Recent research indicates that there is uncertainty among children as well as among adults of where to draw the line between everyday stressors and mental health problems that could indicate a need for a common terminology and language regarding mental health (Wickström & Lindholm, 2020; Hellström & Beckman, 2021). The increased prevalence rates of self-reported mental health problems such as bad mood, difficulty sleeping, headaches or stomachache among youth shows a worrying trend in Sweden as well as internationally (Hagquist et al., 2019; Potrebny et al., 2017). At the same time, mild symptoms of mental health problems can be relatively common and be an expression of everyday challenges (Hellström & Beckman, 2021; Wickström & Lindholm, 2020). This contradictory trend is confirmed in the largescale cross-national survey Health Behavior in School-Aged Children, showing reports of very good health and quality of life among young people in Sweden as well as an increase in self-reported mental health problems (Public Health Agency of Sweden, 2018).

Adolescence is a period that involve many changes in different areas such as increasing academic demands and academic competition, a decrease in teacher-student relationship closeness or school safety, rearrangement of relationships with parents and peers including an increase in social comparison, identity issues, as well as thoughts about the future (Bremberg, 2015; Brown, 2009; Tetzner et al., 2017). In addition, the increased emphasis on high-stakes testing, assessment and grading due to recent school reforms in Sweden have shown potentially negative effects on Swedish pupil’s health (Högberg et al., 2021). There is a need to identify what causes stress in the everyday life of adolescents as they could potentially develop into mental health problems (ref). Studies show that when adolescents and young adults put it into their own words, the most pronounced everyday stressors include academic failures, relationship problems, negative self-evaluations through social comparisons, and other performance-oriented tasks (Gustafsson et al., 2010; Hellström & Beckman, 2021).

To be able to design interventions to decrease mental health problems and increase mental wellbeing for youth a common language is needed. The International Classification of Functioning, Disability and Health (ICF) provides a conceptual framework and terminology for describing health and functioning in everyday life and can serve as a common framework for developing comparable concepts (WHO, 2001). According to ICF, participation is defined as involvement in life situations promoting health and wellbeing (WHO, 2001). The ICF defines components of health included as domains described from the perspectives of the body, the individual and society. Developing a common language will make it easier to interact, discuss and plan health interventions based on young people’s perceptions (Adolfsson et al., 2018; Augustine et al., 2021; Klang Ibragimova et al., 2011; WHO, 2007). The current study investigates how youth explain stressors in their everyday life that could be conceptualized as everyday challenges and possibly symptoms of mental health problems.  Hence, the aim of this study is to conceptualize adolescents’ experiences of everyday stressors, using the ICF as an analytic tool.

This study is a part of a wider project aiming to test and evaluate an intervention to enhance mental wellbeing among school students using an experience-based co-design. The sample includes 65 adolescents (45 girls and 20 boys) in grades 7–9 at seven schools in southern Sweden. Data collection took place during the autumn of 2020. The youth were identified through a purposive sampling procedure, by a gatekeeper assigned by the principal at each school, with the intention of obtaining a wide distribution of experiences to gain transferability of the results. At each school, eight to twelve participants were included. The participants were told to discuss perceived everyday stressors in pairs/smaller groups and documented words from the discussion on post-it notes. The documented words constitute the empirical data in this study. A data analysis with both manifest and latent elements, inspired by a deductive reasoning approach has been adopted. We have aimed to stay close to the text, describe what the adolescents actually say and describe the visible and obvious in the text. To make the manifest linking processes systematic and consistent, the process of coding the documented words/concepts to ICF codes (e.g., “Handling stress and other psychological demands”, “Global psychological functions” and “Emotional functions”) followed established linking rules based on the ICF (Cieza et al., 2005). To ensure that the latent interpretation could lean on a multidisciplinary background knowledge about child functioning, all three authors with different professional backgrounds conducted individual coding (Fayed et al., 2012). In cases were the authors’ linking processes resulted in different ICF codes, a latent procedure with interpretation of the underlying meaning of the content on the post-it notes were conducted by two of the authors (LH and MS). The meaning of the content on each post-it note were thoroughly discussed until consensus was achieved. 39 number of linkages were discussed jointly by the two researchers in relation to the coding scheme. When consensus was obtained, the exact agreement was 94 percentage inter-coder agreement on the 2nd ICF-level. The study was approved by the Swedish Ethical Review Authority (reg.no. 2019-06430 / 2020-04-07).

The findings raise awareness about the concept of everyday stressors among adolescents. The aspects of everyday life that adolescents find challenging and stressful can be conceptualized and guide conversations with and about young people and guide supportive actions. The adolescence in this study expressed high psychological demands in combination with a lack of support, mainly from parents, and a lack of resources, mainly time restraints as great challenges. These demands can most often be related to performing well in school or in social contexts. Demands and their effect on wellbeing are essential aspects in the lives of young people when it comes to everyday stressors that needs to be considered in everyday conversations. For parents, school personnel or other adults this could mean talking to adolescents and young people about overwhelming demands and help them sort out what demands they can influence and what demands are hard for them to tackle alone. Here, the relation between demand and control may be a useful theoretical framework and efforts to strengthen a sense of coherence could be a useful coping strategy providing adolescents and young people with a greater sense of control. In addition to demands, how they are perceived by others and how they compare to others are other sources of stress among the adolescents. Social comparisons can function as tools for self-evaluation and self-enhancement in young people’s identity development. However, when these comparisons become stressful and potentially harmful, parents, school personnel or other adults can talk to young people about alternative strategies for identity development. Based on the results in this study in combination with previous research showing a lack of knowledge surrounding mental health, examples of relevant theoretical frameworks to enhance adults’ and young people’s mental health literacy could be demand/control model, sense of coherence and social comparison theory.

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