Trapped and lost in transition - existential loneliness during adolescence described in retrospect by Swedish university students

Experiences of loneliness are common during adolescence and previous research has shown these experiences to be related to physical and mental ill-being. However, there is limited knowledge of one kind of loneliness during adolescence – existential loneliness – which can challenge the possibilities of offering adequate support. Narrations of experiences in retrospect may lead to a deepened understanding of a phenomenon. Therefore, this study aims to describe the phenomenon of existential loneliness during adolescence through Swedish university students’ retrospective written narratives ( n = 67). The study has a qualitative design with a phenomenological approach, and the data were analysed inductively. The findings show that existential loneliness during adolescence means feeling empty and lost while painfully trapped in an alienating borderland in the search for belonging, sense of self, and meaning. This knowledge can be used as a basis for the development of interventions aiming at supporting adolescents’ well-being.


Introduction
Adolescence is a part of life when great changes occur regarding the body, identity, and social relationships (Sawyer et al., 2018).It is the period between childhood and adulthood when the child is becoming an adult which can be understood as a developmental transition.Meleis (2010) describes transitions as passages from one life phase, condition, or social role to another, which may result in a temporary disconnectedness from everyday life.During adolescence many thoughts and emotions arise, and the period is described as involving emotional chaos (Gross, 2013).The pubertal bodily changes may feel strange and even frightening, and uncertainty may arise about whether the bodily, as well as the psychological and relational, changes are 'normal', i.e. met by the societal normative expectations.Comparisons with peers (Rotenberg & Hymel, 1999), and through social media (Sebre & Miltuze, 2021) are, therefore, not rare and may lead to feelings of loneliness (Hemberg et al., 2022).During adolescence experiences of loneliness are common (Qualter et al., 2015), and are even seen as a global public health issue (Surkalim et al., 2022).Therefore, it is important to recognize, interpret, and understand adolescents´ experiences of loneliness in order to support their well-being.
Loneliness is a multifaceted emotion that can feel unbearable and may include great suffering.A recent integrative review showed that there are multiple causes of loneliness and different dimensions of suffering among adolescents and young adults, depending on personal barriers, negative life experiences, and life transitions (Korzhina et al., 2022).In addition, loneliness is described as a universal human experience (Mijuskovic, 2012;Rotenberg & Hymel, 1999), which most people will encounter during a lifetime.An evidence synthesis by Mansfield et al. (2021) identified three distinct but overlapping types of loneliness: social, emotional, and existential loneliness.Social loneliness is the most common type of loneliness described in the literature, which is seen as an 'objective' condition related to the number of social relationships.This type of loneliness is linked to a subjective feeling of isolation, i.e. a sense of disconnection from others.Emotional loneliness can be understood as not simply a dissatisfaction with the number of social relationships, but also a lack or loss of meaningful relationships.Existential loneliness means not only the absence of meaningful relationships, but also feelings of fundamental separateness from others and the wider world.Even if these different types of loneliness are distinguished from each other, they are seemingly interrelated.
Existential loneliness may thus be understood as an 'experience of total absence of any relatedness' (Ettema Derksen et al., 2010, p. 151), a condition of human existence which is mainly connected to negative emotions.Existential loneliness has been described as a deeper form of loneliness (Bolmsjö et al., 2019;Phoebe et al., 2023), which has been studied mostly among adult persons in vulnerable situations: in disease groups (Mah, 2019;Mayers & Svartberg, 2001;Nyström, 2006;Sand, 2008), in older migrants (Chung et al., 2020;Olofsson et al., 2021), and in frail older people (Sjöberg et al., 2018(Sjöberg et al., , 2019)).Among adolescents, existential loneliness has been described as related to experiences of gaining insight of being unique, and, therefore, painfully realizing that one can never be fully understood (Garnow et al., 2022).'Existential isolation' is often used to describe a similar experience, and sometimes the terms are used interchangeably (Gil Álvarez et al., 2023).The existential psychotherapist Irvin Yalom (1980) describes existential isolation as a painful part of being human, which can arise when a person becomes aware of their own existence and that they are ultimately alone in the world.Existential isolation is often described as feeling alone in one's subjective experience (Helm et al., 2019;Pinel et al., 2017Pinel et al., , 2022)); feeling that one will never be ultimately understood.Similarly, existential loneliness has been described as 'the immediate awareness of being fundamentally separated from other people and from the universe' (Bolmsjö et al., 2019(Bolmsjö et al., , p. 1322)), which is related to negative feelings such as sadness and meaninglessness because of experiences of not being met at a deep human level.
Existential loneliness often occurs during transitions; adolescence is a transition when existential thoughts are common, e.g.thoughts about life, meaning and meaningless.However, research on existential loneliness among adolescents is limited (Mansfield et al., 2021).Among the few studies conducted, existential loneliness in adolescence has been shown to be related to negative experiences such as social exclusion and in-betweenness (Garnow et al., 2022).The adolescents chose between sharing or not sharing their inner lives with someone else, and they tried to avoid the burdensome feelings; sometimes in ways that were not healthy for them.They longed for someone to talk to who was willing to listen and who tried to understand.Many of the adolescents explained that they had not talked about their experiences of existential loneliness with anyone before (Garnow et al., 2022).Lifeworld experiences, such as existential loneliness, are sometimes hard to express, or even to be fully aware of, during the time they occur (Husserl, 2014).However, when narrating experiences afterwards, even in writing, the experiences may come across in a more conscious and reflective way (Casey et al., 2016), which may be helpful when trying to understand a phenomenon.Therefore, when exploring existential loneliness as a phenomenon it is important to allow retrospective descriptions of experiences to be part of the knowledge development, to gain increased insight and an understanding of the phenomenon.The knowledge can hopefully be used to recognize, interpret, and support existential loneliness among adolescents.Therefore, this study aims to describe the phenomenon of existential loneliness during adolescence through Swedish university students' retrospective written narratives.

