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Inside Schizophrenia: Schizophrenia in Men

Men and women experience schizophrenia differently; from the age of onset to symptoms and how society treats those with mental disorders. 

Schizophrenic, Rachel Star Withers and co-host Gabe Howard continue the discussion of the differences from the last episode but change the focus to men. 

Jason Jepson, an author who has schizophrenia joins for a man’s perspective and Dr. Hayden Finch returns to explain the clinical side of the issues.

Highlights in “Schizophrenia in Men” Episode

[01:30] Age of onset

[04:00] Symptoms in men vs women

[05:00] Interview with Jason Jepson

[07:30] Jason discusses homelessness

[10:00] Words from Jason

[16:00] Lifestyle differences

[12:45] Testosterone

[24:00] Interview with Dr. Hayden Finch

[29:30] Dr. Finch explains how society sees men differently

[36:00] Gabe’s and Rachel’s takeaways from the past two episodes

About Our Guests

Headshot of Jason Jepson

Jason Jepson, Author

Mr. Jepson was diagnosed with schizoaffective Disorder while he was enlisted in the United States Army. Jason lives in Richmond, Virginia where he is active on the Veterans Council at the McGuire Veterans Hospital. His story of recovery has been published in numerous online and print publications such as Yahoo News, The Mighty, and OC87 Recovery Diaries. He has written two books, When We Were Young, a fictionalized memoir of his late teens, and a book of poetry called Misfires of a Lyrical Mind.

Amazon direct link to Jason Jepson’s works

https://www.psychcentral.com/lib/author/jason-jepson/

Headshot of Dr. Hayden Finch

Hayden Finch, PhD in Clinical Psychology

Dr. Finch is passionate about serious mental illness and is an accomplished clinician and writer.  In addition to developing outpatient and residential treatment programs for people with serious mental illnesses, she has been involved in mental health policy and legislation advocacy.  After graduate school, she was fortunate to combine her commitment to Veterans and passion for mental health by training at the VA, where she was involved in developing an inpatient treatment program for Veterans with serious mental illnesses.  A true lifelong learner and teacher, Dr. Finch is now applying her passion for education and serious mental illness to developing educational materials aimed at reducing stigma about serious mental illnesses and coaching people with serious mental illness, their providers, and their families to work toward recovery.  Dr. Finch practices what she preaches regarding setting life goals and is most content when she’s traveling with her family or walking with her dogs.

Get Dr. Finch’s new book on schizophrenia:

www.haydenfinch.com/schizophreniabook or Amazon direct link

Computer Generated Transcript of “Schizophrenia in Men” Episode

Editor’s NotePlease be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.

Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference?  There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia.

Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central podcast. I’m Rachel Star here with my co-host, Gabe Howard. Last episode we discussed how schizophrenia affects women. And this episode we are focusing on the gentlemen. Exciting. We have Jason Jepson, who’s going to join us. He is a mental health advocate and also a veteran who has schizophrenia. And Dr. Finch will return to help us understand the medical side of things that are going on.

Gabe Howard: Rachel, I’m looking forward to a great show.

Rachel Star Withers: I’m excited too, Gabe.

Gabe Howard: Last month, Rachel, we learned how schizophrenia impacts women. You know, things like motherhood and pregnancy and menopause and aging. And I don’t think that a lot of people were surprised that any illness would impact a female differently than it would a male. But we sort of want to open that up because there were some big differences in how schizophrenia presents in males over females. And I think that was surprising for us during the research because we just assumed that an illness hits women differently, because I think society is conditioned to believe that women go through everything differently.

Rachel Star Withers: The one fact that we hear mentioned over and over is that men tend to get diagnosed far earlier in life than women do with schizophrenia. However, as we talked about last episode, that’s not always true, especially in families who have a history of mental illness. And even amongst like different ethnic groups. But due to being diagnosed at a younger age, men often have not attained the same degree of social development as women do at the onset of schizophrenia. And that can contribute to poorer social outcomes.

Gabe Howard: During our research, we learned that the reason that men are often diagnosed earlier is because men are showing more emotions or vulnerabilities. And when seen in women, as we learned last month, they’re just like, oh, well, she’s a woman, so of course she’s being emotional. Where when the exact same symptom is seen in men, they’re like, oh, this is a problem. But as you pointed out, getting diagnosed earlier isn’t necessarily the advantage that we think it is in males. Because stereotypically, they’re looking at you for all kinds of issues. As we’re going to learn from our guest, one of those issues is violence or rage or anger. My question to you, Rachel, is do you think that men have an easier time with schizophrenia or is it just a different time?

