Mental Health Day: Psychology says people who always say “I’m fine” may be hiding these feelings. Why WHO wants 'voices heard'

When someone asks how you are doing, “I’m fine” is often the quickest answer. But behind those two words, a person may be dealing with stress, loneliness, emotional exhaustion or problems they are not ready to discuss. In some cases, the response is simply a social habit. In others, it may reflect a reluctance to share difficult feelings.

This World Mental Health Day, observed on October 10, the World Health Organization (WHO) is calling for a shift in how society listens to people living with mental health conditions. Its 2026 theme, “Lived experiences heard: real voices, real change,” highlights the need to include their experiences in decisions about mental health policies, treatment and support services.

The message goes beyond encouraging people to speak openly. It also asks families, workplaces, healthcare providers and governments to take those experiences seriously and use them to improve mental health support.

Mental Health Day: Why do some people say “I’m fine” when they are struggling?

There is no single explanation for why someone may hide their feelings. Some people prefer to deal with problems privately, while others worry about being judged, misunderstood or becoming a burden to those around them.

Psychologists use the term expressive suppression to describe efforts to conceal outward expressions of emotion. Research on emotion regulation has linked habitual suppression with difficulties in social relationships and lower well-being in some contexts, although the effects can vary between people and situations.

A report by TIME, featuring clinical psychologist Jennifer C. Veilleux, discussed how “I’m fine” can become an automatic response even when it does not reflect how a person feels. The report also highlighted the importance of finding ways to communicate honestly without feeling pressured to disclose everything.

For some, saying “I’m fine” may be a way to protect their privacy. Others may not yet have the words to explain what they are experiencing. The phrase alone, therefore, cannot establish whether someone is facing a mental health problem.

Five feelings people may find difficult to talk about

1. Loneliness, even when surrounded by people

Having friends, colleagues or family members around does not necessarily mean someone feels emotionally connected to them. A person may participate in conversations, attend social gatherings and appear cheerful while feeling that nobody truly understands their concerns.

This can make loneliness difficult to recognise from the outside. Instead of assuming that someone is fine because they are socially active, it can help to ask how they are actually feeling and give them room to answer honestly.

2. Stress and emotional exhaustion

Some people continue meeting deadlines, looking after their families and fulfilling everyday responsibilities even when they feel overwhelmed. They may avoid discussing their difficulties because they believe they are expected to manage everything themselves.

Workplace pressure, financial worries, family responsibilities and a lack of rest can all contribute to stress. Persistent exhaustion or difficulty coping deserves attention, particularly when it begins to interfere with sleep, relationships or daily activities.

3. Fear of being judged

The fear of being labelled weak or incapable can make people reluctant to discuss emotional difficulties. This concern may be particularly strong in environments where people are expected to remain productive, independent and composed.

WHO has identified stigmaand discrimination as major barriers to mental health support. Its work on reducing stigma highlights how negative attitudes can discourage people from seeking care and contribute to social exclusion.

A person may therefore choose a reassuring answer rather than risk a response that makes them uncomfortable.

4. Sadness they cannot easily explain

Not every difficult emotion has an obvious cause. Someone may feel low, irritable or disconnected without being able to identify exactly what has changed.

They may also struggle to explain their feelings to friends or family members. Asking them to simply cheer up or look on the bright side may leave them feeling misunderstood.

Persistent sadness, loss of interest in usual activities or changes in sleep and appetite can be reasons to seek professional advice. These signs do not, by themselves, establish a diagnosis.

5. The feeling that they must handle everything alone

Some people find it easier to support others than to ask for support themselves. They may fear inconveniencing friends, disappointing family members or appearing unable to cope.

A 2022 qualitative study examining survivors' experiences after the Manchester Arena bombing foundthat having emotional concerns acknowledged and understood was an important part of the informal support participants described. The researchers also documented experiences in which feelings were dismissed or judged, sometimes making people less willing to open up. The findings offer insight into the importance of supportive responses, although the small, specific sample cannot represent everyone's experience.

Mental Health Day Theme: What does WHO mean by “Lived experiences heard: real voices, real change”?

WHO's 2026 campaign focuses on people who have personally experienced mental health conditions and the challenges of accessing or receiving care.

The organisation argues that their knowledge should be recognised as a form of expertise. People who have experienced mental health difficulties can identify barriers and practical problems that may not be apparent to policymakers or healthcare professionals working without that direct experience.

The campaign calls for people with lived experience to be involved in designing, delivering and evaluating mental health services, rather than being invited to share personal stories without having a say in the decisions that follow.

WHO's Mental Health Atlas 2024 survey also points to gaps in participation. Among countries responding to the survey, 45% reported ongoing collaboration with people with lived experience and family or caregiver advocacy groups in the planning, delivery or monitoring of mental health promotion, prevention, treatment and rehabilitation. The figure suggests that meaningful participation is not yet universal.

The distinction matters. Listening to someone's account is a starting point; allowing that experience to influence services and policies is a further step. WHO's message this year is that mental health systems should be built with people who use them, not simply for them.

How can you respond when someone says “I’m fine”?

A person does not have to explain every feeling or share private information to receive support. What matters is making it easier for them to speak if they choose to.

Here are a few ways to respond:

• Ask gently: Instead of repeatedly asking whether everything is fine, try, “How have things really been for you lately?”
• Listen without interrupting: Give the person time to explain their concerns in their own words.
• Avoid rushing to solve the problem: Ask whether they want advice or would prefer someone to listen.
• Do not dismiss their feelings: Comments such as “others have it worse” can make a person feel that their concerns are not worth discussing.
• Respect their boundaries: If they are not ready to talk, let them know you are available when they want support.

These small interactions cannot replace professional mental health care when it is needed. They can, however, help create an environment in which people feel more comfortable asking for help.

Why being heard matters on World Mental Health Day

The phrase “I’m fine” does not always conceal a problem. Sometimes, it is simply the answer someone wants to give. But when people repeatedly feel unable to discuss their difficulties, the response can also point to a wider problem: the absence of a safe, supportive space for honest conversations.

World Mental Health Day is an opportunity to examine how people talk about emotional well-being and how others respond when they do. WHO's 2026 campaign puts the emphasis on moving beyond awareness towards meaningful participation, better support and decisions shaped by the people whose lives are affected.

The message is straightforward. Listening is important, but listening without judgement and acting on what people say can make that support more meaningful.