What's Really Behind 'I'm Fine': A Mental Health Expert on Men's Hidden Struggles

LANCASTER – Movember, also known as Men's Health Awareness Month, shines a light on issues that often go unspoken, including men's mental health.

Kaiser Permanente Antelope Valley Therapist Edwin Aguirre shares why men struggle to open up about their mental health, and how breaking that silence can save lives.

The 'I'm Fine' Default Response

"When I ask men how they're doing, I hear 'I'm fine' so often, even when it's clear they're struggling," says Aguirre. "This automatic response is deeply ingrained in many men from a young age. They're taught that expressing vulnerability is weak, that they should handle problems on their own, and that asking for help is somehow less masculine."

This cultural conditioning has serious consequences. Men are significantly more likely to die by suicide than women, yet they're far less likely to seek mental health treatment. "We've created a situation where the people who need help the most are the least likely to ask for it," Aguirre explains.

Recognizing the Hidden Signs

Because men are conditioned to hide their emotional pain, their struggles often show up differently than they might in women. "Men are more likely to express depression through anger, irritability, or risky behavior rather than sadness," says Aguirre. "They might work excessively, drink more, or withdraw from relationships without recognizing these as signs of a mental health issue."

Warning signs that a man might be struggling with his mental health include:

• Increased anger or irritability

• Withdrawing from family and friends

• Changes in sleep or appetite

• Substance use escalation

• Reckless or risky behavior

• Loss of interest in activities they once enjoyed

• Physical complaints like headaches or fatigue

Creating Safe Spaces for Conversation

"Men need to hear that it's OK to not be OK," Aguirre emphasizes. "Strength isn't about handling everything alone – it's about recognizing when you need support and having the courage to reach out."

He encourages friends and family members to create opportunities for authentic conversation. "Instead of accepting 'I'm fine' at face value, try saying something like, 'You don't seem like yourself lately. I'm here if you want to talk,'” he said, “Sometimes, men just need permission and a safe space to open up."

Redefining Strength

"The narrative around masculinity is slowly changing, but we still have work to do," says Aguirre.  "I try to help men understand that taking care of their mental health isn't weakness – it's taking responsibility for their wellbeing, which is actually one of the strongest things they can do."

He notes that therapy doesn't have to mean years of treatment. "Sometimes men just need a few sessions to develop better coping strategies or work through a specific challenge. There's no minimum level of struggle required to benefit from professional support."

Aguirre also addressed the importance of male role models speaking openly about mental health. "When men see other men – whether it's athletes, celebrities, or their own friends – talking about therapy or mental health challenges, it normalizes seeking help," he said.

Take Action:

• Check in with the men in your life beyond surface-level conversations.

• If you're struggling, reach out to your doctor or a mental health professional.

• Use Kaiser Permanente's telehealth options if in-person feels intimidating.

• Remember that seeking help is a sign of strength, not weakness.

• Encourage open conversations about mental health in your circles.

To learn more about mental health services or to schedule an appointment with a Kaiser Permanente therapist, members may visit kp.org or call 1-833-574-2273. If you're in crisis, call 988 for the Suicide and Crisis Lifeline.