“People just think she's crazy” - Adolescent girls' and young women's sense-making of mental health in a diagnostic culture

Reports of increasing mental health problems among adolescent girls and young women are frequently framed as a mental health crisis, raising questions about whether this reflects a rise in distress or a redefinition of mental health within a diagnostic culture. However, there is a dearth of knowledge on how adolescent girls and young women conceptualize mental health and what implications this has on their lived experiences, which was explored in this study. Qualitative data was generated through in-depth interviews with 29 women aged 16–18 and 21–23 living in Sweden and analyzed using a cultural psychological and critical phenomenological framework. A limitation of the study is that it was based on a self-selected sample, which may have limited the diversity of perspectives. The analysis identified two central themes: diagnosis as a device for sense-making and orientation and narrowing the space for normality . Diagnoses were described as legitimizing and destigmatizing, providing meaning to distress and affirm coherence and sanity. At the same time, the expansion of what was understood as psychiatric conditions appeared to narrow the boundaries of what is considered acceptable and normal. The findings extend the concept of diagnostic culture by demonstrating how diagnostic practices and gendered norms jointly shape adolescent girls’ and young women’s lived experiences. While diagnoses can be destigmatizing and support agency, they may also reinforce normative pressures and obscure gendered, social and structural conditions of mental health experiences. Hence, psychiatric diagnoses may provide moral relief for the particular adolescent girl or young woman while at the same time narrowing the space for womanhood - thereby making the world less homelike for everyone.