Study design
This study had a qualitative design with a phenomenological approach.The data consisted of written retrospective narratives which were analysed inductively using a phenomenological method described by Colaizzi (1978).The study is reported according to The Consolidated Criteria for Reporting Qualitative Studies guidelines (Tong et al., 2007).

Participants and data collection
The study employed convenient sampling of narratives written by university students attending a nursing programme in the south of Sweden.The data was collected between December 2021 and December 2022.
In the programme, there was a non-mandatory study assignment where the students were asked to write a story where they narrated, in retrospect, a personal event during adolescence when they had experienced existential loneliness.These stories were then used as a basis for discussion and reflection among the students in the class.In the study assignment, adolescence was described as a transition between childhood and adulthood; existential loneliness was described as a deeper sense of loneliness, a feeling that can come and go, which is related to experiences of not being able to share one's innermost feelings and thoughts, and of never being fully understood (see supplementary file for a complete description of the study assignment).The students who were willing to do the study assignment submitted their written narratives to the learning platform.The narratives did not contain any personal information such as real names or other information that could reveal who had written them.However, the students were informed that their de-identified narratives would be read by fellow students and that teachers had access to the learning platform, and thereby would be able to read the narratives and see the names of those who had submitted them.
The university students were informed about the study through an information letter in the learning platform.If they also wanted to let their written narratives be included in the study, they gave their written consent to the first author, who then got access to the learning platform and could collect the written narratives.The first author did not have any teaching or assessment function with the participants.In all, 102 nursing students (from a total of 271) wanted to participate in the study and contributed with their written narratives.
After the data collection all the authors read all the narratives individually and then jointly discussed whether the narratives responded to the aim of the study.When uncertainty arose regarding certain narratives, they were read through several times and were jointly and thoroughly discussed.Criteria for inclusion were narratives describing own experiences of existential loneliness during adolescence.Mansfield et al. (2021) description of the three different types of loneliness (briefly presented in the introduction section of this paper) was used as guidance during this process.Finally, 35 narratives were not included because they did not describe existential loneliness but primarily social loneliness (n = 26), evidently concerned adult life i.e. they did not focus on adolescence (n = 7), or did not describe the person's own experiences (n = 2).Therefore, the final sample consisted of 67 individually written retrospective narratives about experiences of existential loneliness during adolescence.The narratives had a mean of 490 words (range 160-2118 words; median 453 words).
For confidentiality reasons, no individual demographic data was collected related to the specific participants, but on group level (i.e. the participants' classes) the mean age was 28 years (range 20-54 years; median age 26) and approximately 85% were registered in the programme as women.

