What Are Internalizing Behaviors?

Are you or someone you know struggling with internalizing behaviors? If so, you are in the right place to get help. When we think about harmful behavior, we usually imagine violent, aggressive, or otherwise damaging actions directed toward others. Many people do not realize that emotional disturbances and mental health disorders can cause those who experience them to attack themselves.

Known as internalizing behaviors, these reactions to stress and negative emotions are often hidden (commonly due to trauma). Because of the tendency to remain out of view, internalizing behaviors are not as well-known as externalizing forms that involve acting out. This does not mean internalizing behaviors are any less damaging. In fact, research suggests that continuing such behavior can cause serious damage to one's overall mental health, self-esteem, and relationships with others. Some of these negative emotions include loneliness, isolation, abandonment, grief, suffering, rage, envy, jealousy, insecurity, self-doubt, and self-hatred.

Struggling With Self-Regulation

Many children, teens, and adults struggle with self-control. This means that they have trouble controlling their emotions and impulsive reactions.

A common example that most of us have witnessed is a toddler throwing a fit in a store because their mom or dad refuses to give them what they want. When throwing a tantrum, toddlers might scream, stomp their feet, and even throw things. Although few adults would find it acceptable, this behavior is somewhat expected for a child under three. So, though we wouldn't want to reward the behavior, we wouldn't find it alarming.

However, what would you think about the same situation but involving a 12-year-old? You might feel differently since you would expect a child of that age to have more control over their emotions. Although not the norm, many young people (who grow into adults) struggle with self-control—even as they age—resulting in negative behaviors.

Externalizing Vs. Internalizing Behaviors: The Difference

Some of these actions, such as those mentioned above, are externalizing behaviors, meaning they are directed toward an individual's environment. Behaviors can be directed at loved ones, parents, and teachers—anyone or anything in the person’s environment. Common examples of externalizing behavior include:

• Verbal aggression

• Physical aggression

• Destruction of property

• Stealing

Although "negative emotions" such as anger are normal stress responses, the outward reaction suggests a person has difficulty with self-control. Many people who display externalizing behaviors frequently end up being diagnosed by a clinical psychologist with one (or more) of the following mental disorders:

• Attention Deficit Hyperactivity Disorder (ADHD)

• Intermittent Explosive Disorder

• Oppositional Defiant Disorder

• Substance Use Disorder

• Conduct Disorder

• Antisocial Personality Disorder

• Pyromania

• Kleptomania

Treatment for externalizing behaviors is both personal and complex. These disorders are not, however, the only way that self-control presents itself.

Some children and adults who have trouble coping with stress and emotions exhibit internalizing behaviors. This is to say that instead of acting out toward others, they self-harm.

Depression and anxiety are two mental disorders that people who practice internalizing behavior often develop. Researchers found that mental health professionals have become even more aware of (and concerned by) internalizing disorder over the past three decades. The results from studies like these done in the psychotherapy field mark how information can lead to changes in levels of understanding of the prevalence of these disorders in adolescents, girls, boys, gender differences with ages, and how peers can support each other through the internal conflict they are facing in addition to learning skills to navigate these thought patterns and isolation.

In situations regarding the mind and aspects of development, it is important to read articles and publication from various sources—the differences in content, criteria of the print, page length, angle of the article, words used, and evidence presented can all provide history and context for a specific community and trauma types effected. Internalizing behavior can lead to consequences in adulthood when experienced in adolescence, and psychology shows that the view of the world can drastically shift from those experiencing these behaviors, as well as understanding their purposes, rights, and version of life.

Internalizing Behaviors and Symptoms May Include:

• Feeling sadness, lonely, afraid, unwanted, or unloved

• Being withdrawn and not wanting to socialize

• Becoming irritable or nervous, especially when stressed or emotional

• Not wanting to talk or communicate with anyone

• Having difficulty concentrating or focusing on important tasks

• Sleeping a lot more or less than usual

• Eating a lot more or less than usual

• Negative self-talk

• Substance abuse

• Suicidal thoughts, attempts, or ideation

Internalizing disorders develop when individuals try to self-control inappropriately. Unlike those with externalizing disorders, they might try "too hard" to control emotions and do so from within.

Also known as "secret illnesses," many people experiencing internalizing disorders hide their symptoms so well that even their family and friends are unaware of their struggles. Many people who experience internalizing behaviors never get help, which means their internalizing behaviors may progress into bodily self-harm (cutting) or suicidal thoughts and attempts.

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached 24/7 at 988 or suicidepreventionlifeline.org/chat/.

