Over the last 33 years, I have been called many things — a cynic, a pessimist, and a few other things that do not bear repeating in polite company. I prefer the term “realist.” Most of the time the name-calling is due to my views on relationships and, well, love in general. We would all like to have that Hollywood love story moment where our eyes meet with another’s from across a crowded room, and we both instantly know that we will live happily ever after with a house in the suburbs, 2.2 children, and a Chocolate Labrador named Buddy. The reality of the situation is that this rarely happens. And by rarely I mean never. Relationships are work, and relationships that involve someone with a chronic illness require extra work.

Many of us who are chronically ill are terrified that if someone we really enjoy being with finds out just how sick we really are, they will run away screaming and never look back

When you are chronically ill, you need someone in your life who is willing to help you when you need help, and be there when you need someone to understand. Even if you are the toughest, most stubborn, never-ask-for-help, son-of-a… (well, you get the idea), you are going to need help or a friendly ear from time to time. When you are younger, a parent or sibling will suffice, but the truth of the matter is that there is no substitute for someone who loves you who is not obligated to do so by a family tree link. Honestly, what this means in practical terms is that, in all likelihood, the relationship is going to be skewed towards one person’s needs — the person who is ill. This ends up causing several specific issues that I have experienced time and again, and dealing with them can be difficult.

The most likely issue that will arise is what I call “silent resentment.” Even if your partner swears up and down that your illness is not a problem, and he or she fully understands the burdens that might be placed upon them in the future, resentment always seems to crop up. Human nature being what it is, anyone who is required to help someone else by sacrificing their own time and energy will resent that person. Fortunately, that person cares for you and knows deep down that it would be wrong to call attention to how your disease is making their life more difficult. So, they keep it to themselves, thinking things like “how can I complain when he/she has to deal with illness every day?” Unfortunately, this results in a slow-building resentment with no outlet, and eventually can lead to an issue which can rip a couple apart. Be aware of this, and make sure you do as much as you can for your partner (within your limits). Also make sure you never take advantage of their kindness – in other words, don’t be lazy.

Another issue that I have dealt with more than once is being with someone who simply does not have the ability to understand illness. I have had relationships where my partner just cannot understand that I have limitations, and that there are certain activities that I just cannot do. No matter how many times I try to explain or point out the reasons that I am unable to do said task, the next day my partner again asks me to do something that I simply can’t. The truth of the matter is that there are some people out there who, although they are capable of love, they are not capable of the type of empathy required to understand someone with chronic illness. As upsetting as it can be, this is a dangerous issue, especially because you may end up pushing yourself to perform when it can be physically dangerous to do so. If this is you, please take stock of your relationship and ask yourself if it is really worth it.

Another problem that I have encountered is an issue that lies with the person who is ill, not their significant other. Many times I have found myself pushing the limits of my abilities in order to make the person I am with think that I am not as ill as I really am. I know that there are many of you out there who do this, and it makes sense in the short term. Many of us who are chronically ill are terrified that if someone we really enjoy being with finds out just how sick we really are, they will run away screaming and never look back. I can’t tell you that a significant other of mine has never gotten overwhelmed, but I can tell you that it has only happened once or twice. I know how much of a temptation there is to make yourself look less ill, and I know how hard it is to let your guard down. All I can tell you is that it is not only dangerous physically, but it also sets a very bad precedent. Trust your partner and your judgment in others enough to let them in to your life (when you are ready), and trust in the relationship enough to believe that it can weather the burden of you.

Everyone who has reached a certain age, I’m sure has experienced issues with their significant others. Those of us who are ill have likely had to deal with one or more of the problems I described above. I am currently single because I did not learn these lessons in time to save some of the best relationships I had. Now that I realize what it takes to be with another when you are ill, I hope I have the good fortune to meet someone again. Don’t read this and take away a view that relationships are too hard when you are ill. Quite the opposite, in fact. Take what I have learned, and use it to help you in your life. Sure, it may be a bit more work, but what isn’t when you are ill? Although people may say to you that you need to find someone who will love you no matter what, the reality of the situation is that, being chronically ill, you do have certain issues that you have to be aware of in order to help make things go smoothly. Needing someone in your life more so than the average person and having a disease that makes it harder than average to be with someone is the paradox we all live with.