Rachel Star Withers: I would definitely say a different time. Being diagnosed earlier, that in itself, and we talked about many episodes ago, where it comes to diagnosing children, where that has a huge impact on you. You know, if you know earlier that you have a major mental disorder that can change just how other people view you, how you view yourself, how your parents view your future. I know that’s definitely come up just in my own life, but I can’t imagine had I gotten the diagnosis in high school, my parents probably immediately would’ve started worrying like, well, she can’t go to college, and just assuming things. So just like being diagnosed sooner, I think is, I mean, it can be really scary. And then the flip side, not being diagnosed until your mid 20s like many women are, you’ve probably been dealing with this for a while and not been able to get help. So it’s definitely a different situation. I don’t think either side is going to be easier. Anytime you’re dealing with schizophrenia, it’s going to be intense across the board.

Gabe Howard: Rachel, let’s do a refresh real quick and talk about symptoms that tend to impact men more than women.

Rachel Star Withers: Men tend to have more serious cognitive deficits, more of the flat affect. Where you have a monotone voice, very dull expression. You don’t really react the way that people would normally react in situations. Blunted emotional responses where it’s just kind of, I don’t want to say chill, but you’re just kind of, you know, straight across the board when things happen. Speech reduction. And men tend to be less active than women.

Gabe Howard: And of course, just because you’re male or female doesn’t mean that you fit in a nice tidy box, right? Just because you’re male, doesn’t mean that you will have all of these. And just because you’re male doesn’t mean that your family will not notice or will notice. We’re speaking in generalities when we talk about how stereotypically this is how schizophrenia presents in men.

Rachel Star Withers: Yes, absolutely.

Gabe Howard: And Rachel, of course, we love you very much, but you’re a woman living with schizophrenia. So you thought it would be appropriate to bring on a male who is living with schizophrenia. And that’s why we have a great guest who you spent some time with, Jason Jepson. And as you said, he’s a veteran. He’s awesome. He’s living with schizophrenia. And you did a great interview. You ready to roll it?

Rachel Star Withers: Absolutely.

Gabe Howard: Here we go.

Rachel Star Withers: Today’s guest is Jason Jepson, who also has schizophrenia. Thank you so much for being with us today, Jason.

Jason Jepson: Thank you for having me.

Rachel Star Withers: So right away, I want you to tell our listeners about yourself.

Jason Jepson: Ok. Sure. I’m a writer. I started journaling when I was in the seventh grade. I have two books. I’m also a veteran. I’m a part of the Vet Council at McGuire Veterans Hospital. We make sure that veterans don’t fall through the cracks and we direct them to mental health services.

Rachel Star Withers: It’s awesome. Well, thank you so much, and thank you very much for serving for us.

Jason Jepson: Thank you so much.

Rachel Star Withers: So what age were you diagnosed with schizophrenia?

Jason Jepson: I received the diagnosis of schizophrenia when I was twenty three, I was diagnosed in the army. The thing is, I don’t know how your schizophrenia is, but my I knew the voices. The voices in my head were the other soldiers at Fort Irwin, California, where I was stationed, and also friends from Richmond, Virginia. So because I saw my head and hear their voices, it took me a little while to accept my illness.

Rachel Star Withers: Did you have signs that you noticed started at an earlier age?

Jason Jepson: Not really. In high school, I had mild depression. I saw a counselor for a short time, but I still was social, had friends and I played lacrosse in high school.

Rachel Star Withers: Now, do you have visual hallucinations also? Or are yours mainly audio?

Jason Jepson: Then, in my 20s, it was mainly voices that I couldn’t figure out where they were coming from.

Rachel Star Withers: So our episode today is focusing on how men experience schizophrenia different than women. Do you have any thoughts on that? Do you feel there’s much of a difference?

Jason Jepson: Well, I think everybody’s experience of schizophrenia is different in general. I think we hear voices; we get delusions. But the specifics of them are different, if that makes any sense.

Rachel Star Withers: Ok.

Jason Jepson: It’s just important to find the right treatment plan for minute men and women, you know, find the right medication, maybe have therapy, have someone to trust like your parents or your friends. And all that takes trial and error for both men and women.

Rachel Star Withers: I want to ask you this, because I think it has, like, you know, two sides that you see a lot of men with schizophrenia end up homeless. And I know with you also working with veterans, you hear that a lot, too, when you have a lot of people coming back with post-traumatic stress disorder. What are your thoughts on that?