Data analysis
The analysis followed a phenomenological method described by Colaizzi (1978) which has the aim of identifying psychological phenomena by describing experiences.Before starting the analysis, it is important to consider one's own presuppositions and create a readiness to discover possible interpretations in the analysis that risk being based on own assumptions rather than the data material.The understanding of the phenomenon was, therefore, jointly discussed since all the authors have conducted previous studies on existential loneliness.The authors also wrote individual retrospective narratives about their own experiences of existential loneliness during adolescence and, thereafter, read the narratives aloud to each other and talked about the experiences.The knowledge about each other's presuppositions (i.e.preunderstandings) of existential loneliness was used during the analysis to protect against the influence of their own experiences.
Colaizzi's phenomenological method contains seven procedural steps that may overlap (Colaizzi, 1978).In the first step all the authors read all the narratives several times to become familiarized with the data, or as Colaizzi (1978, p. 59) puts it 'to acquire a feeling for them, making a sense out of them'.In the second step, significant statements were identified that had direct relevance to the phenomenon.This step was taken individually by the first and last authors, and the significant statements chosen were then compared and jointly discussed.Meanings were then formulated out of each significant statement by the first author and discussed with all the authors.Colaizzi (1978, p. 59) describes this third step as engaging in 'creative insight' since the researcher 'leaps from what the subjects write to what they mean'.In the fourth step, the first author organized the formulated meanings into themes and discussed the themes with the last author.The themes were also referred to the original narratives to validate them.In the fifth step, the themes and the formulated meanings were integrated into an exhaustive description of the phenomenon, which forms the basis of the findings in this study.From this description a statement of the phenomenon's fundamental structure was formulated in the sixth step.The findings were then discussed by all the authors.
The seventh step involved validating the findings by returning to the participants and asking them how the description of the phenomenon compared with their experiences.All the students in the involved classes got a message in the digital learning platform, where those who had participated in the study were asked to give feedback regarding whether the themes Table 1 compared with their experiences of existential loneliness during adolescence.If they felt that their experiences did not fit the description, they were asked to indicate what was missing.The students were offered various ways to respond to the first author: via the learning platform, email, and telephone.During this final step of the analysis, 38 students gave feedback and no new data emerged.
During the entire analysis the authors stayed close to the data to prevent their own presuppositions influencing the analysis.All the included narratives contributed to the analysis and are represented in the findings.Illustrative quotations, which are presented in the findings section, represent 25 different narratives (from the total of 67 narratives).To gain a greater understanding of how the participants phrased and expressed existential loneliness in their written retrospective narratives a brief description is presented at the beginning of the findings section.

Ethical considerations
The study was approved by the Ethical Review Agency in Sweden (reference number EPN 2018:842; supplementary application 2021-05179), and all procedures were conducted in accordance with the Declaration of Helsinki (WMA, 2013).Ethical considerations were borne in mind during the entire research process.Research focusing on adolescence is important since adolescents are seen as a marginalized group (Källström & Andersson Bruck, 2017), and the research is useful when developing knowledge of lived experiences (Åkerström & Brunnberg, 2013;WMA, 2013).However, the researchers must be responsive, especially when the research topic could bring up negative emotions (Crane & Broome, 2017), therefore, there was a readiness to arrange contact with student healthcare if needed.
When conducting research among students in a university setting there are challenges regarding existing power structures between the students and the researchers that may affect the experienced voluntariness in participating in the study (Connor et al., 2018).For that reason, the voluntariness of participation in this study was emphasized in the information letter.It was also important to ensure that the first author, who collected the data and involved the participants in validating the findings during the analysis, did not have any teaching or assessment function with the students.In addition, due to confidentiality reasons no individual demographic data were collected related to the specific participants.

Findings
This findings section begins with a brief description of how the Swedish university students expressed existential loneliness in their written retrospective narratives.Thereafter, the fundamental structure of the phenomenon of existential loneliness during adolescence is presented, followed by an exhaustive description of the phenomenon based on themes and related formulated meanings.

