A great deal of the human experience revolves around the way in which we identify ourselves and those around us. For example, I’m a woman, mother, wife, and friend. These words not only tell us about our place in the world, but they illustrate how and why we matter to others. While many of my childhood friends dreamed of being doctors or lawyers, I always wanted to be a mother and a teacher. However, once I was diagnosed with psoriatic arthritis (PsA) in my mid-20s, the reality of what I would look like as a wife, mother, and teacher looked very different from the way I pictured it as a young girl.

There is a great deal of pressure on women to make it look like we have it all together, to easily manage both a career and a family. Little Timmy is sick with a stomach bug? No problem—I’ll just stay home from work. Soccer game at 4, doctor’s appointment at 530, and swing by the in-laws at 715? Gas up the minivan—I’ve got this.

And before being diagnosed with PsA, I’d say that I was doing a pretty good job of living up to these expectations. I had a career as an elementary school teacher, was married to the love of my life, and was an active mother to three young children. By some miracle, I managed to keep all of my balls in the air, juggling the demands of my career while arranging my family and home life.

“I could no longer hold myself to such high expectations if I was going to have any hope of being happy while living with a chronic disease.”

And before being diagnosed with PsA, I’d say that I was doing a pretty good job of living up to these expectations. I had a career as an elementary school teacher, was married to the love of my life, and was an active mother to three young children. By some miracle, I managed to keep all of my balls in the air, juggling the demands of my career while arranging my family and home life.

That is, until I couldn’t.

Shortly after my diagnosis of PsA, I was prescribed methotrexate, just like the majority of newly diagnosed patients. Unfortunately, methotrexate made me terribly sick, causing random bouts of extreme nausea and debilitating vertigo nearly every day. Between the pain and fatigue that PsA was causing and the added impact of the methotrexate, I was forced for the first time to stay home as my son played his first soccer game and my 2-year-old went down the “big slide” on her own for the first time. During these days when I laid in bed, I distinctly remember that, as a mother, I felt like a complete failure. I was missing out on everything that an involved mom is supposed to do: kiss boo-boo’s, cheer on the sidelines, and basically hold family life together.

I also felt like a failure as a wife. My husband and I were married in 2010, a few years prior to my diagnosis of PsA. At the time, he was an auto mechanic while I taught 3rd grade. Our friends jokingly called us, “The All-American Couple.” While we included the usual “in sickness and in health” line within our marriage vows, the daily reality of living with someone who is constantly sick was exhausting my husband and putting a lot of our stress on our relationship. He didn’t sign up for a lifetime commitment to someone who couldn’t pull their half of the relationship weight. PsA changed me from a dependable, reliable partner to an ongoing burden.

And let’s face it, overwhelming fatigue isn’t exactly sexy. Weight gain from prednisone isn’t sexy. Psoriasis and swollen joints certainly aren’t sexy. All of these things take the romance out of the bedroom and make it challenging to even contemplate any action between the sheets, even if you happen to have the desire or energy.

I’m not going to sugarcoat it—those first few years following my diagnosis of PsA were bleak. No matter how I looked at it, my life had become drastically different. I could no longer manage to teach full time, and so, my career was over. Chasing my kids around the yard in a game of tag? Forget it. Making dinner from scratch 5 days a week? Nope. As a wife, my house was basically falling apart around me. Since there were still bills to pay (and medical bills on top of all of the normal expenses), my husband still worked full time and could only be around so much to help out. Was I depressed? You bet.

I remember mentioning my fragile emotional state in an off-hand sort of way to my rheumatologist, who suggested that I discuss things with my primary care physician. But at that point, I was so tired of the endless doctor appointments and tests that the thought of trying to fit in yet another doctor’s appointment just overwhelmed me even more, so I was left to deal with things on my own.

“Like many women, I still struggle with perfectionism, but I’ve certainly come a long way. Once you learn to ask for help, you also learn to let go of some control and need for everything to be ‘perfect.”

Eventually, I woke up one morning and recognized that something had to give. I could no longer hold myself to such high expectations if I was going to have any hope of being happy while living with a chronic disease. As a result, I had to learn about resilience, dependency, and even perfectionism in the years following my diagnosis. The online community of PsA patients was remarkably helpful in terms of offering support, understanding, and simple tips to make daily life a little easier. Living with PsA changed the way that I look at pretty much everything. Had I continued to see myself as a failure as a woman, wife, and mother, I can’t imagine the terrible impact it would have ultimately had on my family.

Today, I recognize that my worth as a wife isn’t measured by the number of the items I am able to check off my to-do list each day. Rather, it’s measured through my appreciation for my husband, who sacrifices working at a job he doesn’t love simply because it offers good health insurance for my biologic medications. He can’t wave a magic wand and make everything better, but he loves me enough to try. His love reflects my worth much more clearly than the tidiness of my home.

My value as a mother isn’t found in the Instagram-worthy pictures of my children. My value comes from the strength of character that I am able to impart to them. Through me, they have learned empathy and understanding. Because of my PsA, my children have learned to keep trying even when things are difficult. They have learned to look for the positive in every situation, and to be helpful and kind.

Like many women, I still struggle with perfectionism, but I’ve certainly come a long way. Once you learn to ask for help, you also learn to let go of some control and need for everything to be “perfect.” Sure, my husband doesn’t load the dishwasher exactly how I’d like. And he doesn’t sort the laundry correctly (or rather, at all). But he has taught me to understand that marriage is about more than a simple partnership. It isn’t always going to be 50-50. My role as a wife is worth more than that of a housekeeper, and I have more to offer our relationship than a paycheck and a partner between the sheets.

When it comes down to it, the key to being a woman with PsA is understanding that despite the sometimes crushing pain and fatigue associated with this disease, you still have value as a woman, wife, mother, and friend. If you surround yourself with loved ones that appreciate what you have to contribute, it becomes much easier to ask for help and ultimately shore up your mental health for the many challenges that lie ahead.

Author Bio: Leanne Donaldson writes about her experiences as a mom and parent with a chronic illness on her blog, Smiles and Sundays.

Participants will receive 2.25 hours of continuing nursing contact hours, including 1.25 nursing pharmacotherapeutic hours, by completing the education, completing an online evaluation, and receiving a post-test score of 70%: RNP V6 Issue 4: Battle of the Sexes: The Differences Between Men and Women with Psoriatic Arthritis