Internalizing behaviors and their impact on mental health

As their name suggests, internalizing behaviors happen in response to a person’s inner world of thoughts and emotions. They are directed at oneself (instead of others) and can include things like social withdrawal or perfectionism. This process is sometimes referred to as internalizing emotions since distress is turned inward instead of expressed outwardly.

Internalizing behaviors often come from uncomfortable emotions like sadness, fear, or anxiety. They can also accompany mental health concerns like depression or anxiety. Some people may try to internalize stress as a way to cope — especially if they’ve learned to manage emotions privately or avoid burdening others.

Unlike externalizing behaviors, like aggression or impulsivity, internalizing behaviors can be harder to detect. But by learning more about them, you can learn to identify internalizing behaviors in yourself and others.

What are internalizing behaviors?

According to the American Psychological Association (APA), externalizing and internalizing behaviors are a way of grouping children’s behavior and challenges based on how they manage emotions when faced with stressful situations. But people of all ages can have internalizing behaviors that negatively impact their well-being.

One of the most challenging aspects of internalizing behaviors is that they’re often overlooked. Unlike externalizing behaviors (like verbal aggression, fighting, or breaking the law), internalizing behaviors can be invisible to the untrained eye. But while they might be less obvious to the outside world, they’re no less challenging to live with. That’s why it’s so important to increase awareness.

Internalizing behaviors can lead to issues like depression, anxiety, physical complaints, and post-traumatic symptoms. When negative or uncomfortable emotions come up, we can sometimes respond with internalizing behaviors as a way to cope with these unpleasant feelings. Over time, this pattern can look like internalized emotional regulation, in which a person manages distress internally but may not express or process those emotions in a healthy way. Some people may also begin to internalize feelings so often that it becomes their default response to stress.

Some examples of internalizing behaviors include:

• Being afraid to try new things

• Chronic worry and anxiety

• Social isolation and withdrawal

• Self-harm or suicidality*

• Engaging in high-risk behaviors that could harm yourself but not necessarily others (like binge drinking or compulsive gambling)

• No longer doing hobbies or activities that used to bring you joy

• Engaging in self-blame or negative self-talk

• Restricting food or other necessary resources

The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. 

If experiencing a life-threatening emergency or you need immediate help, please call 911.

It’s important to note that when internalizing behavior continues, it could mean that a person may need professional help. Engaging in the occasional internalizing behavior does not necessarily mean that a person has a mental health condition.

But when these behaviors happen frequently and become a pattern, it could be due to an internalizing disorder like an anxiety disorder or depressive disorder. Fortunately, internalizing disorders are highly treatable. With the right support, typically in the form of therapy and/or medication, people living with these conditions can regain control of their behaviors and lead full, balanced lives.

Why do people internalize?

We know that a person’s internal experience is often influenced by their external environment. At the same time, behavior is shaped by one’s internal experience.  In other words, behavior is like a language that reflects a person’s internal emotional state. So as you can imagine, people internalize for many different reasons. Sometimes, it can be the result of a mental health condition.

But researchers have identified some other risk factors for internalization, including:

• Experiencing childhood trauma or other negative life events, like violence, poverty, abuse, grief, or parental separation

• Exposure to environmental toxins like lead

• Prenatal exposure to alcohol, tobacco, or marijuana

• Personality traits like shyness, fearfulness, and a tendency to quickly withdraw from uncomfortable situations

• Having a close relative, like a sibling or parent, who has a mental health condition like depression or anxiety

Remember, having any one of these risk factors does not mean that you’ll automatically experience internalization or develop an internalizing disorder. You don’t need to have a formal diagnosis or a deep understanding of why you internalize to ask for help.

Dig deeper:

• Could projective identification explain your internalized emotions?

How to tell when you’re internalizing your feelings

It’s not always obvious when you’re internalizing your feelings. You may not even realize you’re doing it at first. Over time, though, certain patterns can start to show up.

Some signs you may be internalizing your feelings include:

• Keeping things to yourself, even when something is bothering you

• Avoiding difficult conversations or conflict

• Overthinking situations without sharing how you feel

• Feeling emotionally distant or disconnected from others

• Telling yourself your feelings “aren’t a big deal” or don’t matter

• Not asking for support, even when you need it

• Noticing tension in your body, like headaches or tightness, without a clear reason

You might also notice that your emotions build up over time. Instead of being expressed in the moment, they can come out later as irritability, withdrawal, or feeling overwhelmed.

Learning to notice these patterns is the first step. Once you’re aware of them, you can start to find safer and more supportive ways to express what you’re feeling.

How to stop internalizing your emotions

If internalizing behaviors are negatively impacting your mental health, you may benefit from working with a therapist. They can help you learn to manage these behaviors using various therapy types.

Types of therapy and therapeutic techniques that can help with internalizing behaviors include:

• Cognitive behavioral therapy (CBT): This form of therapy can help you learn to recognize and interrupt internalizing behaviors. It can also help you learn new ways to cope with stress and regulate your emotions.

• Exposure therapy: This is a form of CBT that involves a gradual introduction to triggers within the safety of a therapy session. It can help you overcome internalizing behaviors by reducing your sensitivity to triggers and shifting how you respond to uncomfortable feelings.

• Interpersonal psychotherapy (IPT): This form of therapy can help you better understand the relationships with important people in your life. It can also address many of the symptoms that frequently occur alongside internalizing behaviors, including communication challenges and social isolation.

• Mindfulness: You can learn mindfulness skills in therapy or on your own. Mindfulness can help you overcome internalizing behaviors by fostering self-acceptance, raising awareness of your thoughts and feelings, and encouraging self-compassion.

In addition to therapy, there are practical steps you can start using in your daily life to sotp internalizing behaviors. 

Strategies you can try include:

• Naming what you’re feeling: Try putting your emotions into words, even if it’s just to yourself. This can help reduce the urge to push them down.

• Writing it out first: Journaling can help you process your thoughts before saying them out loud.

• Practicing “pause and check-in” moments: Take a few seconds during the day to ask yourself, “What am I feeling right now?”

• Challenging the thought that your feelings don’t matter: Remind yourself that your experiences are valid, even if they feel uncomfortable.

Clinician’s take

In my experience, internalizing behaviors often show up as holding in emotions, overthinking, or blaming yourself instead of speaking up. It might look like staying quiet when you’re hurt or replaying situations in your head. The good news is these patterns can change.

Brandy Chalmers, LPC

Clinical reviewer