Adolescents’ Experiences of Existential Loneliness Regarding Receiving and Providing Support

Among adolescents, loneliness is common. One kind of loneliness, existential loneliness, is understood as a painful part of the human condition. During adolescence, existential loneliness has been shown to be challenging to navigate independently. Therefore, this study aimed to explore Swedish adolescents’ experiences of existential loneliness regarding receiving and providing support. This study had an exploratory qualitative design based on focus group discussions ( n = 9) comprising 30 Swedish adolescents (median age 18). The data was analysed inductively using thematic analysis. The adolescents’ experiences of existential loneliness regarding receiving and providing support were represented in four themes: Wanting to face existential loneliness alone, but seeking relief and support when needed; Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability; Wanting to share the experiences, but nobody is there; Supporting friends by trying to be there, but feeling insecure. In conclusion, knowledge of existential loneliness and a sensitivity to adolescents’ personal needs is crucial. Supporting and being there for adolescents may increase their ability to encounter ̶ their own or others’ ̶ experiences of existential loneliness, which could be promotive for their well-being and personal growth.


Introduction
Loneliness is seen as a global public health issue (Nyqvist et al., 2016).Among adolescents, loneliness is common (Qualter et al., 2015) and is described as a risk factor for their health and well-being (Lyyra et al., 2018).Loneliness during adolescence is for example linked with adolescent depression (Binte Mohammad Adib & Sabharwal, 2024) as well as mental illness in adulthood (Bean et al., 2019).An evidence synthesis (Mansfield et al., 2021), identified three types of loneliness that are distinct but overlapping: social loneliness-a dissatisfaction with the number of social relationships; emotional lonelinessthe absence of meaningful relationships; and existential loneliness-an experience of being disconnected or fundamentally separated from others and the wider world.Existential loneliness during adolescence has been described as an immense and consuming loneliness that is challenging to manage on onés own (Garnow et al., 2022(Garnow et al., , 2024)).To be able to provide support to persons who experience existential loneliness, sensitivity to their needs is required (Sundström et al., 2018(Sundström et al., , 2021)).Therefore, understanding adolescents' support needs regarding existential loneliness is crucial.
In the literature, existential loneliness-at times described as existential isolation-is understood as a universal phenomenon connected to the essence of human existence (Gil Álvarez et al., 2023), which occurs when a person becomes aware of their own existence and of being ultimately alone in the world (Yalom, 1980).Existential loneliness often arises when a person is in a vulnerable situation, when thoughts about meaning and meaninglessness come to the surface.Existential loneliness is connected to suffering and has mainly been studied among frail older persons, and persons in disease groups (Gil Álvarez et al., 2023).Consequently, knowledge of existential loneliness in adolescence is limited (Mansfield et al., 2021)-a phase in life connected to vulnerability.Previous research has revealed that existential loneliness during adolescence relates to painful experiences of emptiness, being lost, trapped (Garnow et al., 2024), and exclusion (Garnow et al., 2022); the adolescents described a longing to share their experiences and they wanted support to manage the suffering.
However, supporting adolescents who experience existential loneliness can be challenging.In Sweden, which is a secular society, there is a common view that adolescents tend to keep their existential thoughts and needs to themselves, as there are few suitable platforms for such discussions (Lloyd, 2018).Moreover, loneliness interventions, which usually target adolescents that are perceived to be at risk, typically focus on loneliness overall or social loneliness, thus often overlooking existential loneliness specifically (Eccles & Qualter, 2021).Additionally, existential loneliness is not a commonly known concept, and since it can be manifested in bodily discomfort and sadness (Garnow et al., 2024;Hemberg et al., 2022), interpreting it and providing appropriate support can be challenging.Lastly, previous research has shown that professionals struggle to address young persons' existential concerns (Lundvall et al., 2019).Consequently, adolescents can be left without the support they may need.
The availability of support, from family, friends, and other social networks, has been shown to influence how adolescents manage the transition to adulthood (Berzin, 2010).Providing support to increase another persons' ability to handle stressful situations or experiences is often described as social support.Social support can be categorised into three types: instrumental support, which means providing material aid such as help with daily tasks; informational support which involves giving advice and guidance; and emotional support which implies expressing empathy and care and providing opportunities for emotional venting (Cohen, 2004).Seemingly, the description of the different types of social support does not explicitly include support regarding existential needs.However, supporting existential needs is important for health promotion and illness prevention (SALAR, 2020).Therefore, in the work to promote adolescents' mental health and prevent their mental ill-being, supporting adolescents' existential needs is crucial, and mental health nursing is a vital component in that aspect.It is also common that adolescents themselves provide support to friends.Supporting peers can have positive impacts on the provider (Shumaker & Brownell, 1984).Nevertheless, it may lead to power imbalances and difficulties maintaining boundaries, and, therefore, adolescents may need assistance from professionals when supporting friends (Dolan et al., 2023;Worrell et al., 2023).Professionals encounter adolescents in various contexts such as the school environment and mental health care.To be able to offer adequate support it is important to take into account adolescents' own experiences.Therefore, this study aims to explore Swedish adolescents' experiences of existential loneliness regarding receiving and providing support.