Jason Jepson: Yes. What kills me, what makes me want to attack this mental health thing for veterans is that veterans are actually committing suicide in the parking lot of the V.A. Can you believe it? I mean, there’s got to be an answer to that. I mean, it took me a while to ask for help myself. But how do we get there? How do we combat that? You know, it’s just I hope the Veterans Council can reach out to them. We were still a new organization, but veterans need to ask for help. And it can be or take a while, but be patient.

Rachel Star Withers: I would say men are typically known for not wanting to ask for help. And I can imagine especially talking about like soldiers, you know, the idea of like masculinity being even harder

Jason Jepson: Yeah,

Rachel Star Withers: For guys like that.

Jason Jepson: Exactly. Well, you know, one thing that’s helping is there’s more athletes coming forward to lessen the stigma for men. I’m sure you for that. Dwayne Rock Johnson has come out saying he gets depressed. I mean, that guy’s a famous actor and that’s going to do great things for men, in my opinion.

Rachel Star Withers: Yeah, it’s huge. You think like about masculinity. He’s just giant,

Jason Jepson: Yeah.

Rachel Star Withers: Muscly.

Jason Jepson: Yeah. Yeah.

Rachel Star Withers: What has been your biggest struggle as a man with schizophrenia?

Jason Jepson: Well, society’s expectations, the stereotypes. Gabe does this wonderful on the social network. But, you know, wife, kids, job. I used to avoid social situations because of the question, “What do you do? What do you do for a living?” Because I didn’t have an answer. Then I realized I was a mental health advocate. And I am proud to be a mental health advocate. When you say you’re a mental health advocate, that opens the door for education. What is it, one in four people have some kind of mental illness? You know. So if you open up as a mental health advocate, well, my sister has bipolar. My uncle is a schizophrenic. You know, it opens it up. And talking about it like we’re doing now is the most important thing is to bust stigma.

Rachel Star Withers: What advice do you have for men that are listening right now with schizophrenia?

Jason Jepson: Accept your diagnosis is probably one of the first most important things I can say. When you accept that you can get on the right medication. Be patient with medication and it’s OK to ask for help, you know, ask for help. It’s OK to ask for help.

Rachel Star Withers: No. Yeah, with our veterans that are out there. Do you have any advice for loved ones who worry about like different people coming back from their time? Military wise? Do you have any advice for loved ones?

Jason Jepson: Let them know about their options. Like my mom researched my illness before I came home, she researched schizophrenia. She was before I came back and, you know, helped me with the V.A. and everything like that. She won’t let me fall through the cracks. I would say be patient. But, you know, you should offer your help, I guess. And do your research on if they come back with a mental illness or whatever. There are support groups caregivers can take. Just go to NAMI.org, they can probably show you something there or you know, if the V.A. has one, if your loved one’s a veteran. But just, there’s gotta be love there. You know, I tell my parents, my dad helps me out, too. I love them so much for everything they’ve done for me. And you may not see that when they first come home, but it’s a journey and you will see it eventually that they’ll help you out and just don’t give up on your loved one.

Rachel Star Withers: That’s incredible. At the Veterans’ Council, do you even have a hard time talking with other vets about being schizophrenic?

Jason Jepson: The Veterans’ Council’s main focus is mental health for veterans. And we are we’re trying to help them out best we can now with a voice for veterans and sometimes run down the V.A., just give my medication. I’m talking with veterans and the mental health waiting rooms. So what do you need? How do you feel about services here? And so far they like the services.

Rachel Star Withers: That sounds awesome, it sounds like you’re the perfect one to be doing that. To be able to write when they join, be like, look, this is what I have. So they’re not scared to admit. I’ve always found with my schizophrenia. The minute I tell someone, they’ll start telling me some other random thing and it’s like, okay. She has schizophrenia. So it’s okay if I let her know I have depression. It’s okay if I let her know that my mom. Such and such. So I really think it’s cool that you, like, open that door for them.

Jason Jepson: Yeah. Have you ever heard of the project semicolon?

Rachel Star Withers: Yes, I have.

Jason Jepson: I have a semi-colon on my hand, and when somebody else has that tattoo, it’s an instant bond. It is so cool. I mean, I picked up my dry cleaners like a couple weeks ago and the cashier girl said, well, I got the same tattoo. Fist bump. It’s the bond. Bond, you know.

Rachel Star Withers: Tell our listeners what the Semicolon Project is.

