How do you know if someone sincerely needs help, or if they’re purposely behaving bizarrely to get attention?

Kanye West makes headlines wherever he goes, and even when he’s not out in public, millions of people still talk about him. He wasn’t at last night’s Grammy Awards, for instance, but his presence was still felt, especially at the end of the night when his public rift with Taylor Swift took center stage during her acceptance speech for Album of the Year. She dissed him without ever using his name.

West also has a new fashion line that’s returning (Yeezy Season 3) and a new album allegedly coming out. (It was scheduled for release this week, but people who have already paid for the music say they have nothing yet to show for it — and now West says it will only be available to subscribers of the floundering music service, Tidal).

Yes, people are talking about West — but the fame, the flamboyance and the music are all taking a backseat to the state of his mental health right now.

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West’s musical colleague Rhymefest posted the following on Twitter on Feb. 12 when a fan asked why he backed out of working with West on his new album: “My brother needs help, in the form of counseling. Spiritual & mental. He should step away from the public & yesmen & heal.”

The two men have worked together for more than a decade, beginning with the rapper’s first album “College Dropout” containing his Grammy-winning song, “Jesus Walks,” all the way up to his more recent work, including “Yeezus.”

“I love my brother. I pray for his health not our entertainment,” Rhymefest posted in a follow-up tweet.

Kanye’s own words on Twitter this week have added to the concern.

“I’M SO HYPE RIGHT NOW EVERYTHING HAS CHANGED … HAVE YA’LL EVER SEEN TRON? THE END OF THE TRON WHERE EVERYTHING LIGHT UP!!!!”

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“Let’s dance in the streets. I am consumed by my purpose to help the world,” he also wrote.

After spurts of incongruent tweets, some of the messages began to reveal that West is $53 million in debt — or so he claims. Early this week, he hounded Facebook founder Mark Zuckerberg for $1 billion to fund “Kanye West ideas,” while harshly criticizing Zuckerberg for wasting money and time on a school in Africa.

“You’d rather open up one school in Africa like you really helped the country…” West posted.

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Is this just another West ploy for publicity? Or are those closest to him right? Are there serious mental health issues the public is watching play out on social media? Even People magazine said of West’s wife, Kim Kardashian, that she’s “all for self-promotion [but] doesn’t approve of [his] Twitter drama.”

Krystal Mattox, a licensed professional counselor in Lynchburg, Virginia, said that while West obviously isn’t her patient and she’s not offering a diagnosis, “there are mental health diagnoses that have a tendency toward aggressive behaviors, but there are a lot [of cases] in which you would never know because they do their best to ‘not be noticed.'”

Social media changes all that. Mattox said these platforms can be “destructive to our mental health” and exacerbate certain issues, and can even push people to do things they wouldn’t normally do.

Dr. Katayune Kaeni, a psychotherapist based in Claremont, California, agreed. “When social media and technology are used in an excessive manner, that can have a negative impact on mood. People can develop obsessive-like tendencies, and become agitated, anxious and depressed after too much use of technology in general,” Dr. Kaeni told LifeZette.

Citing Harvard Medical School research, Mattox added that one in four U.S. adults per year have some form of mental illness or substance abuse. Many of those cases are mild, but 14 percent of the population has moderate or severe mental illness. Social media can significantly amplify a number of mental health issues, according to the findings of a University of Michigan study.

“Facebook and Twitter are great. However, there is also a constant stream of ideas, messages and information that can be overwhelming and overstimulating. This dynamic can impact one’s mood,” said Dr. Kaeni.

If there is anything the rest of us might take away from watching this awkward situation unfold in public, it is this: Mental health issues are real, they affect millions, and the best place to offer support for someone who needs help is not online, for all the world to see.

If you are concerned a friend or family member or anyone else might need help, connect directly with that person. Let someone else know as well, including a professional. Watch for agitation, anxiousness, depressed feelings and loss of sleep.

“Talk to the person about it, face to face. Have a real conversation, not a text conversation, and let the person know your concerns,” said Mattox.

Before starting the difficult conversation, practice what you intend to say, and research local agencies that might be able to provide help and services, she added. “Depending on the person’s state, there are many resources available.”

Some friends or family members may not want to listen, and some may not think they have issues at all. Prepare yourself for that. In West’s case, it doesn’t appear he’s listening to those who have commented publicly about him — and it doesn’t appear he’s able to put his phone down anytime soon.