Study design
This study had an exploratory qualitative design, based on focus group discussions, and employed an inductive thematic analysis as described by Braun & Clarke (2006, 2021).It adheres to the reporting guidelines of The Consolidated Criteria for Reporting Qualitative Studies guidelines (Tong et al., 2007).

Participants
This study used purposive sampling, and the inclusion criteria were adolescents from upper-secondary school who had experience with existential loneliness-either their own or others.Initially, 36 upper-secondary schools across urban and rural parts of Southern Sweden were approached and five schools agreed to participate in the study.The first author visited classes at those five schools and gave the adolescents verbal and written information about the study.In the information letter, existential loneliness was described as 'a deep form of loneliness' .Interested adolescents could get involved by either reaching out to the first author directly or informing their teacher, who would then relay the information to the author.In total, 40 adolescents agreed to be part of the study.They could choose to participate either individually or as a part of a focus group discussion.However, only one adolescent requested an individual interview, which was later excluded due to the lack of reported experiences related to their own or others' existential loneliness.
Despite expressing initial interest, nine adolescents opted not to participate before focus group discussions took place.Ultimately, 30 adolescents from five different schools took part in the study.The adolescents were between 16 and 21 years old (median age 18), comprising 18 persons who identified themselves as girls or women, and 12 who identified themselves as boys or men.They were enrolled in both vocational and preparatory programmes for higher education across private and public upper-secondary schools in both rural and urban locales.A description of the final sample can be found in Table 1.Krueger & Casey (2015) suggest that an ideal focus group should consist of five to eight participants, but when exploring peoplés experiences smaller groups are recommended.Accordingly, in this study, the intention was to include about five adolescents in each group.However, due to dropouts and logistic issues, group size ranged from two to five participants, with a median of three.Adolescents attending the same school and programme were included in the same focus group.Homogeneity in the groups aims to create a shared understanding and to encourage the discussion of experiences (Krueger & Casey, 2015).The adolescents in this study all wanted to share experiences of existential loneliness which supported homogeneity in each group.However, heterogeneity aims to bring diverse experiences to the table, contributing to a richer understanding and broader awareness of the topic (Krueger & Casey, 2015).Heterogeneity in the focus groups was supported in terms of gender identity and age.

