When you live with chronic health issues like I do, there’s a whole other layer to your marriage that most people never have to think about. It’s not just about who’s doing the dishes or whose turn it is to take the dog out. It’s about symptoms, doctor visits, medication changes, and flare-ups that sometimes come out of nowhere. It’s about the pain you can’t always describe and the kind of fatigue that sleep doesn’t fix. And if you’re not talking about it – really talking about it – it can quietly wedge its way between you and your spouse.

I’ve lived with Crohn’s disease for most of my life, and in all honesty, it took me years to learn how to speak up about how it was really affecting me. I used to downplay things, keep it inside, tell myself I didn’t want to be a burden. But being married to someone like Nathan – someone who listens, who cares deeply, who notices even when I try to hide it – has taught me that the strongest marriages are the ones where we face the hard stuff head-on, together.

Why Talking About It Matters

Let me just say this: silence creates distance. If you’re holding it all in – whether it’s physical pain, emotional exhaustion, body image struggles, or fears about the future – it doesn’t go away. It builds. Your spouse might not know exactly what you’re feeling, but they’ll feel something is off. And when you’re not opening up, it’s easy for them to feel helpless or even shut out.

I’ve found that when I let Nathan in, when I say, “Hey, I’m not okay today,” it changes everything. It gives him a chance to show up for me. And more importantly, it reminds me that I don’t have to carry it all alone.

Start With Honesty, Even if It’s Messy

You don’t have to have the perfect words. God knows I never do. Sometimes I just start with, “I don’t even know how to say this…” or “This might not come out right, but I need to talk.” And Nathan, bless him, just listens. No fixing. No judging. Just being there.

It’s okay if you cry. It’s okay if your voice shakes. The point isn’t to have it all figured out – it’s to let your partner see what’s really going on inside of you. The raw honesty is what makes space for real connection.

Talk About Intimacy, Even When It’s Awkward

This one took me time. There have been seasons when I didn’t feel like myself. My body didn’t feel like mine. Pain, medications, surgery, my ostomy – so many things have impacted how I see myself and how I feel about being touched. And let’s be real: that affects intimacy.

What’s helped is being vulnerable, even when it’s uncomfortable. Saying things like, “I want to be close, but I’m nervous,” or “I’m afraid this might hurt,” or even just “Can we try something different?” makes such a difference. It’s not about rejection – it’s about finding new ways to connect when the old ways aren’t working.

And Nathan? He always meets me with patience and gentleness. That kind of safe space makes all the difference.

Let Them Help – But Set Boundaries Too

I’ve always been a little stubborn. I like being independent. But I’ve also learned that part of being strong is letting Nathan help me when I need it. Whether it’s helping me into bed on a bad pain day or running out to grab Gatorade when I’m dehydrated, he does it without hesitation.

At the same time, I’ve learned it’s okay to say, “I need a minute,” or “I just want to be alone right now.” Communication goes both ways – it’s about knowing when to lean in and when to give space. And honestly, the more we’ve talked about it, the easier that balance has become.

Make Space to Check In

It’s not enough to talk when things are falling apart. One of the things Nathan and I try to do is check in with each other regularly – not just about to-do lists or schedules, but really check in. We’ll sit down and say, “How are you doing this week?” or “What’s been heavy for you lately?” Sometimes I’ll say something I didn’t even realize I was carrying until I heard myself say it out loud.

Those moments keep us close. They remind us we’re a team.

You Don’t Have to Do This Alone

If there’s one thing I’ve learned, it’s that love doesn’t mean pretending everything’s fine. Love is saying, “This is hard, and I’m still here.” It’s choosing to keep showing up for each other, especially when life gets messy and unpredictable.

Nathan and I don’t have a perfect marriage, but we have a strong one. And that strength comes from talking about the pain, the fears, the frustrations, and the wins (even the small ones). It comes from knowing that no matter what my body is doing on a given day, we’re facing it together.

So if you’re holding something in, consider letting your spouse in instead. You don’t have to carry it alone. You’re not a burden – you’re human. And the right person won’t run away from the mess. They’ll pull you closer.