Anyone who keeps an eye on US political discourse these days will be familiar with the epithet TDS, or Trump Derangement Syndrome, a term routinely used to describe the irrationality of President Donald Trump’s critics. The term frequently crops up in editorial writing, comment threads, social-media debates, and ordinary conversation: “Clearly suffering from TDS”; “Another victim of TDS”; “Typical TDS symptoms,” and so on. The implication is that the critic in question is afflicted by a pathology that makes objective analysis of Trump and his policies impossible.

The origins of the TDS accusation date back to what now seem like the placid years of the George W. Bush presidency. In a scathing 2003 article about Democratic presidential candidate Howard Dean for the Washington Post, conservative columnist Charles Krauthammer wrote: “A plague is abroad in the land. Bush Derangement Syndrome: the acute onset of paranoia in reaction to the policies, the presidency—nay—the very existence of George W. Bush.” This virus, Krauthammer continued, “is spreading. It is, of course, epidemic in New York’s Upper West Side and the tonier parts of Los Angeles, where the very sight of the president … caused dozens of cases of apoplexy in otherwise healthy adults.”

Bush, of course, was widely (and wildly) vilified in those days. A cottage industry of books, articles, and punditry condemned his invasion of Iraq, his stewardship of the US economy, his response to the flooding of New Orleans, his deference to Machiavellian subordinates like Vice President Dick Cheney and Defence Secretary Donald Rumsfeld, and his shadowy ties to American and Saudi oil interests. Popular documentaries included Michael Moore’s 2004 polemic Fahrenheit 9/11 and even a 2006 “mockumentary” titled Death of a President, about Bush’s fictionalised assassination. By the end of his second term, a Gallup poll found that Bush’s approval rating had slumped to a lowly 25 percent. Bush Derangement Syndrome, it seemed, was highly contagious.

In a September 2015 article, Krauthammer’s semi-satirical diagnosis was adapted by his Post colleagues Norman Leahy and Paul Goldman to describe overwrought reactions to Trump’s upstart presidential campaign. The following year, the phrase “Trump Derangement Syndrome” appeared in the headline of an article by Charles Hurt in the Washington Times. The term gradually shed its sardonic undertone to become the reflexive rejoinder of Trump’s defenders during his first term as US president and beyond—an all-purpose deflection and rhetorical bon mot still employed to this day. During an interview with Fox News in February 2025, Elon Musk told Sean Hannity that when he mentioned Trump’s name to his companions at a recent dinner, “it was like they got shot with a dart in the jugular that contained, like, methamphetamine and rabies.”