When discussed in the context of diagnosing or medicating children, psychiatrization is usually portrayed as a more or less monolithic top-down process, which, according to some, enables a child's right to health, while for others is a form of child abuse. This article challenges these conceptualizations in two steps: First, it draws on available literature on psychiatrization (including its top-down and bottom-up operations, and its ideological and material aspects), and its relationship to various psy-practices, and wider processes of (bio) medicalization, psychologization and reification. Second, using two detailed vignettes from ethnographic research with children and youth in Poland, the article demonstrates that children and youth are not necessarily passive recipients of psychiatrization as they themselves navigate, appropriate, resist, and transform top-down influences. While one vignette details a child's more or less open resistance to psychiatrization through their attention-deficit/hyperactivity disorder label, the other vignette shows young people embracing and positively identifying with bio and psy-knowledge in relation to depression. However, both vignettes show how children and youth make psychiatrization meaningful as it shapes their lifeworlds, with them sometimes becoming agents of psychiatrization themselves. Our data illustrate the nuances of psychiatrization of, with and by children, and we draw on this to complexify existing literature and framings of psychiatrization.