President Trump unleashed one of the most vitriolic insults of his presidency Thursday morning, saying MSNBC Morning Joe host Mika Brzezinski was “bleeding badly from a face-lift” while at his Palm Beach resort for New Year’s Eve. He also described her as “low I.Q. Crazy Mika.”

The president sent a pair of Tweets aimed at Brzezinski and co-host “Psycho Joe” Scarborough, apparently in response to Thursday morning’s episode (though he tweeted that he no longer watches the show).

Backlash to the comments has come from all angles, but first, here’s video of what might have set him off from Thursday morning’s show:

.@morningmika: “Nothing makes a man feel better than making a fake cover of a mag about himself, lying every day and destroying the country” pic.twitter.com/r30Acu5y2P

— Tom Namako (@TomNamako) June 29, 2017

Susan Collins, R-Maine, one of four Republican women in the Senate called for “respect and civility” and that “This has to stop.”

This has to stop – we all have a job – 3 branches of gov’t and media. We don’t have to get along, but we must show respect and civility.

— Sen. Susan Collins (@SenatorCollins) June 29, 2017

Rep. Lynn Jenkins, R-Kan., pointed to what many see as inherent sexism in the comments.

Sen. Lindsay Graham, R-S.C., who has never been shy in speaking out against Trump, said the tweet was “beneath the office and represents what is wrong with American politics, not the greatness of America.”

Sen. Ben Sasse, R-Neb., a frequent Trump critic, echoed that, calling his comments “beneath the dignity of your office.”

In a press conference, Speaker of the House Paul Ryan, R-Wis., said he didn’t “see that as an appropriate comment.”

In response, MSNBC said, “It’s a sad day for America when the president spends his time bullying, lying and spewing petty personal attacks instead of doing his job.”

Brzezinski penned her own retort:

pic.twitter.com/8YhzcCUwM1

— Mika Brzezinski (@morningmika) June 29, 2017

The Morning Joe co-hosts have had an up-and-down relationship with the president since his campaign to say the least. The show averages about a million viewers a day, and recently set a quarterly audience record for MSNBC for the 6-9 a.m. time slot.

As Trump’s campaign was ramping up, he would call into the morning show and speak kindly with the pair.

“You guys have been supporters,” he said on the show last February. “And I really appreciate it. And not necessarily supporters, but at least believers. You said there’s some potential there.”

But as Trump’s presidency has worn on, Brzezinski and Scarborough have turned into fierce critics. Trump claims he no longer watches the show, but deputy White House press secretary Sarah Huckabee Sanders implied the president was responding to something from the show, noting he was fighting “fire with fire.”

“This is a president who fights fire with fire,” she said on Fox News after the tweet, “and certainly will not be allowed to be bullied by liberal media and the liberal elites within the media or Hollywood or anywhere else.”

That is similar to what first lady Melania Trump’s spokeswoman, Stephanie Grisham, told CNN: “As the First Lady has stated publicly in the past, when her husband gets attacked, he will punch back 10 times harder.”

That despite Melania Trump’s focus on cyber bullying. The first lady’s website says:

“Mrs. Trump cares deeply about issues impacting women and children, and she has focused her platform as First Lady on the problem of cyber bullying among our youth.”

Thursday’s tweets obviously weren’t the only time Trump has gotten push back for offensive remarks he’s made about women. His tweet referencing “bleeding” hearkens back to 2015, when he said Fox’s Megyn Kelly had blood “coming out of her eyes, coming out of her wherever.”

That came after tough questioning from Kelly during a GOP primary debate about Trump’s past offensive comments about women.

It’s also not the first time the public is questioning the president’s unorthodox use of Twitter.

In an NPR/ PBS Newshour/ Marist poll released this week, just 21 percent of American adults find the president’s use of the social media platform “effective and informative,” while 69 percent find it “reckless and distracting.”

Copyright 2017 NPR. To see more, visit http://www.npr.org/.