Story highlights The shooting suspect's demeanor in court is instructive, experts say

James Holmes appeared dazed, emotionless

Theories range from medication to a complete break with reality, experts say

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.

Photos: Colorado movie theater massacre Photos: Colorado movie theater massacre The public gets its first glimpse of James Holmes, then 24, the suspect in the Colorado theater shooting during his initial court appearance July 23, 2012. With his hair dyed reddish-orange, Holmes, here with public defender Tamara Brady, showed little emotion. He is accused of opening fire in a movie theater July 20, 2012, in Aurora, Colorado, killing 12 people and wounding 70. Holmes faces 166 counts, almost all alleging murder or attempted murder. He has pleaded not guilty by reason of insanity. More photos: Mourning the victims of the Colorado theater massacre Hide Caption 1 of 45 Photos: Colorado movie theater massacre Police release the official photo from Holmes' booking after the shooting. Hide Caption 2 of 45 Photos: Colorado movie theater massacre Holmes often had a blank stare during his July 23, 2012, court appearance, seeming to be in a daze. Hide Caption 3 of 45 Photos: Colorado movie theater massacre Victims and their relatives and journalists watch the proceedings in 2012. Hide Caption 4 of 45 Photos: Colorado movie theater massacre Flags fly at half-staff on July 23, 2012, at the Arapahoe County Courthouse in Centennial, Colorado, where the movie theater shooting suspect had his first court appearance. The murder counts against Holmes carry a possible death penalty. Hide Caption 5 of 45 Photos: Colorado movie theater massacre Arapahoe County District Attorney Carol Chambers talks to reporters July 23, 2012, before heading into the courthouse. The murder counts against Holmes carry a possible death penalty. Hide Caption 6 of 45 Photos: Colorado movie theater massacre Family members of the victims arrive at the courthouse July 23, 2012, for the suspect's first court appearance. Hide Caption 7 of 45 Photos: Colorado movie theater massacre The Century Aurora 16 multiplex in Aurora becomes a place of horror after a gunman opened fire July 20, 2012, in a crowded theater. Hide Caption 8 of 45 Photos: Colorado movie theater massacre Holmes is accused of opening fire during a midnight screening of the Batman movie "The Dark Knight Rises." Holmes purchased four weapons and more than 6,000 rounds of ammunition, police say. Hide Caption 9 of 45 Photos: Colorado movie theater massacre Police investigate outside the Century 16 multiplex July 21, 2012, a day after the mass shooting. Hide Caption 10 of 45 Photos: Colorado movie theater massacre Agents search the suspect's car outside the theater. Hide Caption 11 of 45 Photos: Colorado movie theater massacre Aurora police escort a sand-filled dump truck containing improvised explosive devices removed from Holmes' booby-trapped apartment on July 21, 2012. Authorities have said they believe the suspect rigged his place before leaving for the movie theater. Hide Caption 12 of 45 Photos: Colorado movie theater massacre Police break a window at the suspect's apartment July 20, 2012, in Aurora. Hide Caption 13 of 45 Photos: Colorado movie theater massacre Law enforcement officers speak with Colorado Gov. John Hickenlooper, center, outside the suspect's apartment July 21, 2012. Hide Caption 14 of 45 Photos: Colorado movie theater massacre Law enforcement officers prepare to disarm the booby-trapped apartment July 21, 2012. Hide Caption 15 of 45 Photos: Colorado movie theater massacre Officials tow cars outside Holmes' apartment July 21, 2012. Police disassembled devices and trip wires set up in the apartment. Hide Caption 16 of 45 Photos: Colorado movie theater massacre Officers prepare to place an explosive device inside the apartment. Hide Caption 17 of 45 Photos: Colorado movie theater massacre Debris flies out a window, right, after law enforcement officers detonate an explosive device inside the apartment July 21, 2012. Hide Caption 18 of 45 Photos: Colorado movie theater massacre People mourn the victims during a vigil behind the theater where a gunman opened fire on moviegoers in Aurora. Hide Caption 19 of 45 Photos: Colorado movie theater massacre A woman grieves during a vigil for victims behind the theater. Hide Caption 20 of 45 Photos: Colorado movie theater massacre A distraught woman receives counseling from the Rev. Quincy Shannon, left, in front of Gateway High School in