Existential loneliness as expressed by the participants
Existential loneliness during adolescence may, according to the narratives, occur suddenly and is an emotion that can come and go but it may also stay for a long time.It is expressed as being completely or extremely lonely in the world, which is painful, consuming, and difficult to endure.It was expressed using phrases like: 'At times I felt infinitely lonely.The feeling of loneliness was merciless.It appeared in different situations like dark clouds.' and 'The existential loneliness makes me feel completely lonely.As if I'm standing alone on the globe, without other people, in a vast space.' (See Figure 1 for an overview of the terms used when expressing existential loneliness).
Many of the narratives contained expressions of how existential loneliness presented itself during adolescence, and some narratives comprised more than one expression (the number of narratives that included each expression that follows is given in parentheses).According to the narratives, existential loneliness during adolescence presents itself through sadness (n = 27), anxiety, stress, and concerns (n = 10), as well as anger (n = 6), and concentration difficulties (n = 1).It may also be shown through bodily expressions such as pain (n = 9), sleeping problems (n = 6), and other bodily discomfort (n = 6).
The participants also expressed that they now realized that their experiences of existential loneliness during adolescence had led to an improved ability to understand other people´s experiences, which they considered valuable in their future profession as nurses.

The phenomenon of existential loneliness during adolescence
The fundamental structure of the phenomenon of existential loneliness during adolescence, as described by Swedish university students, is: Feeling empty and lost while painfully trapped in an alienating borderland in the search for belonging, sense of self, and meaning.
The fundamental structure is based on six themes, with related formulated meanings, describing the phenomenon of existential loneliness during adolescence: Being lost in a borderland, having no control; Being invisible, feeling abandoned; Being socially excluded, feeling misunderstood; Being in a vacuum, lacking meaning and hope; Being burdened, hiding painful feelings; Being trapped, wanting to escape (see Table 1 for an overview of the themes and the related formulated meanings).Different thoughts and feelings arise, often many at the same time and some completely new, which may feel frightening.It is described as: 'I was trying to figure out who I was while dealing with inner thoughts and feelings.'It feels like not recognizing or understanding oneself, and being torn between others' expectations and one's own will.Feelings of helplessness and of being exposed and lost occur.
Existential loneliness means losing control, and even losing oneself.It is described as: 'I had grown up too soon and I had been thrown into the adult world without my consent.I felt like I had no control.'and: Like throwing yourself into the unknown.Losing control (. ..) changing identity and the idea of who you were and who you could become.The transition created an internal conflict between my past and my new reality.

Being invisible, feeling abandoned
Experiencing existential loneliness during adolescence means being invisible and feeling abandoned.It has to do with not being seen or listened to and, therefore, feeling neglected.It is described as: 'I also felt a bit "abandoned", that they did not really think about how I felt and that no one cared about me.'It also feels like being insignificant: It felt like I was invisible and in a very dark tunnel where it was hard to see the opening at the other end (. ..)I felt lonely, so small and insignificant and like I did not deserve any kind of friendship, I felt so strange.
Existential loneliness is also experienced as not being prioritized, and as lacking someone who has one's back.It is described as: 'My mother prioritised her new family over me (. ..)I somehow became the one who fell through the cracks.' and 'It was very rare that someone stood up for me or defended me.' Existential loneliness means being left alone with one's emotions and thoughts and not knowing where to turn.It is described as: 'Then you are left alone with all your thoughts and feelings that only grow bigger and louder by the minute.'It is difficult to deal with the emotions alone: I do not know how to deal with my emotions anymore.Nobody sees me, nobody cares.I want to be seen and heard but I don't know how to do it.It almost feels like I am wearing a muzzle.
Existential loneliness awakens a strong feeling that implies a longing for talking about one's innermost emotions and thoughts, and a yearning to be listened to.It is described as: 'I had no one to turn to, no one to talk to who understood, and no safe arms to crawl into.The existential loneliness caused me to completely break down'.