Jason Jepson: Well, it’s when you go through a mental health crisis, it’s not the end. It’s not a period or a question mark. It’s a semicolon. It’s a pause. And then you keep right on going. Keep right on living.

Rachel Star Withers: Thank you so much for being here with us, Jason. Let our listeners know how can they find the books that you’ve written?

Jason Jepson: It’s on Amazon. One is on a poetry book, Misfires from a Lyrical Mind. I always wanted a poetry book and it was published through Amazon. It’s free verse and stream of consciousness poetry. Misfires from a Lyrical Mind on Amazon, and then my memoirs are kind of based on journal entries from 17 to about 22. It’s called When We Were Young.  When We Were Young is pretty much a time capsule of old friends and old experiences. And there’s some funny stuff in there. And I think it’s a good read. People seem to enjoy it.

Rachel Star Withers: That’s awesome. And you have some articles up with sites central dot com that we have a link to in our podcast description. Well, thank you so much, Jason, for sharing your experiences with us. And we can’t wait to talk to you again sometime.

Jason Jepson: While we’d like to see you, you too are doing great things for the mental health movement. Thank you for having me. And thank you for all that you do.

Rachel Star Withers: All right, thank you.

Gabe Howard: Rachel, that was awesome. Aside from everything that we heard in the interview, what was your overall impression of Jason and how he manages his schizophrenia?

Rachel Star Withers: It’s always exciting for me to get to speak with and meet other people with schizophrenia. It’s not something that comes up regularly for me. You know, where you just can be like, oh, hey, you got schizo, too? Awesome! So, it’s really cool getting able to speak with him. And I loved his outlook on life. I really loved the way like he is just so inspirational.

Gabe Howard: I completely agree with you, Rachel. He was very inspiring, very honest. He has a great outlook. And of course, because he has treatment, he has just a normal life. One of the things that he mentioned was, you know, a lot of people coming back from the military have mental health issues and we have to be there to help them. Do they all have PTSD? No, of course not. Just like they all don’t have schizophrenia or depression or any number of maladies. But his work outside of his own issues to make sure that mental health treatment is available for our veterans is very, very inspiring. And I wish we could have left more of that in the interview because he just does such incredible work from that. So, Jason, thank you again for being on the show. We we really appreciated it.

Rachel Star Withers: And just like we said earlier, that just because that you’re male or female doesn’t mean you’re going to necessarily fit in to these little boxes. We talked about with me, I was diagnosed in my 20s. However, my symptoms were flaring up as a child. Whereas Jason is the opposite of what we said earlier. He wasn’t diagnosed until pretty much he was in the military already in his 20s. So just because you’re male or female and you don’t line up with one of the things we’re talking about today, don’t let that stress you out, OK? That was just a perfect example, though, of one of those key things that we started off saying almost always, and then me and Jason are the contradictions to it.

Gabe Howard: Just look at it this way, Rachel, you’re the exception that proves the rule.

Rachel Star Withers: There we go.

Gabe Howard: Let’s move on to lifestyle changes when it comes to the stereotypical male and schizophrenia.

Rachel Star Withers: Males have higher cigarette usage and self-medicating with drugs and then also tend to self neglect and have a reduced interest in getting a job, which unfortunately can leave a lot of men homeless. We talked about in our last episode that people are kind of more open and willing to reach out to women who are homeless than they are men. And I think, you know, part of that is just that men come off as just scarier. You tend to worry more so you want to be more protective. Whereas if a woman’s homeless, a woman and her child, you’re like, more sympathetic.

Gabe Howard: Rachel, obviously some of this has nothing to do with schizophrenia at all. It just has to do with the way that our society is structured. Ever since I was a small child, I always heard women and children first. It’s a man’s responsibility to protect. It’s not even just that. It’s hold open doors. They’re the fairer sex and just on and on and on. So I can see where if you are a man and let’s say that you’re a big guy and you’re yelling, you’re erratic, you’re screaming, you’re not making a lot of sense. People would fear you. Whereas if you’re presenting the exact same way as a female and you’re a smaller person, you just don’t come off as scary. And we see this a lot and the research shows that it makes it harder for men to get help. There are significantly more female shelters than there are male shelters and there’s almost no male shelters. And again, we’re talking across an entire nation and doing averages. Your community may be very, very different. It’s one of the things to think about that this really just has nothing to do with schizophrenia. This is just the social culture of our communities.

