Lady Gaga has written an open letter on her struggles with PTSD following an appearance on the Today show earlier this week. The letter was posted to her Born This Way Foundation website for fans after revealing her disorder when she visited the Ali Forney Center for homeless LGBTQ youth in Harlem, NY.

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

PTSD is a debilitating mental illness that affects everyday life and needs to be addressed in order to heal from the past trauma.

Gaga went on to elaborate on her struggles with triggering events, such as an injury on her Born This Way Ball Tour, where she was forced to perform in mental and physical pain. PTSD also involves symptoms of dissociation.

In the letter the “Joanne” singer writes, “which means that my mind doesn’t want to relive the pain so ‘I look off and I stare’ in a glazed over state.” She writes that doctors have told her that the “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.”

Gaga went on to admit that her PTSD makes it difficult for her to regulate her anxiety, which in turn makes it difficult to work on music. She wrote that she is currently in psychotherapy and takes medicine for the condition prescribed to her by a psychiatrist.

She claims that “Kind words… positive words… words that help people who feel ashamed of an invisible illness to overcome their shame and feel free. 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.”

Read the full letter posted to her website here.

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