Being socially excluded, feeling misunderstood
Experiencing existential loneliness during adolescence means being socially excluded and feeling misunderstood.It has to do with experiences of not belonging, and of being left out.It is described in this way: 'There were many feelings and ideals that made me feel extremely lonely and left out.' Existential loneliness is also about feeling different and not fitting in, as well as feeling alone with the experiences and having different values and thoughts than others: I felt left out in their [the classmates] presence (. ..) feel left out even though you really are not (. ..)I always felt more mature than the others in my class (. ..) no one else thinks the way I do.
Existential loneliness occurs even when people are around, and it is also then it may feel most noticeable.It is described as: 'I can feel this loneliness even with a lot of people around me.Perhaps it is even most painful then because it becomes extra clear in some way when others are around.'At the same time, it is not certain that one is perceived as lonely by others: Even though I am sitting in a physical room with many friends (.)It occurred to me that it would not have mattered if I had been there or not (. ..) when I said something I got the feeling that no one was really listening.Therefore, from the outside it looked like I was never alone, but the feeling I had was different.It has been like my thoughts did not match the ones I hung out with.
Existential loneliness arouses feelings and thoughts about not being good enough and of not being accepted for who one is.One feels misunderstood and it seems as if nobody understands which may feel frustrating.It is described as: 'It did not feel like I had anyone close, no one who really accepted me for who I was and no one who chose me (. ..)It felt like no one really understood me.' and 'No one could understand my feelings or my sadness (. ..)I needed someone who could understand my feelings.I got angry and irritated when people thought they could understand me.'

Being in a vacuum, lacking meaning and hope
Experiencing existential loneliness during adolescence means being in a vacuum and lacking meaning and hope.The experience of being in a vacuum has to do with feeling empty or experiencing having a hole inside which is painful.It is described as: 'For me, the loneliness felt like an emptiness, a type of vacuum.' and 'There was a great black hole with loneliness that swallowed me from within.'The experience of emptiness is present despite simultaneously being filled with different emotions.It is described as: 'I felt a great emptiness at the same time as I was full of emotions.'Feelings of hopelessness and a sense of lacking meaning and coherence occurs.It is described in this way: 'I experienced an emptiness and could also feel a form of isolation.Some days I was sad and quiet.Lack of meaning and coherence and a sense of hopelessness led to an existential loneliness for me.' and 'My whole life felt empty and meaningless.'

Being burdened, hiding painful feelings
Experiencing existential loneliness during adolescence means being burdened and hiding painful feelings.It has to do with not sharing one's innermost feelings and thoughts, which may be because of not daring to share because one is afraid of the other person's reactions, or not being able to share since there is a stated or unspoken desire from others that one should not speak: At school, no one saw that I was struggling, because I was not loud, aggressive, or problematic.Mom could see that something was wrong, but I only closed in more when she asked, because Dad did not want Mom to know what it was like at his house.
Existential loneliness is experienced as carrying a painful secret or a heavy burden.It is described as: 'I was involved in something that left a big wound in me, a wound I could not heal.I did not tell anyone about this incident, I carried it around myself, which was very heavy.' and 'I felt very lonely.I did not want anyone to know.At the same time, I just wanted to shout straight out to every single one that I could no longer live with my thoughts and feelings.'The painful feelings are kept inside, and some are related to guilt and shame, and not wanting anyone to know.It is described as: 'I had painful thoughts, and it was not something I liked to talk about with my friends.I thought it was embarrassing.[I] was very ashamed.' and 'I carried my shame in silence.I created a little room inside me where I locked away the incident and then pretended everything was normal.'It may feel like being inside a bubble: 'I was in my own little bubble.'Hiding the feelings also has to do with not wanting to show weakness or burden others with worries.But when not showing one's inner life to anybody, no one truly gets to know one on a deeper level.
I did not feel like I wanted to tell my friends as it would make me appear 'weak' and I certainly did not feel like I wanted to tell my family and, thus, put a burden on them (. ..) no one but myself really knew me and knew how I really felt.

Being trapped, wanting to escape
Experiencing existential loneliness during adolescence means being trapped and wanting to escape.It is described as being behind a wall: 'A wall was built between me and those who were my age.', and as being in deep waters: 'It feels like I am slowly drowning.Sinking further and further below the surface without anyone seeing or hearing me, no matter how much I scream.'Experiences of being trapped have to do with not being able to flee burdensome feelings and thoughts.One feels stuck, locked in, or paralysed.It is described as: 'But worst of all was probably this loneliness.The feeling of being locked in with your thoughts, your anxiety, and your nightmares.' and 'Part of me just wanted to be heard and listened to, but the loneliness and the thoughts that the loneliness created within me paralysed me.'One wants to disappear, zoom out, and there is a yearning to escape.It is described as: 'A feeling of wanting to escape while being trapped.' and 'It was as if I zoomed out while everything became much clearer.All the little details became much sharper.I guess it was my life world that got smaller and the outside world that became bigger.

