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This article explores mental health struggles experienced by international adoptees. A series of 26 qualitative retrospective interviews with international adoptees in Norway, aged 21–34 at the time of interview, shows how a considerable number of these adoptees experienced profound mental health issues, particularly depressive symptoms. The findings suggest that struggles relating to mental health are strongly associated with the challenge of constructing a sense of identity, the lack of a sense of belonging, and grieving for adoption-related losses. The adoptees with these struggles also tended to lack narrative agency—the ability and opportunity to change and influence one's own life course. This research has implications for policy and practice in the sense that adoptees' self-reports of mental health struggles, and their link to adoption-specific issues of identity and belonging, demonstrate the need for post-adoption services tailored to supporting adoptees in the construction of a secure sense of identity and belonging. Post-adoption support can help to reduce the risk of rumination over adoption-related questions in solitude and, as such, contribute to protecting the mental health of adoptees. [ABSTRACT FROM AUTHOR]