Data collection
Data was gathered through nine focus group discussions from September 2023 to January 2024.Focus group discussions are ideally moderated by a moderator and a co-moderator.The moderator's role is to facilitate the discussion and encourage the participants to interact and share their experiences (Krueger & Casey, 2015).The assistant moderator is responsible for note-taking, posing follow-up questions, and providing brief summaries at the discussion's conclusion.After each discussion, the moderator and the assistant moderator hold a brief debriefing.The first author served as the moderator in five of these discussions, with the last author acting as assistant moderator.Due to logistical constraints, four focus groups were conducted without an assistant moderator: three by the first author and one by the last author.
The focus group discussions were conducted in separate rooms at the participants' schools to ensure privacy and confidentiality.Participants were courteously greeted by the moderator, and casual, initial conversations were held to familiarise the participants with the researcher(s).Additionally, the adolescents' background data, such as age, gender identity, school, and programme, were collected.The moderator then laid out the ground rules for the discussion.These included points of confidentiality, the roles of the moderator and assistant moderator, the audio recording of the session, and the principle of open discussion.The participants were encouraged to converse and share diverse views, and it was emphasised that there were no right or wrong answers.
The moderator began the focus group discussion by asking the first question from the interview guide concerning loneliness, followed by a question on experiences of existential loneliness.The guide described existential loneliness as a deep form of loneliness that may come and go, a description previously tested in other studies (Edberg & Bolmsjö, 2019;Garnow et al., 2022).The guide also posed questions about receiving and providing support from and to others.Probing questions were used to deepen the discussion (the interview guide is available as a Supplementary File).
As recommended by Krueger & Casey (2015), focus groups with young persons should last around one hour.The focus group discussions in this study were restricted by the school schedules of the adolescents, with a median duration of 58 min (ranging from 44 to 85 min), and they were digitally audio-recorded.Thereafter, a professional secretary transcribed the focus group discussions verbatim, and the first author validated these transcriptions.

Data analysis
The transcribed data was inductively analysed using thematic analysis, adhering to the method outlined by Braun & Clarke (2006, 2021).This approach is characterised by "searching across a data set […] to find repeated patterns of meaning" (Braun & Clarke, 2006, p. 86).All analysis was performed manually.
The first phase of analysis required familiarisation with the data, accomplished through multiple readings of the transcriptions by all authors (Braun & Clarke, 2006, 2021).After individual readings, the authors came together for joint discussions.The first author then reread the transcriptions, marked relevant data extracts, took notes, and marked ideas for coding, which were then discussed with the last author.During the second phase, the first author organised the data systematically into meaningful groups by producing initial codes, which were then collectively discussed by all the authors.In the third phase, the first author generated initial themes from the coded and collated data.The fourth phase involved a development and review of the themes by the first, third and last authors, to validate the themes' relevance to the data.In the fifth phase, the themes were finally refined, defined, and named by all the authors.The codes and collated data extracts for each theme were then organised into a narrative by the first author.The sixth and final phase culminated in a comprehensive report, which constitutes this paper's results section.

Ethical considerations
The study received approval from the Swedish Ethical Review Authority (EPM 2023-01645-01), adhering to the procedures of the Declaration of Helsinki (WMA, 2013).Research among adolescents is important in order to make their voices heard and to create knowledge that can be used to increase their well-being.However, given their vulnerability during adolescence, the researchers must be particularly sensitive (WMA, 2013).Since the adolescents were recruited in the school environment, where power imbalances can already be evident, the voluntariness in participating in the study was emphasised during the recruitment and data collection.The adolescents were informed about the study both verbally and in writing.Upon their acceptance, they signed confirmed consent forms.Additionally, they were given the choice to participate in either a focus group discussion or an individual interview, as they preferred.Because the research topic might stir negative emotions, the moderator of the focus group discussions was prepared to connect them with school health care services if needed.

Findings
The adolescents' experiences of existential loneliness regarding receiving and providing support are represented in four themes: Wanting to face existential loneliness alone, but seeking relief and support when needed; Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability; Wanting to share the experiences, but nobody is there; Supporting friends by trying to be there, but feeling insecure.

Wanting to face existential loneliness alone, but seeking relief and support when needed
This theme represents adolescents' experiences of wanting to face existential loneliness alone but seeking relief and support when needed.For several adolescents, facing existential loneliness in solitude was perceived as contributing to personal development and growth.Therefore, to be respected and left alone was important for them, yet it brought comfort to know that there was somebody there to turn to when necessary.
Participant 1: I think it is quite important that we feel a little bit lost on that level.
Participant 2: Yes, you must prepare yourself as well… Participant 3: Then it is also important to be alone and get time for yourself that way and decide for yourself.Participant 3: And that can also sometimes be all that is required, that you know that they are in the living room, for example, and I know that I can go there.