Discussion
The aim of this study was to describe the phenomenon of existential loneliness during adolescence through Swedish university students' retrospective written narratives.The findings show that the fundamental structure of existential loneliness during adolescence means feeling empty and lost while painfully trapped in an alienating borderland in the search for belonging, sense of self, and meaning.Experiences of being trapped have in previous research shown to be related to feelings of hopelessness, and to suicidal ideation (Höller et al., 2022).Being trapped, or 'stuck' is, also, described as a central part of suffering (K.M. Galvin & Todres, 2013), which is manifested through a lack of purpose and a sense of meaninglessness.In our study experiences of being trapped and lacking meaning and hope were central.When experiencing existential loneliness during adolescence the walls towards the outside world may feel solid and can be perceived as impenetrable, but at the same time the influences from outside are tangible and important for the understanding of the self.
Existential loneliness during adolescence means being lost in a borderland and having no control when losing oneself.Feelings arise of lacking meaning, hope, and belongingness.This has similarities with our previous research among adolescents where existential loneliness was shown to be related to lacking belongingness (Garnow et al., 2022).Previous research focusing on adolescents and young adults has described existential loneliness as being lost in life (Hemberg et al., 2022), and existential concerns have been shown to always be present when trying to form an identity (Lundvall et al., 2020).Identity formation is central during developmental transitions, such as the transition from childhood to adulthood.Meleis (2010) describes, through 'transitions theory', that the transition can be experienced as losing oneself and having to create a new self-image which can lead to feelings of uncertainty, disconnectedness, and meaninglessness.To avoid being trapped in meaninglessness, when in a vulnerable situation, it is up to each individual to find meaning (Udo, 2014).Narrating one's own experiences is one way of creating meaning, belongingness, and a sense of self during adolescence.According to the philosopher Ricoeur (1994), humans create and discover themselves when narrating their experiences, and the self is created through reflection and interpretation.However, the person's narrative, or 'life story', is not a static story, but is constantly recreated and renegotiated in the relational framework (Ricoeur, 1994).It can be understood as the person depending on and inhabiting a intersubjective world (Colaizzi, 1978;Merleau-Ponty, 1999).By narrating their own experiences, the person expresses their identity and through the story the person emerges, i.e. this is how persons 'become' (Ricoeur, 1994).To narrate one's own experiences is thus an important part of identity creation during adolescence.
However, existential loneliness during adolescence means being invisible and feeling abandoned and it has to do with not being seen or listened to and being left alone with emotions and thoughts.It was described as most noticeable and painful when people were around.What happens when adolescents are vulnerable and unable to narrate their experiences, and when they do not share their inner lives with another person?What happens, then, to their self-understanding if narrations are such a central part of identity creation?A plethora of questions arise regarding the relation between identity creation, vulnerability, and narrations.Perhaps it is this non-narrative that becomes central to vulnerability, when experiencing existential loneliness during adolescence, as it concerns the understanding of the self and the existence.According to Ricoeur (1994), a person is active and capable, and at the same time vulnerable and in relation to the world.Vulnerability may, thus, be described as a constitutive part of what makes a person.Regarding existential loneliness during adolescence, the vulnerability may be connected to the person gaining an insight into their uniqueness and, in their inner life, standing alone.Philosophers, such as Mijuskovic ( 2012), even claim that existential loneliness constitutes the very core of a person's (self-)consciousness in the awareness of the uniqueness.A person's uniqueness means always being alone because, by being unique, they cannot fully share their experiences with anyone else (Mijuskovic, 2012).These insights of uniqueness, and therefore never being fully understood, were also shown in a previous study on existential loneliness among adolescents (Garnow et al., 2022).Existential loneliness is, thus, connected to realizing one is alone even when people are around.However, the different types of loneliness, as described by Mansfield et al. (2021), to some extent overlap, and may therefore be challenging to distinguish.The findings in this study showed that existential loneliness has connections with emotional loneliness, i.e. the absence of meaningful relationships; not having anyone to share one's innermost feelings and thoughts with.However, these experiences were, as mentioned above, connected to existential experiences of being ultimately alone in the world; that no one validates or understands one's subjective experiences.
Existential loneliness during adolescence is painful.It is expressed using terms like 'extreme', 'merciless', and 'infinite loneliness'.It is difficult to handle and arouses feelings of being alone with the experiences, being the loneliest in the world and being lonelier than ever.The findings showed a yearning to escape and a will to flee the burdensome feelings and thoughts.Existential loneliness among adults has in previous research also been shown to be connected to suffering, and when describing existential loneliness during adulthood 'deep loneliness' is a common term (Bolmsjö et al., 2019).However, the participants in our study did not use that term, instead they used terms that indicated that the experiences were very painful and had not previously been experienced.This may be interpreted as existential loneliness arises for the first time in life during adolescence.When it occurs, it may be experienced as frightening since existential loneliness is not widely known, and not something people in general are aware of and used to talking about.
Existential loneliness during adolescence may show itself through for example pain and sadness, and there may be challenges in interpreting how it is expressed.In another study, focusing on adolescents and young adults, existential loneliness was shown through what was described as deep sadness (Hemberg et al., 2022).The body and mind are intertwined (Merleau-Ponty, 1999), and there is a risk that existential loneliness will be met inadequately, since it may be interpreted as symptoms of another problem, for example, depression or physical pain, and thus treated as such.To initiate conversations about experiences of existential loneliness during adolescence is, thus, important when aiming to support the individual, but also when developing knowledge of the phenomenon.Existential knowledge, and a vocabulary of existential knowledge, are needed to guide caring practice (K.Galvin, 2021;Udo, 2014).Existential suffering is important not to pathologise because it risks discounting the existential dimensions of our lives, which are then not given a natural space in everyday life (Binder, 2022).When not meeting these dimensions, it can hinder experiencing existential health, which in the long term affects health and well-being negatively.Professionals, who in their daily work encounter adolescents, have an important role in supporting adolescents as they go through healthy transitions (Meleis, 2010), and they need to understand adolescents' well-being as well as suffering since they meet them in different life situations and with different existential needs.To share experiences of existential loneliness may be one of those needs.
Existential loneliness during adolescence arouses a yearning to be listened to.This is in line with results from previous research that showed that young adults had a longing to share their vulnerability regarding existential concerns (Lundvall, Lindberg, Hörberg, Carlsson, et al., 2019), and adolescents with experiences of existential loneliness longed for someone to share their inner lives with (Garnow et al., 2022).However, previous research among professionals has shown that it may be challenging to meet young persons' existential needs since doing so may stir up their own existential vulnerability (Lundvall, Lindberg, Hörberg, Palmér, et al., 2019).However, humans have a longing to narrate their experiences and their inner lives (Ricoeur, 1994), and when sharing experiences of existential loneliness, it has, in previous research among adults, been shown that development and personal growth emerge (Ettema Derksen et al., 2010).The participants in this study also experienced some kind of development.They expressed that they now had realized that their experiences of existential loneliness during adolescence had made them improve their ability to understand other persons' experiences which they considered valuable in their future profession as nurses.Professionals' own experiences and life histories shape how they create relationships with patients and how they are engaged emotionally.Self-knowledge is described as a prerequisite for healthcare professionals to be able to give person-centred care (McCormack & McCance, 2017).Developing self-awareness through self-reflection leads to personal growth, and is, therefore, important for professionals since it may generate a readiness to meet existential needs.When experiencing existential loneliness during adolescence it is important to have the possibility to share the experiences with persons who are familiar with existential loneliness, and who are willing, and have the courage, to listen and support the person having those painful experiences.