Rachel Star Withers: I used to work in homeless shelters many, many, many, many, many, many, many years ago, but we had a male one and a female one. And the males were constantly getting kicked out. It did not take much to get the men kicked out. However, most of the women on the women’s side were there with their children and they could get away with so much because you did not want to throw, you know, the child out. You couldn’t, like, kick the women out. And the men, on the other hand, it’s like a revolving door. The littlest thing could get them kicked out of the homeless shelter. So, I mean, I think even just whether you are talking about mental health or not, the standards are different.

Gabe Howard: I used to work in a homeless shelter as well, and I saw the exact same thing, and I think that anybody listening to this show, if they searched deep in their hearts, they would realize the same thing. They would tolerate a lot more from, you know, like you said, a mom with a child than they would a single male. Unfortunately, we do have higher expectations of men. And, you know, that cuts both ways. It’s not surprising that gender roles in society would impact how we’re treating mental health issues. And also, we want to touch on this as well. Women are more likely to ask for help. And asking for help means you’re much more likely to receive help. Men are significantly less likely to ask for help and therefore less likely to receive help.

Rachel Star Withers: And not just that whole stereotypical, well, men are prideful, not willing to ask for help. You take that plus schizophrenia making you withdraw inside yourself and it’s sometimes asking for help isn’t even an option. It’s not that the person is well, I’m just too prideful to ask for help. It’s that’s just something that’s too far gone to even be an option for the person.

Gabe Howard: And going back to what Jason stressed, women are likely to ask for help for other women because women have fostered a culture where this is acceptable. Men, unfortunately, have fostered a culture where you must be tough. You must be strong. So men are much less likely to ask other men for help. And I know that Jason stressed repeatedly that this is a culture that has to change, not just for people to receive help with schizophrenia, but for all sorts of issues, especially mental health issues from PTSD to depression to anxiety. Men really have to change because our own biases are impacting the way that we are being treated for and getting help for schizophrenia. It is not surprising that our society is influencing mental health care and schizophrenia care. Rachel, let’s switch gears and talk about something that men have more of than women do, and that’s testosterone. How does having more testosterone affect schizophrenia?

Rachel Star Withers: Studies have found that low levels of testosterone appear to be associated with the more severe negative symptoms of schizophrenia. So negative, which we’ve talked about before, is lacking from a quote unquote normal personality. So your depression, your speech deficits, things like that, testosterone deprivation, which results also in low estrogen levels, which we talked about the role that estrogen plays last episode, has been related to increased psychosis. So a lot with these hormones, that’s completely out of our control what’s going on. When you’re talking about men or women, the different hormones that are coming into play and it affects our schizophrenia so much.

Gabe Howard: One of the studies showed that men with low testosterone levels in the schizophrenia group had significantly worse face recognition results than did those with high to normal testosterone. Can you explain that a little bit? Because I thought that that was very compelling information.

Rachel Star Withers: This is actually a very interesting symptom that we have not talked about much in our podcast on schizophrenia, but yes, being able to recognize people’s faces, it plays into our memory. And yeah, the low testosterone seems to, for whatever reason, affect that part of memory of being able to recognize people by their face. I always tell people, you know, I teach modeling and acting and I have so, so many students in the hundreds. And I always tell them I’m not going to remember your name, but I’m also not gonna remember your face. So if you see me like out shopping at Wal-Mart, walk up to me and tell me who you are and how I know you. I just want to put it out there. It’s not that I don’t like you, I just I remember nothing. And that I’ve learned over the years, though, is part of schizophrenia and how it affects your memory. That’s kind of what that study was discussing.

Gabe Howard: We will be right back after this message from our sponsor.

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Gabe Howard: And we’re back discussing how schizophrenia impacts men. Rachel, let’s move on to Dr. Hayden Finch. Now, for those of you who listened to last month’s episode, you know that Dr. Hayden Finch is awesome. And she gave us lots of great information on how women present with schizophrenia. And of course, this month, she’s going to give us some information on how men present with schizophrenia.

Rachel Star Withers: She is absolutely lovely.

Gabe Howard: All right, are you ready? Let’s roll it.

Rachel Star Withers: We’re here speaking again with Dr. Hayden Finch. She joined us last episode, that was about women who have schizophrenia. And she’s joining us again to focus now on men. Thank you so much for being here with us again, Dr. Finch.

Dr. Hayden Finch: I’m happy to be back, especially to talk about the men who were neglected last time.

Rachel Star Withers: So let’s dive right in. What issues do men with schizophrenia tend to seek help with?

