Daily Mail White House columnist Andrew Neil said people working around President Donald Trump have told him they are concerned about what they describe as a visible decline in Trump’s physical and mental condition as the conflict with Iran intensifies.

Neil wrote Friday that he had spoken directly with people close to the president in Washington. “‘Donald is deteriorating before our very eyes,’ I was told in Washington this week by a close confidant who sees him regularly. ‘His physical and mental health is in decline. Those around him don’t know what to do about it. It can only get worse. He’s 80 – and it’s showing,’” Neil wrote.

According to Neil, the war is not only dominating Trump’s presidency but is also affecting the president personally. He described a recent Oval Office meeting in which Trump allegedly launched into an expletive-filled denunciation of Iranian leaders.

“During a recent meeting in the Oval Office, he ranted against Iran’s leaders, calling them ‘scumbags’ and ‘lunatics’ in an expletive-ridden diatribe. There is growing concern for his physical health and mental stability,” Neil wrote. “... But it’s not just age – or the decline in cognitive capabilities that can afflict those entering their ninth decade. Trump is lashing out at all and sundry in frustration at the lack of any good options now facing him.”

Neil reported that hardliners in Tehran believe Trump is weakening and have rejected a secret U.S. effort this week to restart the peace process, leaving the White House to escalate its rhetoric. Aides have described Trump as being in “revenge mode,” Neil wrote, while the president has sounded increasingly combative. On Thursday, Trump said he was close to deciding on a “massive attack.”

“Even senior aides in the White House don’t know what this would mean,” Neil wrote. “The number of influential voices in Washington who think even ramped-up airstrikes – as I write, we’ve just had the 14th consecutive night of renewed US attacks on Iran – will cow Iran into submission are now passing few. In truth, nobody around Trump really knows what to do next – or what he will do.”

Neil said he had heard several influential figures close to Trump discuss possible military options. “... I listened to several influential figures close to Trump mull over the options. The assumption was that some sort of ground incursion was inevitable. That is certainly the new vibe coming out of Washington,” he wrote.

Those discussions included talk of seizing Iranian territory along the northern shores of the Gulf in an effort to take control of the Strait of Hormuz from Tehran, Neil said. The strait is one of the world’s most important oil-shipping chokepoints, making any military discussion involving control of the waterway significant beyond the immediate U.S.-Iran confrontation. He added that the figures again raised the possibility of invading Kharg Island, from which Iran ships most of its oil exports.

Neil also warned that some discussion was even more alarming: the possible use of tactical nuclear weapons to “send a message” to Tehran and “concentrate its mind” on peace. No nuclear weapon has been used in war since 1945, and even discussion of battlefield nuclear use carries implications for U.S. credibility, alliance politics and the global nuclear taboo.

“This took me aback. ‘Do that,’ I snapped ‘and you destroy America’s reputation and standing for the rest of the century. You’ve also paved the way for President Putin to do the same in Ukraine.’

“I was met with silence,” Neil wrote.