Strengths and limitations
In this study university students wrote retrospective narratives about their experiences of existential loneliness during adolescence.When narrating experiences in writing, compared to oral interviews, there is a reduction of influence from the researchers during the data collection, In addition, the authors jointly discussed their presuppositions, and during the analysis, stayed close to the data to further reduce the risk of biased interpretation, which can be considered a strength regarding the confirmability (Shenton, 2004).Another strength is the variety of data and the richness of the description of the phenomenon, with representations of it from all the narratives, as well as several direct quotations.
The study assignment did not contain a definition of adolescence as a phase between specific ages.This created possibilities for the participants to write about their experiences during what they, themselves, interpreted as their adolescence.However, regarding credibility (Shenton, 2004), it may be seen as a limitation that the participants were not asked to specify at what age they had those experiences; information that may have been useful when describing the phenomenon.Also, since existential loneliness is not widely known, data collection about the phenomenon may be challenging.A description of existential loneliness was, therefore, considered necessary, but not an overly detailed description that would highly influence the participants' statements.Therefore, the description of existential loneliness in the study assignment was based on the description previously used in interview guides in other studies on existential loneliness (Bolmsjö et al., 2019;Edberg & Bolmsjö, 2019;Garnow et al., 2022), which also strengthens the study's credibility (Shenton, 2004).
Nevertheless, a fundamental challenge in studies that are based on lifeworld narratives lies in the relationship between the lived life and the life that is remembered and narrated, which may be considered as a limitation regarding credibility (Shenton, 2004), especially since the experiences that were narrated may have occurred a long time ago.However, memories are a unique resource when gaining access to past experiences (Ricoeur & Backelin, 2005).New nuances may emerge that create a deeper knowledge and understanding of a phenomenon when it is narrated afterwards (Casey et al., 2016), which can thus be seen as a strength of this study since the aim was to describe a phenomenon.
However, limitations regarding credibility (Shenton, 2004) are aspects related to experienced voluntariness and confidentiality.The students were aware that fellow students and teachers would read their narratives, which may have influenced which experiences they chose to write about, as well as whether they decided to participate or not.It is thus possible that other experiences would have been represented in the data if the data collection had been carried out differently.However, a strength regarding the data collection is that the study assignment was voluntary, but still a part of the nursing programme, and thus the students did not have to be burdened with additional tasks beyond those already included in the programme.
Another strength regarding credibility (Shenton, 2004) is that the process of analysis thoroughly followed the steps described by Colaizzi (1978).The method has many similarities with other phenomenological methods, but also some differences.The final step in the analysis (Colaizzi, 1978) has been questioned by other phenomenologists (Giorgi, 2006), but according to our understanding it should be considered a strength regarding credibility (Shenton, 2004) since it means that the findings were validated among the participants.Furthermore, Colaizzi (1978) uses the term 'the fundamental structure' which we interpret as being similar to 'the essence' that is usually formulated in phenomenological studies.In addition, to gain a greater understanding of existential loneliness during adolescence we decided to add a description of how the participants phrased and expressed existential loneliness in their written narratives.
To strengthen the dependability (Shenton, 2004), we reported the methodological processes in detail.However, there are limitations in this study regarding transferability (Shenton, 2004) related to the uniqueness of the sample.When transferring the results to other settings, it is thus important to take contextual aspects into consideration.

