Colorado Shooting Holmes

(CNN) -- Colorado shooting suspect James Holmes' dazed demeanor during his first court appearance has given rise to a multitude of theories about his mental state, ranging from full-blown psychosis to little more than being "some freak," as one victim of the shooting rampage described him after the hearing.

Holmes, with bright orange-dyed hair, appeared to stare blankly off into space for much of the proceedings. At times, he closed his eyes and his head nodded as if he were falling asleep. At others, he opened his eyes wide and looked straight ahead. He never spoke.

Holmes is accused of donning head-to-toe protective gear and wielding at least three weapons to kill 12 people and wound 58 in a shooting rampage during an early Friday morning screening of the new Batman movie at a theater in Aurora, Colorado. Authorities say he also rigged a complex and deadly booby trap at his nearby apartment.

After the attack, Holmes identified himself to police as "The Joker," Batman's archenemy.

Some have speculated the 24-year-old Aurora man was heavily medicated during his initial court appearance Monday. Others have suggested he was in the midst of a psychotic breakdown and hearing voices. Others say he may have just been exhausted, or feigning mental illness to game the judicial system.

"He has no right to come into court looking like he has a sad face. It's not right," shooting survivor Corbin Dates said after the hearing. "The look that he has right now is not something that's going to be believable by anyone."

Some psychologists, however, believe Holmes wasn't faking anything.

"In my opinion, he was heavily medicated," said Chicago clinical psychologist Daniela Schreier.

But she said an underlying mental health issue seems likely, as well.

He may be a longtime psychopath who turned to violence to show the world he could make a lasting mark, she said. Or he could have suffered a psychotic breakdown as recently as this spring, triggering his decision to drop out of graduate school, start buying weapons and launch his attack amid paranoid delusions, she said.

But, she added, the medications he could have been on during the hearing likely masked his true nature.

Asked Monday whether Holmes was medicated for his court appearance, Arapahoe County Undersheriff David C. Walcher said he did not know, and couldn't reveal that information to the media even if he did.

Dr. Mark Levy, a forensic psychiatrist in Mill Valley, California, said he doesn't think Holmes' behavior was due to medication.

Instead, he said, Holmes' blank, emotionless expression fits what happens in a psychotic breakdown that severs a person's ability to distinguish reality from fantasy.

"Whatever is happening on the outside of him is like a fly buzzing around the room, something you occasionally take note of," he said. The rest of the time, he explained, a person in such a state is inwardly dealing with an invisible roiling chaos, unaware of what's going on around him.

Chris Cline, vice president of clinical services at Skyland Trail, a mental health services facility in Atlanta, said it's not clear from Holmes' appearance whether mental illness is a factor.

"I think we need to see what comes out with more data before we rush to judgment about whether he has a mental illness or something else that's different than that," he said Tuesday on CNN.

Criminal defense lawyer B.J. Bernstein also cautioned against rushing to judgment. Holmes could be "bewildered" as a result of his sudden change in circumstances, or he could just be exhausted, she said.

"I don't take the bizarre behavior yesterday as confirmation of mental illness," she said.

The issue continued to be a topic of discussion Tuesday, with commenters on CNN and other online venues debating what the unusual appearance meant.

"He's a pathological, homicidal sociopath. He literally has no feelings for those around him," said one commenter on CNN.com who went by the screen name JR4. "Like his acting job in court? He knows that spending life in a psych ward with meds will be a lot better than spending hard time on death row in a maximum security prison."

HLN's Dr. Drew Pinsky believes it's likely that Holmes is suffering from some sort of mental illness, and probably should have been on medication if he wasn't already.

In many ways, however, he said Monday's court appearance speaks for itself.

"You can draw your own conclusions," Pinsky said Monday on his show. "Not a normal guy."

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