Aurora, where the families of the missing met after the shooting. Hide Caption 21 of 45 Photos: Colorado movie theater massacre Lin Gan of Aurora holds back tears as she speaks to reporters about her experience in the Century 16 theater. Hide Caption 22 of 45 Photos: Colorado movie theater massacre People embrace before a vigil for victims behind the theater where a gunman opened fire on moviegoers. Hide Caption 23 of 45 Photos: Colorado movie theater massacre Investigators work on evidence near the apartment of James Holmes on July 20, 2012. Hide Caption 24 of 45 Photos: Colorado movie theater massacre Members of the Aurora Police Department SWAT unit walk near the Holmes' apartment. Hide Caption 25 of 45 Photos: Colorado movie theater massacre Television news crews gather in front of the home of Robert and Arlene Holmes, parents of suspect James Holmes, in San Diego on July 21, 2012. Hide Caption 26 of 45 Photos: Colorado movie theater massacre A popcorn box lies on the ground outside the Century 16 movie theater. Hide Caption 27 of 45 Photos: Colorado movie theater massacre Adariah Legarreta, 4, is comforted by her grandmother Rita Abeyta near the Century 16 Theater in Aurora. Hide Caption 28 of 45 Photos: Colorado movie theater massacre Jessica Ghawi, an aspiring sportscaster, was one of the victims. Hide Caption 29 of 45 Photos: Colorado movie theater massacre A woman waits for news outside Gateway High School, a few blocks from the scene of the shooting at the Century Aurora 16. Hide Caption 30 of 45 Photos: Colorado movie theater massacre Aurora police chief Daniel J. Oates speaks at a press conference near the Century 16 Theater on July 20, 2012. Hide Caption 31 of 45 Photos: Colorado movie theater massacre Agents search the trash container outside the suspect's apartment in Aurora. Hide Caption 32 of 45 Photos: Colorado movie theater massacre A Federal ATF officer carries protective gear onsite at the home of the shooting suspect. Hide Caption 33 of 45 Photos: Colorado movie theater massacre President Obama speaks on the shootings at a July 20, 2012, event in Fort Myers, Florida. Hide Caption 34 of 45 Photos: Colorado movie theater massacre Moviegoers are interviewed at the Century Aurora 16. Hide Caption 35 of 45 Photos: Colorado movie theater massacre Officers gather at the theater July 20, 2012. Hide Caption 36 of 45 Photos: Colorado movie theater massacre Investigators were a common sight at the theater on July 20, 2012. Hide Caption 37 of 45 Photos: Colorado movie theater massacre Authorities gather at the shooting suspect's apartment building in Aurora. Police broke a second-floor window to look for explosives the suspect claimed were in the apartment. Hide Caption 38 of 45 Photos: Colorado movie theater massacre Screaming, panicked moviegoers scrambled to escape from the black-clad gunman, who wore a gas mask and randomly shot as he walked up the theater's steps, witnesses said. Hide Caption 39 of 45 Photos: Colorado movie theater massacre Onlookers gather outside the Century Aurora 16 theater. Hide Caption 40 of 45 Photos: Colorado movie theater massacre A woman sits on top of her car near the crime scene. Hide Caption 41 of 45 Photos: Colorado movie theater massacre Police block access to the Town Center mall after the shooting. Hide Caption 42 of 45 Photos: Colorado movie theater massacre Cell phone video taken by someone at the theater showed scores of people screaming and fleeing the building. Some, like this man, had blood on their clothes. Hide Caption 43 of 45 Photos: Colorado movie theater massacre Witnesses told KUSA the gunman kicked in an emergency exit door and threw a smoke bomb into the darkened theater before opening fire. Hide Caption 44 of 45 Photos: Colorado movie theater massacre What is believed to be the suspect's car is examined after the shooting. Hide Caption 45 of 45

"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."

Holmes may have been medicated, said Chicago clinical psychologist Daniela Schreier.

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

Some people may think Holmes was a longtime psychopath who turned to violence to show the world he could make a lasting mark, she said. After seeing him in court, though, Schreier said she believes Holmes 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.

If Holmes was on medication, that may have made him appear more drowsy, making it more difficult to get a complete picture of his mental state, she said.

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."