Dr. Hayden Finch: Well, men with schizophrenia tend to have more problems with substance use. So that’s definitely something that will bring them into treatment. We also see more negative symptoms. So in the last episode, we talked about positive symptoms being things that are added to the experience like hallucinations and delusions, whereas negative symptoms are things that are missing that ought to be there. So men with schizophrenia will come to treatment for those negative symptoms. So there’s things like apathy or loss of motivation, nothing really seeming fun or interesting, a decreased social drive, or a lack of social interest and just really not paying attention to social or cognitive input.

Rachel Star Withers: Are there therapies that tend to work better for men than women with treating schizophrenia?

Dr. Hayden Finch: Not really. Interestingly, even though the illness presents a little bit differently in men and women, most of the treatments that we have for schizophrenia are equally effective in men or women. Or actually a little bit more effective for women, which we think is just because women tend to be a little bit better about adhering to their treatment plans than men are. But in general, most of the therapies that we have are equally effective.

Rachel Star Withers: Men with schizophrenia tend to have higher homelessness rates than women. What’s the cause of that?

Dr. Hayden Finch: I think there are a lot of things that contribute to it. One is that because they tend to develop schizophrenia earlier in life than women do, they don’t have opportunities to develop their full social skills and occupational skills. And those skills can protect people against homelessness. So when you have really good social skills and really good occupational skills, you’re more likely to be able to get a job and keep a job. So without those skills being as well developed, they’re at higher risk for homelessness, but also women are more likely to be married and that domestic partnership can protect them against homelessness, whereas men don’t as often have that protection. The substance use is another factor. With greater substance use, the risk for homelessness increases. It affects jobs, stability and security of housing. But also, there are slightly more resources available for women who are at risk for homelessness. There are domestic violence shelters. There are shelters for women and children. And there are more opportunities for women than for men. Still, we’re really lacking in that area and we need more resources. But men have fewer of those resources than even women do.

Rachel Star Withers: Why is substance abuse much worse with men?

Dr. Hayden Finch: We don’t really know. It’s partly, we think, just the way that they are culturally conditioned or taught to deal with feelings. There’s often a family history of substance use so that’s modeled for them. Their parents were struggling with alcohol or addiction. We see that a little bit more with men than women.

Rachel Star Withers: Is there a particular substance?

Dr. Hayden Finch: The most common, of course, is cigarettes, which we don’t really think of as substance use. But the majority of people with schizophrenia smoke cigarettes. So that’s most common. And then after that would be alcohol. And beyond that, I really am not sure what the most common substances are.

Rachel Star Withers: It’s funny because you said women tend to adhere to taking their medications and following treatment

Dr. Hayden Finch: Yes.

Rachel Star Withers: More strictly. But then men tend to be more likely to add to their

Dr. Hayden Finch: Yes.

Rachel Star Withers: Treatments. So.

Dr. Hayden Finch: Well, you know, and part of the reason that they smoke cigarettes is because it affects how the antipsychotics work. And I talked about this in my book. But nicotine affects the way the medications work in the body and can reduce the side effects. So it actually gives you ultimately less medication and then fewer side effects. So some people are sort of medicating themselves against the side effects of antipsychotics with things like nicotine. So it’s sort of this very complicated interaction between seeking treatment and self-medicating against the medication.

Rachel Star Withers: That’s interesting. No one’s ever worded it that way. Why are men with schizophrenia more likely to have trouble holding down a job than women? And we talked a little bit about the negative emotions, but going into that more.

Dr. Hayden Finch: So the biggest thing that predicts occupational functioning, which is how well we perform in our jobs, the biggest thing that predicts that are how good your social skills are, how long you were sick before you ever got treatment, and how much support you have from people around you. And in all three of those areas, men tend to suffer more than women. So men’s social functioning is less well developed than women. They tend to be a little bit longer than women are before they finally get treatment and they have less support, unfortunately, from friends and family than women do. So all of those things put men at more of a disadvantage than women. The other thing is that because women aren’t usually diagnosed until mid to late 20s. So, now they have more of a chance to complete their education before the illness starts. And that’s another factor that can make it easier for them to get and keep a job than men do.

Rachel Star Withers: We actually did an episode about violence and schizophrenia, but men are seen to be more violent than women, and I think more people, if you have a woman who’s having a psychotic break, versus having a man, people get a lot more afraid. Can you talk to us about that, Dr. Finch?

