A determination regarding the appropriateness of sending a message can be based on one or more factors. For example, the determination can be an analysis of a message to determine the likelihood that the sender has the target physical condition and/or a likely degree or severity of the target physical condition. The analysis determines, with reference to a baseline of the user, one or more of a number of errors (spelling and/or grammar) in the message, a response time, a non-fluency level associated with the message, a spell check of the message and recipient information associated with the message. Based on this analysis, the message can be managed in accordance with one or more of sending the message after a delay, returning the message to a sender for approval, managing the message based on a profile and holding the message for management at a later time.