“What you are exhibiting are classic signs of PTSD,” my psychiatrist said during our session. Earlier that morning, I’d had an encounter with someone at work that left me rattled. I was having trouble dealing with the aftermath. As far as I knew, I had anxiety, not post-traumatic stress disorder.

I’m not a veteran, I thought to myself. I need a second opinion.

“What do you mean?” I asked. I was confused, but I was also curious to know why he thought PTSD was causing my symptoms. My psychiatrist said he believed I’d been misdiagnosed with generalized anxiety disorder and that the sexual assault I experienced as a teenager was still affecting me in my adult years. The insomnia, the constant night sweats, the splitting headaches, the muscle tension, the hypervigilance — those were all symptoms PTSD.

And PTSD isn’t exactly rare — 1 in 11 Americans are diagnosed with PTSD, and women are twice as likely to have this disability. Lucky for me, I had access to a mental health team to help me figure out a plan. I was prescribed gabapentin. I was advised to seek out cognitive behavioral therapy and build out a regimen centering high intensity exercise. And after some time, I could tell the plan was working. I was finally sleeping well, identifying my triggers and finding security through community. For the most part, my physical symptoms were under control, and I was feeling somewhat whole again.

But no matter what I did, there was one symptom that didn’t improve at all — my issues with sexual functioning. Sexual dysfunction is a little known and rarely discussed symptom of PTSD. In my case, I had a very low sex drive and difficulty climaxing. Every night I would hope my partner wasn’t feeling intimate either so I wouldn’t have to deal with the fact that I just did not want to have sex. On days where I felt motivated, I spent hours trying to connect with myself in a sexual way.

All of this was taking a toll on my relationship, and I wasn’t making much progress in this area of my life. It was frustrating — what was once a pleasurable experience was turning into a place of shame. No one understood what I was going through. When I looked over my care plan, I was surprised to see that my mental health team hadn’t collected much information about my sexual history, especially considering my experience with sexual assault.

I asked my team for help. Psychiatrists recommended additional medication to counteract the side effects of other medication, therapists recommended I see sex therapy, which is rarely covered by insurance, and the internet — well, it wasn’t helpful. I had to figure this one out on my own. Unsure of what to do, I started by having a conversation with my partner.

This was a real lesson in vulnerability. It is saddening to realize that you don’t have the type of sexual relationship you want with someone you love deeply. Even though my partner was understanding, I had no idea how long my symptoms would last, and I wondered aloud if I was letting him down.

Part of my journey towards sexual liberation through a PTSD diagnosis was finding alternate ways to be intimate. There’s an unfair expectation that everyone should experience sex in a certain order. Knowing that my partner and I could build a ritual of our own took the pressure off of me to be the perfect partner. We also took it upon ourselves to go to couple’s therapy, not sex therapy. My partner wanted to understand more about my PTSD and support me across all areas of my life. He wasn’t just interested in our sexual relationship — he was also invested in our emotional and physical relationship. This was a game changer.

Developing my own sensual rituals was also paramount. Every night for the last year, I prioritized a nighttime routine. Before I went to bed, I would dim the lights, turn on the hot water, light a candle, infuse lavender into the room and allow myself to just be. All the tension I was holding in my body seemed to wash away, and I much more open to sexual exploration. When taking time to masturbate, instead of focusing on the destination (climaxing), I would prioritize the journey. I carved out a process of self-pleasure. Watching porn, reading erotica, hanging out naked and daydreaming became my ways of coping.

Healing was very important to me. So many of us feel like we have to compromise our sexuality in the face of a chronic illness. But I needed to find a way to meet my sexual needs in the middle of a crisis. It was the only way I was going to make it to the other side.

Although I’m still working towards a complete recovery, knowing that I can be comfortable in my own body and experience sensuality in new ways has been profoundly liberating. I keep a journal where I note my daily moods and emotions around sex, and when I look at the data over the past six months, even though my healing journey hasn’t been linear, it’s clear that I’ve been improving.

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