Focus group 1
At times, they wanted to have a respite from their painful experiences.They then searched for relief in different ways: listening to music, dancing, exercising, working in the garage, interacting with pets, journaling emotions, or being close to someone without the need for conversation.Relief was also found in educational materials, youth films, and social media, through recognition and understanding that others had similar experiences.Some of the adolescents derived support from their religious beliefs, and engagement in religious text or prayer brought them relief and security.Sometimes relief was found through distraction by spending time with friends, even with those they deemed harmful.Some of the adolescents believed that focusing on negatives could potentially harm their well-being.They felt personally obligated to change their situation for the better.Existential loneliness could, though, also dissipate over time, but sometimes they felt a need for support from others.
When needing support from others, it had to be on their own terms: they alone decided when and how to reach for it.The adolescents often sought support from those closest to them, like parents, siblings, friends, or school staff.However, at times, they preferred to confide in someone they did not interact with daily because this allowed them to control whether and when they discussed their experiences again.They generally turned to persons who had previously provided support, whom they could trust and who made them feel safe.These were persons who were likely to remain there for them, who tried to understand, and who demonstrated genuine care for their well-being.
When searching for support from others, the adolescents desired to be treated with seriousness, sensitivity, and understanding.They wanted to feel valued and prioritised.Most of the time, they just needed someone who listened to them, but occasionally, they also required guidance or exposure to another person's knowledge or experience.Even though they felt it was their duty to communicate their feelings and the support they needed, they hoped to be understood without explanation, given the difficulty in expressing their experiences and needs.Expressing through written form, using a friend as a mediator, or discussing with another adult before approaching a parent were sometimes easier options.It was also easier when the other person demonstrated vulnerability or revealed similar experiences.Consequently, the adolescents created opportunities to share their experiences by initiating conversations about other persons' feelings and thoughts.

Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability
This theme represents adolescents' experiences of wanting to share the experiences of existential loneliness, but not knowing how to do so, and being afraid to bare the vulnerability.When it was difficult to recognise their own experiences, it was even more challenging to tell another person.Similarly, when not understanding their own support needs it was hard to know where to turn.
The adolescents could experience the need to safeguard themselves which hindered them from sharing their experiences with someone even though they yearned to do so.They were reluctant to burden others or face betrayal and judgement.They harboured fears of being abandoned or feeling even more desolate or odd after verbalising their emotions.They were also hesitant about being perceived as victims, inviting others' pity.Moreover, they wanted to avoid experiencing shame due to feeling too mature to seek solace, and if they were young men, societal norms could dissuade them from showing vulnerability.
Participant 1: …it's maybe a little harder to be a guy, to talk about your feelings… Participant 2: Sure, it's hard to say 'Oh, brother, I feel lonely' like that.You often joke about it instead… Participant 1: Yes Participant 2: … you must look stronger, even in mental health as well… Participant 1: Yes, it is so.

Focus group 7
The adolescents also anticipated that the support from friends might harm rather than help them, such as being offered drugs for relief.When they had prior negative experiences of sharing, it made them avoid sharing again, and thus they did not receive support.They kept their experiences of existential loneliness within because it seemed as if nothing would help.Their silence also served as a way to shield themselves from repeated questioning, which they believed might morph into excessive, painful reminders of their suffering.However, when they withheld their emotions and thoughts, they often felt overwhelmed, which sometimes led to emotional outbursts in safe places, such as in their own room or among family.

Wanting to share the experiences, but nobody is there
This theme represents adolescents' experiences of wanting to share the experiences of existential loneliness with another person but feeling that nobody is there to share with.When there was no one to communicate with, nobody who genuinely listened, empathised, or took the concerns seriously, they felt burdened and yearned for love, attention, and support.
The adolescents did not want to seek support from those who they perceived as unavailable, who did not show a sincere interest in their being and well-being.Participant 2: …which is quite a big request from adolescents who are not feeling well.

