San Francisco ? The man charged with threatening House Speaker Nancy Pelosi was so livid over the health care overhaul that he made at least 48 calls to her offices and homes, leading the Democrat to fear that her family might be in danger, federal prosecutors said Thursday.

Gregory Lee Giusti, 48, of San Francisco, cried and looked disheveled in a gray T-shirt and khakis as he appeared for the first time before Magistrate Judge Bernard Zimmerman, who said Giusti may have bipolar disorder and should be receiving treatment.

Zimmerman initially refused a request by Giusti to be released to a halfway house, saying he would be able to walk away from such a facility.

Prosecutors said Giusti made at least four dozen calls to the San Francisco and Washington, D.C., offices of Pelosi between Feb. 6 and March 25.

Pelosi told the FBI the caller had used “extremely vulgar and crude language” on two occasions when she answered the phone at her Washington residence. She also thought her family might be in danger.