Please Think Twice Before Diagnosing a Public Figure With an Illness

This question comes up all the time, about all kinds of public figures and various sorts of disorders. Does Donald Trump have narcissistic personality disorder? Did Freddie Mercury have undiagnosed bipolar disorder? Do the Kardashians have body dysmorphic disorder? Does Joe Biden have dementia? Was Nancy Reagan codependent?

Seven years ago, I wrote about Emily Dickinson. I said it is impossible to know whether Dickinson or any other historical personage had any psychiatric disorder and, if they did, what it was. Now I have basically the same thing to say about the “diagnoses” of public figures.

It’s impossible to say whether any given celebrity — or indeed any public or private individual — has a psychiatric disorder unless that person has spoken about it publicly. We cannot assume, just from the little we know about another person, that they live with any given condition. This is true not just of psychological disorders, but also physical ones. In the past, it was easier to keep physical difficulties secret. Few knew that John F. Kennedy wore a back brace because of an old injury or that Franklin D. Roosevelt used a wheelchair because of polio. In many cases, it is only now that their memoirs or the memoirs of their friends have revealed these previously secret afflictions do we know about them.

When it comes to psychiatric diagnoses, the difficulty is not that friends may or may not keep a public person’s secret, but that the public has no real right to know unless the celebrity is open about it. The relationship between a psychiatrist and a patient is confidential. Only the patient can give permission for the doctor to disregard that confidentiality. Lately, it has become common for political figures to endure public examination of their medical records and even psychological records. But this is by no means a requirement for a public office such as president. Really, a president of the U.S. only has to be over 35 years of age, be a natural born citizen, have lived in the U.S. for at least 14 years, and get the most votes. And such scrutiny is hardly a requirement — completely irrelevant — for entertainers and athletes.

Speculation about the private lives of public figures has reached the level of a sport. It seems that just because a person has achieved some measure of celebrity, their life is now an open book. Their fans (and detractors, for that matter) often want to feel they have a personal connection with the public figure. Many want to believe they know the celebrity better than anyone else. They may feel a kinship with the person because they have the same disorder the public figure supposedly has. But the most you can say about a public figure is that they show some behaviors that can be associated with a certain diagnosis — not that the person actually has that condition.

Some celebrated sports figures and actors have been upfront about revealing their own and their families’ stories of psychiatric illnesses. Catherine Zeta-Jones, Glenn Close, Carrie Fisher, and Michael Phelps have let such conditions be known, in hopes of reducing the stigma surrounding mental illness and encouraging others to seek help for their conditions. But I believe these people are the exception. Most people, both celebrities and the general public, struggle in silence.

Basically, the only way to diagnose a person is for them to have an ongoing relationship with a psychiatrist or psychologist. A doctor who has spoken to the individual and spent time with them is the only person who can make that diagnosis. Even psychiatrists who testify at trials about the mental state of defendants may not have had any previous, personal contact with them. Yet their opinions help determine the fates of people they don’t really know.

Public figures don’t belong to the public, whatever their fans or detractors may think. Their minds especially are their own. It is reckless, improper, and ultimately futile to speculate on a public or historical figure’s mental state, in my opinion. But people do so and will continue to, as long as there are celebrities and people who feel they have a right to analyze them.