July 18, 2025.
Written by General Psychologist, James Blaze

Men’s Mental Health – Noticing Inner and Outer Signs of Struggle

Men’s mental health is a subject often related to traditional masculine ideals. These can include rigid and excessive self-reliance, emotional control, provisioning focus and productivity. Traditional masculine ideals represent differences in mental health between men and women and can make it especially difficult for men to seek help. Being aware of inner and outer signs of struggling in men can help identify when mental health issues can show up.

Internalising behaviours are ways people respond to distress, involving turning distress inwards onto themselves. For men, these can include avoiding social interactions and withdrawing from friends, negative self-talk, delaying handling responsibilities, saying, “I’m fine” when untrue, suppressing emotions through sarcasm or self-deprecating jokes, experiencing physical symptoms with mental health-related causes and having suicidal thoughts. Internalising behaviours may not be easily detected as they might seem secretive or be seen as characteristic of the person themselves. Internalising struggles can be related to mental health stigma around help-seeking as weakness, discouraging men from readily seeking help. Turning distress inwards can exacerbate existing mental health issues, possibly going undetected.

Externalising behaviours can see men turn their distress outwards towards the world and others. Externalising behaviours may look like anger outbursts, irritability or verbal/physical aggression in the home, at work or in public. They may also surface as a tendency to stay back late at work or work excessively when not necessary, which might serve the purpose of avoiding self-reflection (“I’m too busy”). You may notice increased use of alcohol or drugs that might serve the purpose of self-medication for emotional pain. Perhaps you experience or see someone you care about taking more risks or breaking rules (for example, as reckless driving) more than usual. Other externalising behaviours can include more frequent unsafe sexual practices or outwardly blaming others for one’s own wrongdoings. Men can be more likely than women to express their distress via externalising behaviours, influenced by gender norms they may have adopted. In combination with help-seeking reluctance, societal mental health stigma and influence of traditional masculine ideals, men may find themselves turning to externalising behaviours to cope with their mental health instead of seeking other support.

Psychologists can work with internalising and externalising behaviours by holding knowledge about traditional masculine norms and their impact on mental health. This can help men feel understood and more willing to disclose openly about the distress they are experiencing. Rallying trusted supports and slowly testing the truthfulness of worries around open disclosure might see some men find solidarity and ongoing social support from friends and family during hard times. Therapy can include cultivating openness to experience to learn that the avoided thoughts or feelings may be more manageable than originally thought. Increasing self-awareness of internalising and externalising behaviours and reducing reliance on unhelpful coping mechanisms might be important ways men can learn to improve their mental health.

Men can be less likely to seek care, less likely to report mental health symptoms and be less likely to receive care. An awareness of and sensitivity to internalising and externalising signs of mental health distress may be key to detecting suffering men before a possible or eventual worst-case scenario.

Reflect on whether you consider strength to be ignoring and suppressing difficult thoughts, emotions and situations or confronting them and learning that you may hold the untapped ability to cope with them. Recognising your suffering may be one of the most powerful steps you take to help yourself, your partner, brother, father or son. If you suspect you are experiencing these signs, challenge yourself to open up and make contact with a mental health professional. If not, think about people in your life showing these signs and whether you will help them understand your concern for them.

References

Smith, D.T., Mouzon, D.M. and Elliott, M. (2016) ‘Reviewing the assumptions about men’s mental health: An exploration of the gender binary’, American Journal of Men’s Health, 12(1), pp. 78–89. doi:10.1177/1557988316630953.

Baker, D and Rice, S. Keeping it real: Reimagining mental health care for all young men. Melbourne: Orygen, The National Centre of Excellence in Youth Mental Health, 2017.