On Friday, Lady Gaga appeared on NBC’s “The Today Show” in a feature on her Born This Way Foundation and made a big admission: she suffers from PTSD (post traumatic stress disorder) stemming from when she was raped at 19, among other things. It is the first time she had revealed any mental disorder from the rape, which she first revealed in 2014.

Later, Lady Gaga published an open letter to her fans thanking them for their outpouring of support and published it on her foundation’s website. We’ve dropped an excerpt below, but you can read the whole thing here.

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.

Watch “The Today Show” segment below. Lady Gaga released her most recent album Joanne in October of this year.