As Mel Gibson’s voicemails to his ex-girlfriend continue to be leaked to the Internet this week, many media outlets are asking questions about Mel Gibson’s mental health. That’s no wonder — the voicemails are laced with profanity, racial epithets, and threats. In a 2008 documentary, Acting Class of 1977, he first talked about being diagnosed with bipolar disorder.

But are the rants to his ex-girlfriend Oksana Grigorieva related to a possible mental health diagnosis? Alcohol? Or something else?

It’s not easy to answer this question, because nobody except Mel Gibson, 54, and his doctors know. All we can do is speculate, based upon observations of his reactions, tone and behavior as recorded in the voicemails that are publicly available. So let’s take a look at some of Mel Gibson’s words and behaviors on these recordings.

1. It’s all about him.

Focusing on one’s own feelings and how another person’s behavior affects us is not a sign of bipolar disorder. It is, however, a possible sign of someone who has a lot of self-involvement or even narcissism. Many celebrities suffer from this concern — it comes with the territory of years of people worshiping the ground you walk upon.

I’m not sure we can glean much from the fact that in many of his voicemail conversations, he focuses on his feelings and how her actions affect him. When a person is drunk, they also tend to focus on themselves and their own feelings — not on others.

2. He sounds mad.

Anger or rage are not typical symptoms of bipolar disorder. While certainly someone might exhibit rage while in a manic phase of bipolar disorder, it is not a symptom one could draw conclusions from. People who are drinking, however, can be less inhibited — emotions are more on the surface than usual. People who are under the influence of drugs or alcohol can anger more easily.

3. His perspective seems warped.

If you listen to the tapes, you hear a man who is greatly upset by perceived behaviors and actions of his now ex-girlfriend. But the things he talks about makes it sound like he has a somewhat warped perception of reality, in my opinion. He talks about burning down the house she is living in — how will that help the situation? He talks about whether she’s gotten breast implants or not and connects that to her being a “whore” — but only a neanderthal from the ice age would connect the two.

Such a discrepancy in perspective or connection to reality can be a sign of a psychotic break — but it’s not a typical symptom of bipolar disorder. People who are under the influence of alcohol or drugs may also have a warped perspective.

4. Who threatens the mother of one’s child?

Mel Gibson sadly threatens to kill the mother of his eight-month-old child in the voicemails released so far. Few dads have ever felt the need to threaten the life of the mother of a shared child — this suggests an uncontrolled anger or rage that is far beyond the norm. This is not a symptom of bipolar disorder, but could be connected to someone who is under the influence of alcohol or drugs.

5. He sounds out of breath.

Mel Gibson sounds out of breath at many points throughout the voicemails, after yelling at his ex-girlfriend and becoming exasperated. Being out of breath is not a symptom of many mental health concerns (panic disorder is the most usual). However, people who have been drinking alcohol or under the influence of drugs may often find themselves at increased risk for respiratory distress. Alcoholics are three to four times as likely as non-alcoholics to develop acute respiratory distress syndrome (ARDS), a life-threatening lung condition characterized by swelling and fluid build-up in the lungs’ air sacs, according to the American Federation for Aging Research. Food for thought.

As I said at the beginning, nobody except Mel Gibson and his doctors know for certain what was going on during those voicemail conversations. What we can piece together is a picture of someone who was in a lot of emotional pain and distress, and very, very angry at the person he was speaking to. I sincerely hope he is seeking help for his concerns, no matter what they may be.