Yale shrink says Trump officials reached out to her last fall, suggests his mental state is rapidly deteriorating

It would seem that matters are far worse than even Donald Trump's fiercest critics have suggested. As the entire world has noticed, on Wednesday the New York Times published an op-ed that is without precedent in American history for what it suggests about a sitting president.

Assuming this is not part of a gaslighting campaign or an effort to uncover Trump's "enemies" in his inner circle — which is not out of the question — what the Times op-ed reveals is terrifying.

An anonymous "senior official" in the administration writes that "Trump is facing a test to his presidency unlike any faced by a modern American leader. . . . The dilemma — which he does not fully grasp — is that many of the senior officials in his own administration are working diligently from within to frustrate parts of his agenda and his worst inclinations."

Many Trump appointees, including the writer, he or she reports, "have vowed to do what we can to preserve our democratic institutions while thwarting Mr. Trump’s more misguided impulses until he is out of office."

From the White House to executive branch departments and agencies, senior officials will privately admit their daily disbelief at the commander in chief’s comments and actions. Most are working to insulate their operations from his whims.

Meetings with him veer off topic and off the rails, he engages in repetitive rants, and his impulsiveness results in half-baked, ill-informed and occasionally reckless decisions that have to be walked back.

There is also more evidence that Donald Trump's mental health is likely impaired:

Given the instability many witnessed, there were early whispers within the cabinet of invoking the 25th Amendment, which would start a complex process for removing the president. But no one wanted to precipitate a constitutional crisis. So we will do what we can to steer the administration in the right direction until — one way or another — it’s over.

Bandy Lee, the Yale University psychiatrist who edited the bestselling book "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President," explained to me in an email conversation that these "revelations" about Trump seem entirely predictable based on his public and other behavior.

According to Lee, the revelations about the Trump White House found in the New York Times article and Bob Woodward's forthcoming book "Fear" suggest "how deeply the troubles run and what effort is required to protect the nation from what are obviously psychological symptoms."

The senior official makes clear that the conflict is not ideology but the lack of "any discernible first principles that guide his decision making. ... [Trump's] impulsiveness results in half-baked, ill-informed and occasionally reckless decisions that have to be walked back." And: "There is literally no telling whether he might change his mind from one minute to the next." These are illustrations of emotional compulsion, impulsivity, poor concentration, narcissism, and recklessness that would normally require an evaluation, since they affect decision-making capacity and potential for violence.

None of the behavior that came out in the Bob Woodward book — as in the Michael Wolff book ["Fire and Fury"] ... is a surprise, since it is all consistent with the psychological signs we observed and warned against 18 months ago. Mental health is a science-based field of serious conditions that have predictable patterns. We foresaw the course of this presidency, based on our knowledge and clinical experience, and were concerned enough to put our warnings into a book. We now warn that things will rapidly deteriorate and that the president should submit to an urgent, independent mental health evaluation by an appropriate specialist, as is warranted. We may be delayed, but it is still not too late. The 25th Amendment is a political decision, but it would set in motion the proper treatment of an individual showing his signs of instability: restraint, limit-setting, and removal from access to weapons.

Lee also told me that these worries about Donald Trump's mental health by staffers and those other people in the president's inner circle predate Wednesday's Times op-ed.