It’s 3 AM on a Saturday night, and I’m not even close to being ready to sleep. Am I out late partying like some other college students? No, I’m unwillingly sitting on the couch doing nothing and putting off going to bed for no good reason, after trying and failing to get any homework done all day long.

I am full of energy all the time. But the problem is, I can’t focus any of it, so it’s completely useless. I go from one thing to the next without finishing anything. I try to complete a task, but there’s always something that catches my attention before I even realize I’ve become distracted. My mind is always buzzing with new ideas, forming connections and taking in the world around me.

I have a big problem with all the jokes about ADHD and people saying they’re “so ADHD” or “just a little ADD today,” because for me, the condition is a daily struggle that can get in the way of everything I do. My inability to concentrate has, in the past, been completely disabling to the point that my mom used to stand outside my bathroom door to prompt me through the three-step process of getting ready for bed. If she didn’t, I could take as long as three hours.

Although I certainly had the classic, sudden-onset OCD characteristic of PANS when I was eleven, the sudden appearance of ADD was the most obvious and alarming for me and my family. I went from being a straight-A student who always got my work done easily to taking half-an-hour to read a single page of a textbook.

Overnight, it became as if I were in slow-motion. I would get “stuck” sitting on the floor of my room for hours because I lacked the willpower or mental energy to get up—even though I wanted more than anything to do so. I was so embarrassed and angry at myself for being that way, yet I felt utterly powerless to do any differently.

Over the years, after being diagnosed with ADHD Inattentive Type, I tried Concerta, Vyvanse, and even Nuvigil, and none of them ever helped my concentration—except perhaps Nuvigil, to a mild extent. I was sent to therapists to learn organizational skills and coping strategies, and none of them ever worked. How could severe ADHD suddenly develop in an eleven-year-old, and why didn’t the treatments help?

But when I was seventeen and finally figured out I’d had OCD for years, I thought maybe I’d found the missing piece in the puzzle. My psychologist told me that OCD can often be misdiagnosed as ADD or ADHD, so maybe with OCD treatment, my “ADD” symptoms would disappear. Indeed, a lot of my problems with reading had stemmed from a mental compulsion of constantly cancelling out all of the intrusive thoughts that the words on the pages triggered.

But today, even though my OCD is minimal, I still have trouble finishing a task, I still get overwhelmed when starting any assignment, and I still have too much energy to focus on one thing. By any metric, I have signs of classic adult ADHD—as does my dad, who definitely doesn’t have PANS. If ADHD is genetic, is this just how my life is always going to be?

Yet I believe there is one last piece of hope… There is no such thing as late-onset ADHD, unless it’s been caused by a brain injury or another disorder (ahem, PANS!).  People don’t just suddenly develop ADHD symptoms when they’re eleven, and I had no signs of ADD or ADHD all throughout my childhood until the other PANS symptoms showed up. So maybe, just maybe, my brain is still healing, and this ADHD struggle will someday end.

But even if I’ll always have some ADHD, it somehow hasn’t prevented me from making it through two years of college (albeit with a lot of determination) and from going after my dreams.  I may struggle, but I’m not going to let it stop me…