not the most important issue in this election. The candidates’ values, motives and deeper mental health matter.  

Armchair psychiatrists have speculated about Trump’s sanity since he began running for office in 2015. But professionals have analyzed Trump’s cognitive and emotional states, too, and we should pay attention. Some of their diagnoses have been remarkably prescient, and what they found is unlikely to change. Based on Trump’s statements, it will get much worse if he wins the presidency’s powers again. 

Dr. Bandy X. Lee is a psychiatrist whose best-selling book in 2019 summarized the findings of 37 mental health experts who evaluated Trump’s mental state. A month before the 2020 election, Dr. Lee warned that because of his narcissistic personality, Trump would rather “destroy the world” than be a “loser.” 

Lee told Salon writer Matthew Rozsa that when an extreme narcissist like Trump experienced “an all-encompassing loss, such as the loss of an election, it can trigger a rampage of destruction and reign of terror and revenge against an entire nation that has failed him.” 

The doctor predicted that if Trump lost, he might “challenge in every frivolous, obstructive way the results of the election in selected states, no matter what the margin of his defeat.” He could refuse to leave office. And “he could egg on his supporters into committing acts of violence or, at the very least, do everything in his power to make sure they do not accept the legitimacy of a Biden presidency.” 

That’s exactly what happened. Since his loss, Trump has triggered death threats against judges, juries and witnesses in his trials and promised to use the powers of the presidency for retribution against his enemies. He openly describes plans to destroy the democracy that “failed him.” 

While in office, Trump repeatedly escaped responsibility for his misdeeds. He is the only president impeached twice, but Republicans helped him avoid conviction in the Senate. One watchdog group reported that Trump amassed a “staggering record of uncharged criminal misconduct” while running for and serving as president. The Center for Responsibility and Ethics in Washington (CREW) counted 48 alleged criminal offenses by Trump from 2015 to 2017. He was not charged with any of them, partly because of the Department of Justice’s policy against indicting a sitting president. 

After losing the election, Trump oversaw a fake-electors plot to steal Biden’s victory and fulfilled Dr. Lee’s prediction he would “challenge in every frivolous, obstructive way the results of the election in selected states.” He unleashed rioters on the nation’s Capitol, “egging on supporters into committing acts of violence,” just as Lee said. 

Dr. John D. Gartner, a widely published psychologist who taught at Johns Hopkins University Medical School, warned in 2017 that Trump’s behavior is typical of “malignant narcissism,” including narcissistic personality disorder, antisocial behavior, and paranoid traits. Gartner said Trump also exhibits a hypomanic temperament needing constant stimulation, which explains Trump’s insatiable appetite for media attention. He concluded, “Donald Trump is dangerously mentally ill and temperamentally incapable of being president.”  

Trump has clearly demonstrated he’s incapable of losing the office. Since his defeat in 2020, he’s become increasingly anti-democratic, unconstrained, vindictive and irrational. The rest of the world has noticed — after surveying international politicians, diplomats and analysts about a second Trump presidency, The Guardian reported they regard Trump as “dangerous, foolish, irrational, scary, terrifying, irresponsible, a clown, a disaster.” 

Trump’s record supports the judgment of his former chief of staff, Gen. John Kelly, that he is “deeply flawed.” “I think we really need to step back,” Kelly said. “I think we need to look harder at who we elect.”  

Indeed, we do.  

Fairly or not, Biden’s age has become an issue. Voters should consider the mental acuity of both candidates. But they should also evaluate each candidate’s character, temperament and mental health. There is a difference between forgetful and delusional.  

Democrats have capable alternatives for president. California Gov. Gavin Newsom, Michigan Gov. Gretchen Whitmer, and Maryland Rep. Jamie Raskin are frequently mentioned along with Vice President Kamala Harris. But we should not let Trump’s attacks or public opinion polls force Joe Biden out of the race. Because of his long and honorable service to the country, President Biden deserves to make his own decision about whether seeking another four years is in America’s and the world’s best interests. 

William S. Becker is co-editor of and a contributor to “Democracy Unchained: How to Rebuild Government for the People,” and contributor to Democracy in a Hotter Time, named by the journal Nature as one of 2023’s five best science books. He previously served as a senior official in the Wisconsin Department of Justice. He is currently executive director of the Presidential Climate Action Project (PCAP), a nonpartisan climate policy think tank unaffiliated with the White House.