Internalizing Disorders And Presentation

Internalizing disorders usually present themselves in these four primary ways:

• Depression

• Anxiety

• Social Withdrawal

• Somatic (Physical) Symptom Disorder

Depression

A common yet extremely serious mood disorder, depression is also known as major depressive disorder or clinical depression. Dysthymia is a milder, but long-lasting form of depression. Although depression can present itself in many different ways, the book Diagnostic and Statistical Manual of Mental Disorders (DSM-5)—followed by mental health professions during diagnosis—lists the following symptoms. Excluding the last, these symptoms must present every day or nearly every day.

• Depressed mood

• Less interest in all, or almost all, activities

• Significant weight loss or gain

• A slowing down of thought along with a reduction of physical movement

• Fatigue or extreme loss of energy

• Feelings of worthlessness or inappropriate guilt

• Diminished ability to think or concentrate

• Recurrent thoughts of death, suicidal ideation with or without a specific plan, or a suicide attempt

Anxiety

Because they occur together so frequently, many people think that depression and anxiety are the same illness when they are different. All anxiety disorders present differently. DSM-5 lists the symptoms of generalized anxiety disorder as:

• Excessive anxiety

• Difficult to control worry

• Restlessness

• Feeling on edge

• Becoming easily fatigued

• Difficulty concentrating

• Irritability

• Muscle tension

• Sleep disturbance

For a person living with an anxiety disorder, internalizing behaviors can be a serious issue. Unfortunately, left untreated, the anxiety does not go away and can also worsen over time. It can also lead to serious mental illnesses such as depression (listed above) and social withdrawal (discussed below).

Social Withdrawal

Social withdrawal can be a symptom of numerous mental health issues, including anxiety and depression. It is also one of the main signs of Avoidant Personality Disorder, which is characterized by the following:

• Extreme social inhibition

• Feelings of inadequacy

• Sensitivity to negative criticism as well as rejection

Social withdrawal is worth mentioning separately because it is a common coping mechanism for those experiencing strong emotions and stress through internalizing behavior. Instead of acting out, introverts and others who look inward choose to be alone rather than interacting with others who could help. Social withdrawal can also affect work and school—something as simple as seeing a “full inbox” sign when checking e-mail may cause anxiety, preventing an individual from sending a response, and increasing social withdrawal.

Somatic Symptom Disorder

One final way that internalizing behaviors often presents is through somatic symptom disorder (SSD). SSD is not as well-known as anxiety and depression. Many people first hear of this disorder at diagnosis.

SSD shows up as physical symptoms with no underlying cause. It is characterized by pain, neurologic challenges, stomach issues (gastrointestinal complaints), and sexual symptoms.

People living with SSD are often viewed as 'faking symptoms' since there isn't an underlying cause that physicians can pinpoint. However, this is a misconception. The distress, frustration, and physical pain from SSD are real and can lead to internalizing behavior.

The effects, while often physical, also manifest in other ways. Children living with an internalizing disorder tend to have trouble with academic performance, socializing with others, psychological adjustment, and employment. Again, these things tend to go unnoticed.

Next Steps

When asked why pinpointing internalizing behaviors is so difficult, especially in the classroom, one teacher described it this way:

Think of a stage where you have 25 dancers. Even if they are all equally talented, the ones in the first row, especially if they are giving more energy, will catch your attention. It does not take away from the abilities of those in the back; it just makes them a lot harder to spot.

If you, your child, student, or someone else you know is struggling with emotional control, anxiety, depression, internalizing behavior, please seek assistance from a professional today. The perception of the condition can be inaccurate, hard to understand, and frustrating until you get a diagnosis—but don’t let fear, helplessness, feelings of guilt, or shame stop you from getting the help you need, even if it feels difficult. It is possible to learn new habits and end self-directed, harmful behaviors through therapy.

Research shows that online therapy can play a significant role in reducing depression and anxiety symptoms. For example, one study found that online therapy was even more effective than traditional in-person sessions, with 100 percent of participants in the online group showing continued symptom reduction three months after treatment. On the other hand, individuals in the face-to-face group showed "significantly worsened depressive symptoms" over the same period. This study explores how internet-based treatment compares to regular face-to-face therapy.

If you struggle with any of these challenges, the last thing you might want to do is drive to a therapist's office for a session. If that sounds like you, online therapy with BetterHelp could be a powerful solution. Plus, you can contact them on a more regular basis, which can be a great comfort during the tough times when you need to speak with a trusted professional. 

Takeaway

Internalizing behaviors can be easy to miss. Their hidden nature—as compared to externalizing behaviors such as ADHD and kleptomania—makes it difficult to identify. That said, when you begin to recognize the symptoms in yourself or others, you can begin to learn healthy alternatives and open up with loved ones or a licensed professional to find help along your journey.

Questions People Often Ask:

What is an internalizing behavior?
What is an example of internalizing behavior?
What causes internalizing?
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What are internalizing problems?
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How do I stop internalizing?
What is the difference between internalizing and externalizing?
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