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Research Article: Between “normality” and diagnosis: strains between the I and the Me in undiagnosed adolescents with ADHD symptoms

Date Published: 2026-05-25

Abstract:
Adolescents who display ADHD-like difficulties but remain undiagnosed occupy a diagnostic borderland in which medical, social, and institutional expectations collide. In the Swedish context, where rates of diagnosed ADHD have risen sharply, this constitutes an understudied and increasingly marginalized group. Drawing on Mead’s concepts of the I and the Me , the study explores how ten Swedish adolescents negotiated their emerging selves while positioned between “normality” and diagnosis. Based on in-depth qualitative interviews and an abductive analytical strategy, the analysis shows that parents, teachers, peers, and digital media frequently activated medicalized interpretations of the adolescents’ behaviors. Participants moved between spontaneous expressions of the I and socially regulated Mes , often experiencing tension when their actions diverged from institutional, familial, or peer expectations. A recurring pattern was a form of double stigma: first, adolescents were judged for behavioral deviations that were not recognized as legitimate symptoms; second, when they received extra support or accommodations in school, these measures were sometimes viewed by peers as unfair due to the absence of a formal diagnosis. Some participants resisted stereotyped images of ADHD, whereas others saw diagnosis as a potential source of recognition, explanation, or legitimacy. Overall, the findings illustrate how medical discourse structures the very terrain on which the self emerges for adolescents positioned outside formal diagnostic boundaries. They also speak to a central concern within clinical psychiatry and diagnostic research on ADHD: as diagnostic frameworks increasingly govern how deviance, normality, and support needs are defined, those who do not neatly align with established categories risk having their experiences misread, marginalized, or left without adequate recognition and support. Further research is needed to examine the prevalence of these dynamics as well as to deepen qualitative understanding of adolescents who inhabit this diagnostic gray zone.

Introduction:
During adolescence, the question “Who am I?” becomes particularly salient. It is a period in which individuals develop a more differentiated understanding of themselves and begin the task of locating the self within a broader cultural and social landscape ( 1 – 3 ). Any answer to the question “Who am I?” is grounded in the individual’s interpretation of themselves in relation to the social world ( 4 , 5 ). This requires both introspection and outward engagement—that is, drawing on personal experience while…

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