Focus group 9
The adolescents wished that an adult would initiate a conversation about existential loneliness.They believed that, if that happened, they would be able to share their experiences and hopefully they would then receive support.Unfortunately, no one ever broached the subject.Furthermore, they had not encountered any discussions about existential loneliness at school.However, they thought such dialogues, if conducted in safe environments, could be preventative, alleviative, and supportive.

Supporting friends by trying to be there, but feeling insecure
This theme represents adolescents' experiences of supporting friends suffering from existential loneliness by trying to be there for them but feeling insecure about how to respond to the friends' experiences.One way of providing support was to try to distract the friend from painful thoughts and feelings by doing things together that the adolescents hoped could bring relief in the moment.However, support could also involve listening to the other person's experiences of existential loneliness and trying to understand.When providing this kind of support, it was essential to help the other person feel safe, acknowledged, and free from judgement.The adolescents could then try to confirm the other person by sharing their own similar experiences and trying to convey hope.At times, encouraging acceptance could be appropriate, as would sharing personal perspectives and providing guidance.When jointly sharing experiences of existential loneliness, a closeness and a deepened relationship were created.
The adolescents who provided support for friends suffering from existential loneliness believed that helping others was a natural human instinct.Understanding and responding to the other person's moods and needs was crucial, though not always straightforward.It was difficult to interpret the other person's feelings and to know what kind of support they needed.Occasionally, they tried to encourage the other person to express their experiences.However, it could be emotionally challenging to handle what came to light.Shouldering another person's experiences could become burdensome.It was also daunting if they perceived that the person required professional help.The person might then need adult guidance, potentially breaching the trust bestowed upon their friend.Additionally, when a friend confided their innermost thoughts and feelings, the expectation to reciprocate with their own experiences also ensued, even if they were reluctant to do so.Above all, they feared saying something wrong that could possibly make things worse.Participant 2: You still want to be there for them.

Focus group 6
Therefore, the adolescents desired increased confidence in these situations, recognising the importance of being there for the other person and offering adequate support.