Dr. Hayden Finch: Sure. So it’s true that men tend to show a bit more verbal and physical aggression than women do. But also we know from some research that came out in 2016 that the relationship between psychosis and violence is explained by three things. One is paranoia. Another is substance use. And the third is not sticking to your treatment plan. So we talked earlier in this episode about how men tend to use substances more than women do. And so that can increase risk for violence and also that women are better at adhering to their treatment plans than men are. So those are some factors that can affect violence in men with schizophrenia.

Rachel Star Withers: And that’s a very good point. It’s a lot of factors. It’s not just schizophrenia.

Dr. Hayden Finch: And of course, all that being said, we know, and I’m sure you covered this in your earlier episode, that people with schizophrenia are far more likely to be victims of violence than perpetrators.

Rachel Star Withers: Yes. If I’m a loved one who has a man, whether it’s a son, husband, cousin, good close friend with schizophrenia, knowing all of this can be a little overwhelming.

Dr. Hayden Finch: Sure.

Rachel Star Withers: How could I help that person? That man in my life with schizophrenia?

Dr. Hayden Finch: The most important thing is usually the relationship and relationships can become very strained when a person is in the depths of the illness, and if they haven’t received any treatment yet and they’re really experiencing some pretty significant symptoms, that compromises relationships. But the relationship you have with a person with schizophrenia is super important. That’s going to help you get the person to treatment and get them to go to appointments, take the medicine. So preserving the relationship is the most important thing, but that is really difficult, but it’s critical. So doing anything you can to make sure that the person is feeling supported rather than alienated. That is where I would focus my energy.

Rachel Star Withers: And we talked last episode that there were some options that women tend to have more of, that they can contact as far as dealing with homelessness and different things like that, getting help when it comes to children. What about men? What type of options are there for men?

Dr. Hayden Finch: Well, many of the options are similar. Communities are all different in terms of what services are available, but a lot of services are available to both men and women. So, things like transportation services, in-home services, where they will come to your home to teach you how to cook or how to mend a shirt that needs fixing. There’s respite care that’s available for men as well. If they need a break from their roommate or they need a safe place to stay for a night. And of course, there are clinical services for people with mental illness. We were talking last episode about mothers with schizophrenia. But of course, there are fathers with schizophrenia. And so all of the services that are available for parents are not just for moms, they’re also for dads. So support groups for parents with mental illness and the specialized clinical services for parents with mental illness would apply to dads as well.

Rachel Star Withers: And that’s something we spoke about in the show as I was doing research for these episodes. It was frustrating for me because I found article after article about motherhood, pregnancy, dealing with children and having schizophrenia. And I couldn’t find anything on fatherhood. Being a father

Dr. Hayden Finch: Right.

Rachel Star Withers: With schizophrenia. So definitely it’s something that’s not addressed as much.

Dr. Hayden Finch: Yeah, absolutely. Unfortunately, a lot of women who get pregnant, the pregnancy is unplanned, unwanted, or sometimes from a sexual assault, and so often they don’t know who the father is. And then when they do, sometimes the father just chooses not to be involved. And so the woman is there left to raise the baby on her own. But you’re right. We don’t have many services for dads with schizophrenia. We don’t know much about them. And as difficult as it is for a mom with schizophrenia, there are probably different factors affecting fatherhood.

Rachel Star Withers: Hayden, now you have a book coming out if you want to tell us about this.

Dr. Hayden Finch: Yeah, I wrote a book, it’s called The Beginners Guide to Understanding Schizophrenia. It is my take on all the latest information on the symptoms of schizophrenia. What causes it. What it looks like in the brain and how to treat it. I’ve written it in the plainest language possible. I just wrote it, so I went through all the research that’s available right now to write it. But my goal was to give people the real technical information, all the details we know. But in language that is super easy to understand. So it’s called The Beginner’s Guide to Understanding Schizophrenia. You can find it on Amazon, ultimately. But, I’ll link to it on my Web site at HaydenFinch.com/SchizophreniaBook. And it’ll also be in the show notes.

Rachel Star Withers: And this book, is it more geared towards loved ones, friends, family, or people with schizophrenia?

Dr. Hayden Finch: I wrote it for both, actually, so the person I didn’t write it for is any sort of clinician or researcher. It’s not for them. It’s for people who don’t know anything about mental health or treatment, who have no scientific knowledge. That’s who I wrote it for. So I wrote it for people who are just trying to understand schizophrenia, whether that’s because you have it or you have a loved one who has it or you’re just kind of curious to know more about it.

Rachel Star Withers: That’s awesome. Thank you so much, Dr. Finch, for joining us once again. Very, very interesting. And thank you for shedding light on these subjects. And we definitely got to check your book out.