Implications
The knowledge developed in this study can be used to recognize and interpret existential loneliness among adolescents by those who meet adolescents in their current or future professions, e.g.school staff, social workers, and healthcare professionals.Our results also indicate that it is important for adolescents to have the possibility to share their experiences with someone who is familiar with existential loneliness and willing to listen.However, more knowledge about adolescents' own desires and needs for support is required to be able to develop tailored support structures.

Conclusion
Existential loneliness is an inherent, but painful, part of the human condition, and may occur for the first time in life during adolescence.Existential loneliness during adolescence means feeling empty and lost while painfully trapped in an alienating borderland in the search for belonging, sense of self, and meaning.It is an immense and consuming loneliness, and adolescents may need support in dealing with the suffering.However, existential loneliness during adolescence is challenging to recognize and interpret.Therefore, those who meet adolescents need knowledge of existential loneliness during adolescence and should not pathologise but support the adolescents in order to help them go through a healthy transition into adulthood.

Figure 1 .
Figure1.The terms the participants used when expressing existential loneliness.

Table 1 .
Themes and formulated meanings of the phenomenon of existential loneliness during adolescence.

Being lost in a borderland, having no control
Experiencing existential loneliness during adolescence means being lost and without control in the borderland between childhood and adulthood.It has to do with feeling simultaneously both young and old, having difficulties understanding oneself, and being uncertain about the future:When it didn't really feel like anyone else I knew was in the same place as me, or had doubts and worries about the future and what 'one would become'.I felt alone in this way of thinking (. ..) it feels like nobody understands what you mean when you try to explain your thoughts and feelings (. ..) in moments of doubt about your purpose in life, it can feel very bleak not knowing what you want when it seems like everyone else around you know what they want!