Discussion
This study aimed to explore Swedish adolescents' experiences of existential loneliness regarding receiving and providing support.Various experiences are represented in the findings, such as wanting to keep the experiences within, but also wanting to share them with another person in order to receive support.Additionally, experiences of wanting to face existential loneliness were present, but also experiences of needing to rest from the suffering.The adolescents wanted to know that somebody genuinely cared about them and was there for them.Despite feeling insecure, adolescents also tried to provide support and be there for friends suffering from existential loneliness.'Being with' can be regarded as one of the most important entry points when trying to reach out to a person and encounter their existential needs (Binder, 2022).When encountering another person authentically and empathically, the person feels recognised by another person, i.e. they experience 'feeling felt' , a feeling linked to psychological growth (Siegel, 2010, referred to in Binder, 2022).When 'feeling felt' the person perceives the suffering as manageable.However, associations have been shown between adolescents' responses to friends who share 'personal problems' and their well-being (Spiekerman & Rose, 2024).For instance, when being met inadequately or with silence there is a risk of deterioration in well-being.Therefore, adolescents may need support regarding encountering their friends' experiences of existential loneliness.Moreover, being there for adolescents with experiences of existential loneliness may be decisive for how they handle their situation.Nevertheless, previous studies have shown that professionals find it challenging to encounter young persons' existential needs because they fear awakening their own existential concerns (Lundvall et al., 2019).When we are unfamiliar with the existential aspects of our lives, there is a risk of becoming foreign to them (Binder, 2022).The experiences then risk becoming seen as pathological and may appear even more fearful and difficult to encounter.When having the courage to genuinely be there for adolescents, it likely increases the adolescents' ability to cope with their own or friends' experiences of existential loneliness.
The findings showed that the adolescents' experiences, and support needs could vary over time.Adolescents who emphasised the importance of facing existential loneliness in solitude, at times also searched for relief from the suffering.This way of relating to existential loneliness can be understood through the Shifting Perspectives Model of Chronic Illness (Paterson, 2001).The model highlights the importance of comprehending the constantly shifting perspectives on a person's needs, where illness or wellness, dialectically, is either in the foreground or the background.Accordingly, when addressing experiences of existential loneliness, the adolescents allowed the suffering to be in the foreground.However, by searching for relief, they tried to keep their painful experiences in the background.Similarly, when adolescents offered their friends relief through distraction, they provided opportunities to place the suffering in the background; when offering their own presence and will to listen, the suffering was allowed to be in the foreground.This has similarities with previous research (Garnow et al., 2022) showing that adolescents had different ways to ease the suffering from existential loneliness, as well as a longing to share their experiences with another person.Research on existential concerns among young adults has shown similar results (Lundvall et al., 2019(Lundvall et al., , 2020)).Therefore, when offering support to adolescents with experiences of existential loneliness it is important to be sensitive to their need either to face or gain relief from their suffering.
The findings also showed that experiences could differ between individuals.Having experiences of existential loneliness could on the one hand include the need to share thoughts and feelings to receive support but could on the other hand entail a need to be left alone to develop personally.Therefore, when offering adolescents support regarding existential loneliness, it is important to properly take their personal needs into account.Focusing on persons' needs is central in person-centred care.Person-centred care is described through various models and frameworks (Ekman, 2020;McCormack & McCance, 2017) that share a humanistic view of persons as equal beings who need to meet as subjects to create understanding.To offer adequate support, it is thus important to try to understand a person's subjective experiences (Merleau-Ponty, 1999).Since persons are part of social contexts, they must also be understood through relational and societal perspectives (McCormack et al., 2017;McCormack & McCance, 2017).This study was conducted in Sweden, a country that has long been described as one of the most individualised and secularised countries in the world, with a developed privatisation of the meaning-making arena (Melder, 2012).Therefore, platforms for conversations about spiritual or existential issues have been viewed as almost non-existent in the public sphere.Perhaps there has been an implicit perception, a norm, that there is no need for such arenas?However, in recent decades, the picture has become more nuanced.The Nordic countries' religious landscapes have been described as changing and becoming more diverse (Furseth, 2017), and the role of spirituality is growing in the public sphere.In this study, some of the adolescents believed it was crucial for them to have a God to talk to.Overall, according to adolescents in this study, talking about existential loneliness in safe and trustful environments could possibly be alleviative and supportive.Experiencing existential loneliness during adolescence has been shown to be perceived as being alone with the experiences (Garnow et al., 2022(Garnow et al., , 2024).An awareness of others having similar experiences may thus be comforting.It is possible, or even likely, that those kinds of discussions could also increase adolescents' confidence when trying to support friends.Support that focuses on existential needs is crucial for promoting mental health and preventing mental illness (SALAR, 2020).Correspondingly, experiencing existential loneliness during adolescence has been shown to be perceived as leading to an improvement of the ability to encounter persons with similar experiences (Garnow et al., 2024).Research among adults in vulnerable situations, has shown that acknowledging and addressing existential loneliness can lead to personal growth (Ettema et al., 2010).Creating possibilities for adolescents to share their experiences of existential loneliness, and offer person-centred support, may thus increase their personal growth and well-being.