Gabe Howard: Rachel, as always, incredible interview. Now, I know that that you talked to Dr. Finch for a couple of hours and obviously we edited it down. Did you learn anything about men with schizophrenia from her that you didn’t know before this interview?

Rachel Star Withers: I learned so much from her and I like that she’s able to explain kind of that medical side and the way she’s able to just explain it so, I guess, simply. Like at a level that me and you can understand, Gabe, you know, we’re not doctors, but being able to like break that down. I really like that kind of explaining the homelessness and then, of course, the substance abuse and all of that playing in more so with the males.

Gabe Howard: Yeah, she’s incredible. Once again, thank you, Dr. Finch, for being here, and please, if you have a moment, pick up her book. She helped us with both episodes, and, you know, she does it free of charge. She’s a great advocate for people with schizophrenia and mental health in general. So once again, hats off to Dr. Finch.

Rachel Star Withers: Yes. Gabe, I want to ask you first, as someone who does not have schizophrenia. What is your take away from these past two episodes on the gender differences?

Gabe Howard: I was surprised and I don’t know why. I feel like I shouldn’t have been surprised. I feel a little guilty. But knowing that the way that society treats the genders so heavily impacted the outcomes and the treatment for schizophrenia from diagnosis to treatment to asking for help to getting care, that really kind of put me on my rear a little because it’s just so sad. Both men and women have the same illness and yes, there’s variance in the presentations, etc. But the thing that made me, I’m gonna go with saddest, is that the outcomes were different based on how society effectively sees men and women. And it’s like, wow. Just wow.

Rachel Star Withers: No, I agree with that completely. We obviously all know the society and, you know, we have these different ideals in our heads. But yeah, to see how it can really affect people who are dealing with serious mental illnesses. It’s definitely eye opening. I see the past two episodes for me have been very fascinating because there are so many factors that are out of people’s control. And whether you’re talking about from hormones that the body creates, like to how your body actually processes the medications. Learning to thrive with schizophrenia is not as simple as take your pills every day. It’s not as simple as make sure you’re going to the doctor. You can be doing everything right. You can be doing everything correctly. Be taking your medication on time. Be going to the doctor religiously. And the deck is still stacked against you. And that’s frustrating. It’s depressing, to say the least, situation to be in. In those times, that’s when it’s time to change the game. I love how Jason hit on how he used to hate it when people would ask him what he did, workwise. And then he came to the realization that, wait a minute, he’s a mental health advocate. He works with veterans. He’s leading a council for veterans. And he’s an author, a public speaker. And it just goes on and on. And that’s like so much. That’s amazing. Like, he does all this, like, incredible stuff. And I don’t know. That gave me so much hope, Gabe. It’s easy to just kind of look at the negative of what maybe someone isn’t doing and not pay attention to all of the amazing, incredible things that they are.

Gabe Howard: And to your point, when you say that it’s easy to look at all the negatives in somebody’s life and ignore the positives, we have to put that on ourselves. Right? It’s easy for us to ignore our own positives and only focus on the negative. As much as I would love to say that stigma and discrimination against people with schizophrenia is all external, there is an internal component, and I agree with you. When Jason realized that he was doing all of this volunteer work in his community. And Jason was using his experience for so much positivity, especially in the veteran community. The fact that he can work with veterans and understand both the mental health aspect and the veteran aspect, it makes him a hot commodity. And him realizing that obviously paid huge dividends for him. So I would put a challenge out to everybody listening. Find the thing that you and you alone are uniquely good at and powerful and keep that in mind.

Rachel Star Withers: That’s awesome. Absolutely, Gabe, well-put. Very cool. Thank you so much for listening. Please like, share, subscribe. And we’ll be back next month with another episode of Inside Schizophrenia, a Psych Central podcast.

Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail [email protected]. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

Inside Schizophrenia: Schizophrenia in Men


Rachel Star Withers

Rachel Star Withers is the host of the Inside Schizophrenia podcast, and a mental health advocate who lives with schizophrenia. She creates comedic and mental health videos and has appeared in numerous TV shows.


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APA Reference
Withers, R. (2020). Inside Schizophrenia: Schizophrenia in Men. Psych Central. Retrieved on March 30, 2020, from https://psychcentral.com/blog/inside-schizophrenia-schizophrenia-in-men/
Scientifically Reviewed
Last updated: 14 Mar 2020 (Originally: 18 Mar 2020)
Last reviewed: By a member of our scientific advisory board on 14 Mar 2020
Published on Psych Central.com. All rights reserved.