【Watch Playboy: Wet & Wild 3 (1991)】

Just after Lady Gaga revealed that she lives with post traumatic stress disorder,Watch Playboy: Wet & Wild 3 (1991) she shared a powerful letter about how mental illness affects her daily life and what she's doing to work through it.

"This is how I and we can begin to heal," writes Gaga on her Born This Way Foundation's website. "I am starting today, because secrets keep you sick."

In 2014, the singer told Howard Stern that a record producer raped her when she was 19-years-old. She's been struggling with PTSD since then, and she recently opened up about the diagnosis for the first time while talking to a group of young people at the Ali Forney Center in New York, which provides services for LGBTQ youth.

In the letter, Gaga explains the trauma can make everything from taking a shower to interacting with well-meaning fans challenging. She also breaks down her body's biological reactions and the disassociate symptoms that disconnect her body from her mind.

She encourages fans who might be going through something similar to seek professional help and reach out to loved ones for support, "No one’s invisible pain should go unnoticed."

Read the powerful letter in full below:

I have wrestled for some time about when, how and if I should reveal my diagnosis of Post Traumatic Stress Disorder (PTSD). After five years of searching for the answers to my chronic pain and the change I have felt in my brain, I am finally well enough to tell you. There is a lot of shame attached to mental illness, but it’s important that you know that there is hope and a chance for recovery.

It is a daily effort for me, even during this album cycle, to regulate my nervous system so that I don’t panic over circumstances that to many would seem like normal life situations. Examples are leaving the house or being touched by strangers who simply want to share their enthusiasm for my music.

I also struggle with triggers from the memories I carry from my feelings of past years on tour when my needs and requests for balance were being ignored. I was overworked and not taken seriously when I shared my pain and concern that something was wrong. I ultimately ended up injured on the Born This Way Ball. That moment and the memory of it has changed my life forever. The experience of performing night after night in mental and physical pain ingrained in me a trauma that I relive when I see or hear things that remind me of those days.

I also experience something called dissociation which means that my mind doesn’t want to relive the pain so “I look off and I stare” in a glazed over state. As my doctors have taught me, I cannot express my feelings because my pre-frontal cortex (the part of the brain that controls logical, orderly thought) is overridden by the amygdala (which stores emotional memory) and sends me into a fight or flight response. My body is in one place and my mind in another. It’s like the panic accelerator in my mind gets stuck and I am paralyzed with fear.

When this happens I can’t talk. When this happens repeatedly, it makes me have a common PTSD reaction which is that I feel depressed and unable to function like I used to. It’s harder to do my job. It’s harder to do simple things like take a shower. Everything has become harder. Additionally, when I am unable to regulate my anxiety, it can result in somatization, which is pain in the body caused by an inability to express my emotional pain in words.

But I am a strong and powerful woman who is aware of the love I have around me from my team, my family and friends, my doctors and from my incredible fans who I know will never give up on me. I will never give up on my dreams of art and music. I am continuing to learn how to transcend this because I know I can. If you relate to what I am sharing, please know that you can too.

Traditionally, many associate PTSD as a condition faced by brave men and women that serve countries all over the world. While this is true, I seek to raise awareness that this mental illness affects all kinds of people, including our youth. I pledge not only to help our youth not feel ashamed of their own conditions, but also to lend support to those servicemen and women who suffer from PTSD.

This is how I and we can begin to heal. I am starting today, because secrets keep you sick. And I don’t want to keep this secret anymore.

A note from my psychologist, Dr. Nancy:

If you think you might have PTSD, please seek professional help. There is so much hope for recovery. Many people think that the event that stimulated PTSD needs to be the focus. Yet often, people will experience the same event and have completely different reactions to it. It is my opinion that trauma occurs in an environment where your feelings and emotional experience are not valued, heard and understood. The specific event is not the cause of traumatic experience. This lack of a “relational home” for feelings is the true cause of traumatic experience. Finding support is key.