The Lived Experience of Suffering Among Transitional-Age Youth with Mental Disorders: A Phenomenological Thematic Analysis.

Abstract

Introduction: Transitional age youth (TAY ; ages 16-25) is a developmental period marked by major biopsychosocial changes and a peak onset of mental disorders. While psychiatric diagnoses rely heavily on distress as a criterion, the concept remains underdefined, particularly for youth who often report subthreshold symptoms. This study aims to explore how TAY with mental disorders experience and describe their suffering, in order to clarify its phenomenological features and clinical relevance within the context of emerging adulthood.

Methods: We conducted individual, semi-structured interviews with 15 TAY receiving psychiatric care at a public hospital in Brussels. Participants were aged 17-25 and came from both inpatient and outpatient settings. Each interview began with a visual tool, where participants brought visual materials representing their suffering. The interviews were analyzed using thematic analysis.

Results: We identified five themes. First, for participants, suffering meant enduring "mental pain," an aversive and inescapable experience, often tied to suicidality. Second, this pain was described as submerging their reality, disrupting their sense of time, world, and self. Third, participants struggled to explain this pain to others and themselves. Fourth, they nonetheless thought it to be abnormal and to require professional help, as it signaled the presence of a mental disorder. Lastly, they reported the underlying cause of their mental pain as having no place in the world, due to patterns of social adversity or an inability to meet social expectations Conclusion: For these TAY, suffering was tied to a damaged social sense of self, fueled by ideals of autonomy and self-improvement that are increasingly hard to achieve. Excessive suffering was often characterized as "depression" and many of their experiences did echo phenomenological accounts of depression. While prior definitions of suffering emphasize causes or outcomes, this study details the experiential core of suffering as mental pain. However, some participants distinguished between pain as an immediate pre-reflective experience and suffering as its reflective aftermath. This supports the view that clinicians must address not only the raw experience but also help patients build meaning from it, bridging symptom relief with narrative understanding.