As close as we are to our significant others, there are always certain things we keep to ourselves. Sometimes they’re minor things (like the fact that we don’t *really* love his famous pasta carbonara). But sometimes we hide bigger issues, worried that it might change how the person we love perceives us, or that it might stress them out. A surprisingly large number of us even keep to ourselves about serious physical problems like chronic health conditions.

Take asthma, for example. According to a survey by Amgen and the Asthma and Allergy Foundation of America regarding people with asthma,

• 56 percent don’t tell their partner they have asthma if they “don’t have to”
• 47 percent feel that loved ones—from friends to family to partners—don’t consider the limitations that come with asthma when planning gatherings
• 46 percent agree their condition interferes with important moments shared with a partner

Especially considering how dangerous asthma can be (resulting in over 4,000 deaths per year, plus other complications) and how common it is (more than 25 million Americans have it), the number of people keeping it to themselves is concerning. Yet we can’t help but understand. Dating with a chronic illness can be tough.

“People can be reluctant to talk about chronic health conditions because they are scared it will frighten their partner, or in worst-case scenarios, think that their partner might abandon them because they are sick,” says Christopher Hansen, LPC, a therapist with Thriveworks in San Antonio who specializes in relationships, chronic illness, and coping skills. “Many times, people do not want to feel like a burden to their partners and do not want them to worry or feel sorry for them.”

Individuals in all kinds of relationships can struggle with this

It doesn’t matter how long you’ve been together; it can be uncomfortable to be vulnerable, or to know you’re worrying your partner. “A lot has to do with the quality and nature of the relationship, as even older relationships can be strained by a chronic problem if the relationship is not close and bonded,” Hanson says. “Conversely, a new relationship where the partnership is strong and secure may do better.”

This phenomenon is present in friendships and other kinds of relationships, too. “I will say a true test of the relationship, whether it be intimate or friendship, is definitely a chronic illness,” Hanson says. “It is very easy to be friends and partners when times are good, but I believe the true nature and character of a relationship is revealed by challenges.”

Why telling your partner is crucial

Even if you’re not experiencing a flare-up at the moment, proactively informing your partner is not only the best thing to do for your health, but also the health of your relationship.

“By not sharing your health status with loved ones and other important people in your life from the start, there’s an increased risk of being forced to share when your health is in danger, which can lead to confusion and lack of preparedness in case of an emergency,” says therapist and New York Times bestselling author Lori Gottlieb, MFT, who recently joined a campaign called The Air Between Us All to help people living with chronic conditions, such as asthma, navigate conversations about their individual health needs.

Gottlieb has found that open, early conversations can “make your relationships even stronger, and even create an opportunity for your partner to share what they may need from you as well.”

Telling your partner may go better than you think. “It can really help to lighten the mental burden when you are able to actually talk about it with someone,” Hansen says. “I believe many people discover how empathetic and supportive others can be in these situations.” (And hey, if they aren’t supportive, that’s good information to have, too.)

Tips for sharing your status and advocating for your needs

Talking about your health won’t necessarily be easy, so allow yourself to feel that discomfort as you share. While you may never feel 100 percent ready to have this conversation, Hansen emphasizes the importance of not feeling forced but not putting it off forever. “Usually, when the thought of telling your partner does not elicit anxiety or another negative emotion, or in fact you feel eager to share, it’s a great sign you are ready,” he says.

Once you decide to open up, what should you include? Hansen suggests sharing what you’re comfortable with, adding it may be important to address your prognosis, how your partner can support you, what treatment or management looks like, and how your condition affects your daily living. If you aren’t sure how they’ll take it, Hansen says “sometimes sharing a small amount may give some insight into the mindset of a partner.”

He also encourages talking this through ahead of time with a mental health provider or other trusted support person. They can help you plan how, when, and where you want to say it, as well as what you want to say. “I think it’s imperative to find a place and time that is comfortable for you where you will not be disturbed, and [where] you feel safe in case there are emotional questions,” Hansen adds.

If your partner doesn’t keep your needs in mind later down the road—such as parking far from buildings despite your pain and breathing troubles, or not giving you gentle love when a flare-up messes with plans—it’s okay to bring that up with them. “There is nothing wrong with a polite reminder if someone forgets about your condition,” Hansen assures. Although your pain might be something you simply can’t ignore, remember that it might not always be top of their mind even after you’ve told them.

This (brave!) step helps you build a broader support system, which Gottlieb says is essential to taking care of your condition—even if it seems counterintuitive at times. “So often we try to hide things that make us feel different, but we’re all going through something,” Gottlieb says. “I’ve found the more my clients talk openly about their chronic conditions, like asthma, the less alone they feel.”