I cried in his arms our first night together. I’m not good, I kept repeating, tears falling into my ears as he caressed my face. I knew what love required, and I knew that, time and again, I’d failed at giving it because of the ways my anxiety distorted my thinking, and my panic disorder made me alternately dependent, selfish, and needy.

I wanted to write him a guide for loving me, so he could understand that when I tried to break up with him when one thing went wrong, when I changed plans because I didn’t feel like I could leave my house, when I criticized him much too harshly, it was because of faulty thought patterns and neurochemical flare-ups, not because I didn’t love him.

Love is hard for nearly everyone. But for those with anxiety disorders and other mental illnesses, love can be a minefield. The National Alliance on Mental Illness reports that 18.5 percent of adults in this country live with a diagnosed mental illness. That’s roughly 1 in 5 people, or 44 million total.

For years, my relationships would end abruptly because I hadn’t prepared the men I loved for the ways I’d lash out when I became claustrophobic; how I’d become distant and cold when panicked, and suddenly clingy and hot when the panic had passed; how I’d pick them apart against my will, obsessing over perceived shortcomings and imperfections, burning with embarrassment when they held forth at dinner parties or cowering with shame when I deemed them too shy.

After I ended my last relationship, I worked with a therapist on how to prepare myself and my partners for being in a romantic relationship not only with me, but with my anxiety and panic ― and how my partner could support me, himself, and us through it.

Dr. Ayelet Krieger, a psychologist who practices in the Bay Area, believes disclosing a mental illness early in a relationship is crucial.

“I like to talk about striking when the iron is cold,” she says. “You don’t want to tell your partner about your diagnosis when you’re in the throes of a crisis. It’s more productive to talk about it when you’re calm.”

Avi Steinhardt, a licensed clinical social worker in Brooklyn, New York, agrees. “Many of the risks of disclosing a mental illness are similar to the risks of falling in love,” he says. “How will this new, suddenly important person react? Will it scare them away? Unfortunately there is still stigma and misconceptions about mental illness in our culture, so there’s a good chance that this person has absorbed some misinformation over the years. But how a person responds to your disclosure may tell you a lot about this person’s sensitivity, biases, and capacity to listen with an open heart. If there is a risk that they won’t be sensitive enough, it is also good to know early on that this person would likely not be a good match.”

Rebecca Chamaa, who has paranoid schizophrenia, was dating her boyfriend long-distance. About three months into the relationship, she was hospitalized after a suicide attempt.

“After my release, I told him about my diagnosis,” she recalled. “He told me he didn’t know if he could handle it. I said, ‘Fair enough.’ But we were in love. The information may have given him pause, but it didn’t scare him away.”

“We were married less than a year later, and since that time my husband has been my number one fan and biggest help and support,” she went on. “I’m glad I was honest with him, and he was able to decide whether he wanted to give our relationship a try or walk away. The best thing that ever happened to me is that he stayed.”

They have now been married for 19 years.

Disclosing can be a valuable litmus test of whether a partner is a good long-term match. Sometimes, it turns out they’re not. Judith (who asked to be identified by a pseudonym to protect her privacy) has complex post-traumatic stress disorder and depression, experienced this when she disclosed to a new partner.

“The first time I spent the night, the sound of his belt buckle as he undressed caused me to completely freeze and shut down, and I had to explain,” she remembers.

At first he was gentle with her, and very understanding. But a few months later, when he witnessed her depression, he didn’t know how to react.

“He had only seen the charming, adventurous optimist I was when healthy,” she said. “When my physical and mental health crashed, he couldn’t wrap his head around the amount of pain I was in, no matter how much I tried to explain it.”

It’s sometimes difficult for those who have never experienced a mental illness to grasp how debilitating it can be.

“You can say you’re drowning, but a fish has no frame of reference for that experience,” Judith says. “I thought I was disclosing fully, but he didn’t understand until I texted him at work to tell him that one of my friends was taking me to the psychiatric ER because I was suicidal.”

If Judith could do it over, she would be much more explicit in describing the seriousness of her depression.

“I didn’t realize he didn’t understand the difference between the clinical use of the term ‘depression’ and its popular use,” she said. “Next time, I will spell it out a lot more clearly.”

The good news is that educating oneself and one’s partner about mental illness is easier than it’s ever been. “There’s so much information online and blogs kept by people who struggle with mental health,” Krieger says. “The more you learn, the more you realize how common these are.”

Another positive aspect of early disclosure is that it can jump-start vulnerability. When one person opens up about something sensitive or challenging, it can elicit trust and an equal willingness to be vulnerable in the other. “It’s rare there’s a relationship in which one person is perfect and one is complicated,” Krieger says. “Both people usually have ‘stuff.’ Disclosing is dropping into that trust and vulnerability sooner.”

Iesha Williams waited 11 months and until she was married to tell her husband about her anxiety and depression.

“It wasn’t a planned conversation,” she remembers. “We talked about my depression on the anniversary of losing a baby, which was an emotional trigger. The depression was intense and seemed inescapable. Thankfully, he listened and was attentive to what I expressed.”

“He admitted to not fully understanding, but did everything in his power to support me,” she went on. “Disclosing my struggles made us stronger and better able to support, understand, and love one another. I’m very glad I disclosed.”

Steinhardt believes these conversations often result in both partners feeling more known, accepted, and loved.

“I can’t think of a romantic relationship where we don’t need to tell one another how we need to be loved, what our challenges are, our triggers, our weaknesses,” he says.

Confronting something this real and personal early in a relationship can be a catapult into deep intimacy and trust.

I told Joel everything right away, that first night. He responded beautifully, holding me and sharing painful aspects of his own life. Within the first few weeks, I taught him about common anxiety-induced relationship pitfalls, and more about panic. Four months in, he has been unfailingly responsive and calm, encouraging and nurturing, and inspires me to be the same with him.

Still, I’ve tried to end it a few times, to save us both the trouble. He reminds me this is part of it: the doubting, the fear, the bliss.

One evening I arrived late to a concert and saw him sitting there, eyes closed, body still. We walked wordlessly toward each other through the crowd and rubbed our faces together, swaying slowly. I let myself submit just the smallest bit more. A woman near us said, “Ah, love.”

We listened to the music.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

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