From Stigma to Support: Understanding Psychosis in Men
- Stephen
- Aug 23
- 5 min read
Psychosis isn’t weakness or danger – it’s a human experience that needs understanding, not fear.
I was recently on a call with a friend who told me about his psychotic break. I could hear the pain and confusion in his voice as he tried to describe what it felt like. When I came off the call, I found myself reflecting on how rarely we talk about the human side of psychosis.
When psychosis appears in the news, the language is often extreme and judgemental. When it comes up in group discussions - or even within families who are directly affected - it’s too often met with silence, discomfort, or dismissive comments.
Silence and stigma get in the way of understanding and recovery... and they feed fear. So here are some of the most common questions about psychosis - answered in plain, human language.
What do we mean by psychosis?
The word psychosis comes from the Greek psyche (soul or mind) and osis (condition). At its simplest, psychosis means experiencing reality differently to those around you.
That might include:
Hearing voices or sounds others don’t hear
Seeing or sensing things other people don’t
Holding beliefs that feel absolutely real, even if others can’t comprehend them
For some men, psychosis appears suddenly and dramatically. For others, the experience builds gradually over time. None of this makes you “mad” or “broken” - it means your nervous system is under extreme strain and needs care.
What is the difference between psychosis and schizophrenia?
This is one of the most common questions people ask.
Psychosis is an experience. It can happen once, or a few times, often linked to stress, trauma, sleep loss, or substance use. A psychotic break doesn’t always mean a long-term condition. Many people recover fully.
Schizophrenia is a diagnosis. The term was coined in 1911 by Swiss psychiatrist Eugen Bleuler, from the Greek schizein (to split) and phren (mind). He was describing a fragmentation of thought, feeling, and perception –-not “split personality,” though that misunderstanding has stuck.
Not everyone who experiences psychosis is diagnosed with schizophrenia. But because the two words are blurred together in public understanding, men often fear the worst. And when fear takes over, silence usually follows.
Why don’t we hear more about psychosis – especially from men?
Simply, because it’s scary, misunderstood, and wrapped in shame.
Many men have learned to keep difficult feelings to themselves, fear being judged, or worry about what a diagnosis might mean for work, family, or identity. Those pressures delay support - and that can make things worse.
Where does the misunderstanding of psychosis come from?
Much of the fear comes from stories, not real life.
In films like The Shining or Psycho, “psychotic” is equated with danger. In reality, people in psychosis are far more likely to be frightened and vulnerable than violent.
In Split, schizophrenia is portrayed as “multiple personalities.” That’s actually a different condition – Dissociative Identity Disorder.
In The Dark Knight, the Joker embodies the “unhinged villain” stereotype. In reality, psychosis is usually a state of overwhelm, not cunning manipulation.
Even nuanced films like A Beautiful Mind focus more on torment than recovery. Everyday stories of rebuilding and living full lives are rarely shown.
These are powerful stories on screen, but they don’t reflect reality. Add to that sensationalist headlines, heavy clinical labels, and masculine norms that punish vulnerability, and it’s no surprise men stay silent. Changing the story helps shrink the stigma.
What does a psychotic episode look like?
From the outside (for family or friends):
Withdrawn, confused, or distracted - as if listening to something no one else can hear
Speech that jumps between unrelated topics
Strong, unusual beliefs (e.g. feeling watched or finding hidden meanings in ordinary events)
Sudden emotional shifts - fear, laughter, anger without clear cause
Pacing, avoiding eye contact, or unpredictable behaviour
From the inside (for the person):
The world feels intensely vivid - sounds louder, colours brighter, events loaded with meaning
Voices or sounds feel as real as any ordinary conversation
Thoughts speed up or become tangled, making it hard to explain
The boundary between reality and imagination blurs, which can be frightening and create mistrust
It can feel like being trapped in a waking nightmare where nothing feels safe
Some clients have described psychosis as “being wide awake in a nightmare you can’t step out of” or “like your brain has been hijacked.”
From the inside, a psychotic episode is rarely about “losing control.” It’s about trying to make sense of an overwhelming reality.
How does psychosis affect the brain?
During psychosis, ordinary experiences feel extraordinary. A sound in the distance may seem like a clear voice. A glance from a stranger may feel threatening. Emotions can surge without warning.
On a brain level, this happens because the filter system - which normally helps us separate imagination from reality - isn’t working properly.
At the same time:
Perception changes - sounds, sights, or sensations are misinterpreted
Thought-processing changes - the brain links unrelated ideas, creating strong patterns of meaning
Emotions intensify - the threat system goes into overdrive, making neutral events feel dangerous
Stress hormones rise - cortisol and adrenaline keep the body on high alert, making voices, visions, or beliefs feel even more convincing
You don’t need to be a neuroscientist to understand the impact: psychosis makes the ordinary world feel extraordinary - and often frighteningly so. That’s why empathy, calm, and safety matter more than argument.
Why is reaching out so hard in the middle of it?
There are two main reasons:
Trust feels risky. If your perception feels under threat, letting someone in can feel unsafe.
Shame. Many men carry beliefs like “I should handle this on my own.” That story can shut down connection just when it’s most needed.
Can psychosis go away? Does it come and go? Can it heal without medication?
Yes - recovery is possible.
Some people have one episode and never experience it again.
For others, psychosis comes and goes, often linked to stress, sleep loss, or substances.
Sometimes psychosis eases without medication, especially if the trigger is removed and the person has rest, safety, and support.
For others, medication reduces intensity - but recovery is rarely about medication alone.
What makes the biggest difference in recovery?
Connection.
Recovery happens in relationships. A supportive network lowers stress, helps spot early warning signs, and gets someone to care sooner.
This can look like:
Family and friends who stay calm, listen, and reassure rather than argue
Peer groups where men can share openly with others who’ve been through it
Gentle approaches like pre-therapy, where the therapist meets the person exactly where they are and slowly rebuilds trust
Everyday foundations: sleep, food, exercise, nature, and routine - the simple things that steady a man when everything else feels shaky
How do you deal with psychosis?
If you’re going through it:
Tell someone you trust: “I’m not OK and I need support”
Focus on safety – rest, food, water, and a quiet space
Prioritise everyday foundations - sleep, movement, nature, routine
Explore activities that bring a flow state - surfing, climbing, painting, playing music
Avoid substances that make symptoms worse
Reach out early to your GP or a trusted therapist
If you’re supporting someone else:
Lead with warmth: “I can see this is frightening. I’m here with you”
Don’t argue about what’s real
Offer choices, not ultimatums: “Would you like me to sit with you?” or “Shall we call someone together?”
Look after yourself - you’ll support better if you feel steady
A final word to men who are struggling
If you’re experiencing psychosis, it’s natural to feel afraid. But you are not your diagnosis. You’re not dangerous - and you’re not alone.
Real strength isn’t silence. It’s letting someone stand with you until the ground feels steady again. That’s the conversation I wish more of us were having - with our friends, our families, and in men’s groups everywhere.
If this is something you want to discuss or explore further, feel free to get in touch.
Comments