Strengths and limitations
This study was conducted through focus group discussions within the school environment, which may be seen as a limitation regarding credibility (Shenton, 2004) because of aspects related to experienced voluntariness and confidentiality.This may have influenced which experiences the participants chose to discuss, as well as whether they decided to participate or not.If the data collection had been carried out differently, it is thus possible that other experiences would have been represented in the data.However, the focus group discussion environment aims to be open and non-judgemental, and the participants are seen as experts on the topic at hand, which promotes the sharing of experiences (Krueger & Casey, 2015).This approach also helps to neutralise the potential power imbalance between researchers and participants, which we thus consider a strength of this study.Additionally, since the topic is relatively unexplored, focus group discussions are deemed suitable; when the participants share their experiences, they create a collective understanding and an awareness of the topic (Krueger & Casey, 2015).Because the concept of existential loneliness is not commonly known, the interview guide included a description used in prior research (Edberg, 2021;Edberg & Bolmsjö, 2019;Garnow et al., 2022), which enhances the study's credibility (Shenton, 2004).
However, logistical issues and participant dropouts resulted in some focus groups being smaller than planned, which might be seen as a limitation of this study regarding credibility (Shenton, 2004).Nevertheless, given that the subject matter could induce negative emotions, smaller discussion groups could prove to be advantageous, prioritising vulnerability and privacy.Krueger & Casey, (2015) have asserted that for sensitive research topics involving young people, smaller groups are preferable.Additionally, some of these focus groups were conducted without an assistant moderator due to logistical constraints.Despite this perceived limitation, we believe that our strong experiences interacting with young persons about existential issues precluded any negative impact on the data collection, particularly given the small size of the focus groups.
Another strength regarding credibility (Shenton, 2004), is the process of analysis that thoroughly followed the thematic analysis described by Braun & Clarke (2006, 2021).Additionally, the collaborative analysis conducted by all the researchers can also be seen as a strength in this study regarding confirmability (Shenton, 2004).By continually verifying the codes and themes within the data material (Braun & Clarke, 2006, 2021), we aimed to limit the impact of our preunderstandings throughout the analysis.Another strength is the rich body of data material with representations from all the focus groups, as well as exemplifying quotations.To strengthen the dependability (Shenton, 2004), we reported the methodological processes in detail.
The study involved adolescent participants from various programmes in both rural and urban upper-secondary schools, aiming to gain a diverse sample for rich data (Creswell & Creswell, 2018).However, the study was conducted in Sweden, a country in the Global North, which may limit the transferability of the findings (Shenton, 2004).Therefore, it is important to consider contextual aspects when transferring the findings to other settings.

Implications
The knowledge created in this study can be used when encountering adolescents with experiences of existential loneliness, or who support friends with those kinds of experiences.The knowledge can also be used in the development of tailored support structures.The findings showed that adolescents were insecure when supporting friends who were experiencing existential loneliness, and their support needs varied regarding their own experiences of existential loneliness.However, they wanted to know that somebody was there for them when needed.Therefore, professionals who encounter adolescents should show presence and a sensitivity to their personal needs.Mental health care, alongside other care services such as school healthcare, are important arenas in the work of preventing mental illness and promoting mental health and well-being among adolescents.However, more knowledge is needed on how best to support adolescents' existential needs.Also, in future research on adolescents' mental health overall, it is crucial to include existential aspects and needs.

Conclusion
Adolescents' experiences of existential loneliness regarding receiving and providing support differ among individuals and vary over time.Therefore, persons who encounter adolescents must have knowledge of existential loneliness and sensitivity to their personal needs.When supporting adolescents, it is important to have a sincere interest in their being and well-being and to create opportunities for them to share their experiences.Having the courage to support and genuinely be there for adolescents increases likely their ability to encounter ̶ their own or others' ̶ experiences of existential loneliness, which could be promotive for their well-being and personal growth.
Participant 2: …that you sort of find out who you are or something.Participant 1: So, you can sort of build yourself up.[…] Participant 3: Maybe you want to be alone for a bit and go away, and then you can come back and talk about it… Participant 4: If they [the parents] have asked and you feel they mean it, you know you can go to them, or you know they care…

Participant 1 :
Yes, and the school social worker is not that, what can I say, welcoming.Participant 2: Yes, but it's not like the school social worker shows up much.Participant 1: No, that's what I mean.Participant 2: That she is there and stuff […] she comes and introduces herself when she started working here, and then she sits in her office and waits for us to come to her… Participant 1: Yes.Participant 3: We forget her.

Participant 1 :
Yes, you can't know the answer to everything, you don't know how, how they will react to what you say.[…] I haven't experienced this before; I don't know what advice to give.If you give advice about something you haven't experienced, it can still lead to hell.Participant 2: Yes, you're a little, you're usually a little afraid of what to say.Participant 1: […] you mostly just sit and try to think something out.Participant 2: Yes, you don't really know what to say, so you sit there and you're afraid that what you say might make them feel even worse.Participant 1: […] you don't want to say anything wrong.

Table 1 .
Characteristics of the sample.