On Tuesday, a widely cited psychologist took to YouTube to raise the alarm regarding “more highly concerning behavior” from President Donald Trump. According to Dr. John Garrison, Trump’s recent actions suggest “steep neurological decline” and a dangerously “manic-like state.”

Garrison began by playing a clip from a recent Fox News interview, in which Trump declared that the price of oil is “going to go down like a rocket.” According to Garrison, “There were two neurological issues in this very short clip, both of them verbal. One is that he’s having speech planning issues, saying ‘going down like a rocket.’ Obviously, that’s combining phrases. He’s having a hard time organizing his thoughts. And second is an involuntary vocalization.” Here Garrison replays the clip, noting an abrupt sound Trump makes, explaining, “The pathways that deal with language are disrupted. We are seeing serious issues with language with President Trump.” What’s more, Garrison asserts that such vocalizations are “relatively new.”

In the interview, Trump begins talking about the midterm elections, saying, “I’m going to campaign like I did for myself and I’m going to hope that people think that I’m on. And if I’m not on, if they don’t go out and vote, if they go out and vote, we’re going to win easily.” As Garrison notes, “What he’s saying makes absolutely no sense. He cannot organize his thoughts. He gets confused and he believes what he’s saying is coherent. But it truly makes no sense.” According to Garrison, this struggle with verbal planning can be evidence of underlying “neurological issues.”

Here Garrison points to Trump’s pupils, which have remained dilated throughout the interview. “Trump is in a very bright room for this interview,” says Garrison. “You can see the lights actually reflecting off of his eyes, and what should be happening is that his pupils should be constricting rather than dilating because when there’s too much light in a room, your pupils get smaller, not bigger.” According to Garrison, “Dilated pupils like this can be from a wide variety of reasons, but it’s not just something that happens,” and likely culprits include medication for something like incontinence, Parkinson’s disease, or seizures.

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