It’s not an easy subject to address especially at a time when we are searching for unity, but it’s also a subject that can’t be ignored. The sadness is that it squarely involves mental illness, which is such a difficult matter and one for which the sufferer often deserves compassion even as the consequences of the condition require action, especially when those consequences affect so many not just here but around the world.

The sad and dangerous reality — ever more apparent than when I first raised it in these columns beginning over six months before the last Presidential election — is that President Trump is a sociopath with the further indication that he is paranoid. He suffers from a damaged sense of self-worth resulting in a very low self-image that can only be offset, however fleetingly, by his sense of having vanquished others. That good self-feeling never lasts long, however, and must be constantly refreshed. When a sociopath lies, there is a good chance that he has even persuaded himself that a readily documentable untruth is in fact “the truth” because, in his mind, no reality contrary to his own self-aggrandizing view could possibly be correct.

That’s the conclusion drawn from the newly published book, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, edited by Yale Medical School Professor Bandy Lee.

Lee’s prologue, co-authored with Harvard Professor of Psychiatry Judith Herman, states, “Power not only corrupts but also magnifies existing psychopathologies, even as it creates new ones…. Sociopathic traits may be amplified as the leader discovers that he can violate the norms of civil society and even commit crimes with impunity. And the leader who rules through fear, lies, and betrayal may become increasingly isolated and paranoid, as the loyalty of even his closest confidants must forever be suspect.”

The book acknowledges the so-called “Goldwater Rule” established by the mental-health community after mental-health professionals who had never actually met candidate Barry Goldwater opined right before his Presidential-race loss to Lyndon Johnson that Goldwater was mentally unstable. Those mental-health professionals were criticized for analyzing Goldwater hastily from afar, especially in a way that could have influenced the results of that election — hence the rule.

However, these 27 professionals, who are among the deans of the American mental-health community, have had almost a year to observe Trump in action in office day-by-day in a way that most psychiatric professionals rarely have the chance to observe their non-hospitalized patients. In these health professionals’ view, warning is required given the very grave signs of dangerously bad, and even further deteriorating, mental health of our President and comports with the California Supreme Court’s “duty to warn” holding in the Tarasoff case. In fact, just this past week Trump’s recasting of his admissions of a year ago about the Access Hollywood video, revisiting Obama birther claims he had disavowed, and retweeting falsely described videos from a racist British site are all reflections of the increasing depths of his disconnect from reality.

The mental-health professionals’ warning is that our nation is in the hands of a truly unstable Commander-in-Chief. That instability is far more concerning than job-performance issues. The latter alone won’t kill us even if displayed by one in a position to initiate nuclear war; by contrast, sociopathology — especially with paranoia added in — very well can.

As one psychiatric professional has said, “Sociopathology feeds on the despair and vulnerability of others to exploit their hopes through false promises. The sociopath creates an ongoing theater of lies repeated over and over.” Sociopaths seek always to convince themselves and others that they have won victory over a perceived adversary; everyone and everything else be damned. Winning in personal terms — including in utter disregard of basic common sense, not to mention concern for others — matters more than anything else. As Lee’s book states, “Life is devoted to destruction in the service of an endless quest for power and admiration, unmitigated by basic empathy or guilt.” Trump “evinces the most destructive and dangerous collection of psychiatric symptoms possible for a leader.”

Sociopathology is an especially sad mental illness: Those who suffer from it are said to lack any capacity for love and to have a very damaged sense of self-worth. Every action taken by them must endlessly further what their sadly disturbed minds see as their own self-aggrandizement. In these frightening mental-health circumstances, it is no wonder that potential application of the 25th Amendment on Presidential disability is now being seriously advanced.