I think the birther nonsense is more key to his current state than people realize. I think that, rather than just being a con man playing rubes for fools, he genuinely fell down the right-wing conspiracy rabbit hole like so many others and his world view ceased even remotely resembling reality. He fits the typical conspiracy victim archetype: dumb or poorly educated (his professor called him the worst student he ever had) but thinks he’s smart, and desperate for validation and respect due to his father’s abusive upbringing. Surrounding himself with people who’d call him a genius and truth-teller for whatever random nonsense he spouted broke his filter on reality and he dove right in and soaked up their approval.

In other words, he’s every moron you see on Facebook, just with a louder voice and more reach. And being nothing special is the worst fate imaginable to a narcissist like him.

Edit: it also makes him far more dangerous, unfortunately. A con man will back down when their con starts unravelling, but if he genuinely believes the shit he’s spewing, he’ll keep pushing far past the point where he hurts himself and everyone around him. Which is what we’ve been seeing.