Major Nidal Hasan, the army psychiatrist who allegedly murdered 13 people and wounded 29 more at Fort Hood, apparently had been trying to contact al Qaeda and had attended the same mosque as the radical imam Anwar al Aulaqi. He reportedly was torn between being a Muslim and serving his country in a war against Muslims. He seems to have written on the Internet that he felt suicide bombers could be heroes, sacrificing their lives for the greater good.

All of this may mean Dr. Hasan was a terrorist, but it also might mean he was insane. I have never met Hasan, but I know as a forensic psychiatrist that a surprisingly large number of delusions—fixed and false, sometimes very bizarre beliefs—that psychiatric patients sometimes exhibit are religious in nature. Hyperreligiousity can be one of the symptoms of bipolar disorder or schizophrenia or schizoaffective disorder (among other conditions). This is why the cliché of a delusional person, as depicted by Hollywood, is frequently someone who believes he or she is God or the devil or a prophet.

Mental illness can hijack our core and strongly held beliefs and behaviors and turn them into grotesque symptoms. This isn’t just the case for our spiritual beliefs, but also for our sexual behaviors, which can also be sent into hyperspace by conditions like those I have named. People vulnerable to mental illness can end up selling sex, buying sex, gambling away their homes and, yes, committing horrible acts of violence in a pathological perversion of the religious belief system that had previously sustained their humanity and sense of connectedness to their fellow man.

Again, I don’t know whether Major Nidal Hasan was simply a terrorist or a mentally ill person, but my point is that much more needs to be uncovered before anyone knows.

After all, it doesn’t make much sense that a terrorist would give as many hints as Hasan to fellow soldiers about his seeming antipathy for America. He may have been “disinhibited,” one of the signs of a mood disorder.

Some radical Islamic terrorists frequent strip clubs, I suppose, but the fact that Hasan reportedly did—staying for several hours at a time— may be further evidence of that sort of disinhibition.

Ultimately, the question of when extreme religious beliefs (especially those connected with murderous intent) constitute mental illness may be one that needs to be answered in this case.

What we need are facts. Did Major Hasan show signs of a mental disorder before the Fort Hood massacre? Does his family have a history of mental illness that would suggest he is more vulnerable to it? When he needed additional supervision while training as a psychiatrist, was that because he was asserting his political/ religious views to patients or because he was unable to refrain from doing so, because he was sick then, too? Was he on psychiatric medicines then or at Fort Hood? Did he prescribe them to himself? If he did take medicines, were they the right ones or the wrong ones? Some can cause severe behavioral abnormalities.

Clearly, it seems to be the case that more should have been done to look seriously at Dr. Hasan’s behavior and his thoughts before he picked up a gun and started shooting. But whether the lens should have been one focused on him as a terrorist-in-army-clothing or one focused on him as a man slipping out of rational thought, into psychosis, remains to be seen.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Today we heard of a shooting at the Holocaust Museum in Washington, D.C. that appears to be the work of a single gunman, whom authorities believe to be a man in his late 80s by the name of James Von Brunn. If this is the suspect in custody, he is actually a World War II veteran and vocal member of the Holy Western Empire, which at this point, seems to be a white supremacy group.

It is sad to see people resorting to violence to settle their differences. And we have to be aware that we still need to be vigilant in our efforts to protect ourselves — despite the feeling of some Americans that security measures in this country have become too intrusive. It’s important to support our men and women in uniform, who at both the local and national levels, do a terrific job of keeping our country safe.

What this man did was an act of terrorism — domestic terrorism.

But the big question is: What’s the psychological profile of this shooter? If you look at some of the psychological profiles of past shooters, they are all different in their own way. However, there always seem to be some common themes.

Most of these people are angry at someone or a group of people, and share a psychotic belief that their misfortunes are predicated on the actions of those they hate.

Usually they are loners — they feel rejected by others or by society as a whole.

For some, substance abuse and depression are common themes, but even knowing these common themes, it is almost impossible to differentiate between who will just withdraw from society and who has the potential to snap and hurt innocent people.

I pray for those hurt in this tragedy and hope that we are able to create systems that could perhaps better identify high-risk people and prevent future tragedies from occurring.

Monday evening, 500 or so residents of Covina, California gathered at the Royal Oak Intermediate School to discuss the horrific Christmas Eve slayings committed by Bruce Pardo.  Pardo, dressed as Santa Claus, walked into a family gathering at his ex-in-laws’ home, shooting a 9-year-old girl in the face and then killing nine other people.  Before escaping and committing suicide himself, he burned the house to the ground.

According to police, Pardo had hoped to kill other people, too, including his mother, his wife’s divorce attorney and the attorney’s family.  They believe he had been planning the carnage since June — perhaps even earlier.

Because of Pardo, 13 young people are orphans.  Still others are without one of their parents.

What makes a man, who appeared to others to be quirky, but friendly, commit such an atrocity?  How is it possible that the same person who had participated in a seemingly rational way in divorce proceedings could have done so with mayhem on his mind?  How could he have wished the owner of his favorite coffee shop—the Montrose Bakery and Café—a merry Christmas just several hours before the slayings?

We know some of the stresses Pardo was facing.  He had lost his job.  His marriage had dissolved in the wake of his wife having learned he had abandoned a son she knew nothing about, a son left brain-damaged by nearly drowning while Pardo was to be watching him.  Perhaps Pardo felt lingering guilt and grief over that tragedy.

Yet, in my 16 years as a psychiatrist, I have met hundreds of men and women who have shouldered equal or greater psychological burdens without their circumstances triggering violence of any kind.  I have been privileged to see many of them face the loss of children, homes, marriages or their own health by looking inside themselves for strength — and finding it.

Pardo apparently had no such reserves of character upon which to draw, no hope for the future, no empathy left for others.  He seems to fit into that category of men I have met in my work as a forensic psychiatrist who, faced with painful changes over which they lacked control, came to see their life stories — including the people in them — as ending, done with … over.  It is as if they were collecting scripts from actors in a play that was going badly and being shut down.  Then the curtain fell.

For Bruce Pardo, I can theorize (even without interviewing him), there had to be a deep-seeded belief — perhaps an unconscious one — that loss of control or perceived abandonment had always meant chaos and terror.  There may have been unavoidable suffering in his own life as a child, suffering he could do nothing to prevent, suffering that left him, long into his adult life, with a child’s intense brand of terror at being powerless.  There can be no consoling such a “man” when events — even those of his own making — seem to be rendering him isolated, subject to forces (like job loss and divorce decrees) he cannot bend to his infantile will, impotent.

Those feelings of impotence, I believe, may have been the ones turned upside-down and inside-out in the months leading to the Christmas Eve carnage in Covina.  They may have been the ones that became fuel for a pathological and sinister plot that, in his own twisted mind, turned Bruce Pardo, for one terrible night, into the strongest man on earth, wielding the power of life and death over others, as though the frailties in his own psyche could somehow be camouflaged, even beyond his own recognition, by a storm of bullets and shield of flame.