"He is unwell and has been getting progressively worse over the past 18 months"

[RobinA]

45. Yep!

And to take it a bit further, his seeming regression, while maybe in part age-related, is because he is a narcissist out of his comfort zone away from the world he has built in which he can function. Like a drowning swimmer, he is thrashing about trying to get back on firm footing. In totally over his head and in an unfamiliar environment, his normal coping skills are out the window and he's got nothing to fall back on. For this very reason, I have predicted a psychotic break since the day he was elected. I have to say, I thought it would come sooner. Assuming it hasn't already.

To use an example, and I am not implying with the example that he is seriously mentally ill, just that this is not an unheard of phenomenon... People who develop serious mental illness often begin to do so in their late teens. It begins and they live in the house they have lived in most of their lives, with their parents or parent who have always been there, they go to a school they are familiar with, have friends they know, etc. The symptoms start to arise and they can fit their coping with them into their already established routine, although they are using more of their resources to hold things together. The illness can be stressful, but the environment is not, because it is known and they are used to working within it, thus they can hide things a bit and function fairly well. Then they go to college. EVERYTHING is different. They don't know the environment, the coping skills they've developed over time for the illness are out the window. They have to learn a new environment (stressful in and of itself) AND they have to do it while compromised AND they have to cope with the symptoms, now becoming more evident because of the stress of the new environment. They run out of resources to deal with it all. So they have their first break freshman year of college.

Trump is an adult with a personality disorder. He's been able to set up a world for himself in which he can get what he needs and function fairly well, but functioning requires a significant percentage of his resources. He's become somewhat inflexible in how he gets his needs met, as do we all by the time we are his age. Suddenly he's thrown into Yikes! the mother of all environment changes. NOTHING he used to do works. His old coping skills don't work in this new life. He can't get what he needs to function reasonably well. He rapidly runs out of resources for dealing and he refuses to conserve resources by asking for help. So, the perceived regression. Back in NYC in Trump Tower he had things figured out, knew what was what and what to expect, how to work the environment. Now? He's a guy running on empty with no way to gas up.