Great strides have been made in recent years to destigmatize mental illness, and a growing number of public figures now speak openly about their struggles with anxiety and depression. But there is a category of mental illness that we might think of as the “Big Ones”; the disorders that still have a connotation of “crazy” or “out of control.” Bipolar disorder probably falls into that category.
According to the American Psychiatric Association, bipolar is a brain disorder characterized by “extreme and intense emotional states” called mood episodes. And for many of us, it brings to mind its more extreme symptoms: increased risky behavior, racing thoughts, and sleeplessness, at one end of the spectrum; and intense sadness or despair, fatigue, and suicidal ideation, at the other end.
Talia Kruse had a similar conception of the condition when she was diagnosed with bipolar II disorder in her early twenties. But now in her thirties, married, and a mother, Kruse has come to see the truth of what her psychiatrist told her upon diagnosis: “You can have a very normal life. But you’ve got to work on some things.” Today she works with other moms as a mental health coach to share the insights she has gained in caring for her own mental health. I spoke with Kruse about her experience living with bipolar and learning to use it as an occasion to flourish. Join us as we take a walk in her shoes.
Can you tell us what your diagnosis is and how you came to receive it?
I was diagnosed with bipolar II disorder when I was 24 years old, and that came about as the result of the psychological evaluation I took upon entering religious life. Where bipolar I is characterized by full blown manic episodes and depressive episodes, bipolar II only has hypomanic episodes and depressive episodes. Traditionally bipolar I can be seen as a little more serious and bipolar II a little less—however that doesn’t mean it should not be addressed.
What did living with bipolar II look like before you received your diagnosis?
I was a pretty typical early twenties adult: I went through college and all of that, but I was very unanchored, I was very lost and very, very lonely because I didn’t know where my place was in the world. I had converted to Catholicism during my college years, so I was asking all these philosophical questions about what my life meant and what I’m going to do with it. All those things I think are very typical. There are a lot of people in their early twenties, college-age years who are very lonely, looking for their place in the world, and trying to test the principles they grew up with concerning what it means to be good, what it means to have a good life.
But for me they manifested in some depressive symptoms, so I just thought I had depression. This is very typical for people with bipolar to first get diagnosed with depression. Unfortunately they just get put on antidepressants, and that usually just revs up the bipolar even more.
I thought my hypomanic episodes were just normal, they were just me: I liked to run a lot, I liked to be creative, I was very good at school, things were very easy for me. I thought, “Well that’s just me.” I have lots of good ideas, I’m very talkative, I’m very outgoing.
So, I did not receive my diagnosis very well. I thought, “I think you’re overreacting here.” At that point I didn’t know about bipolar. I did have a close family member with it; I knew it has a genetic component, and so in one sense the diagnosis didn’t surprise me. But at the same time I had the same thought everybody has, “Oh that’s a kind of ‘crazy.’ You’re on some special black list now.”
When you describe a hypomanic episode, my first thought is, “That sounds pretty great!” When you received your diagnosis, did you have any thought of, “You’re diagnosing as a problem, something that I see as an advantage”?
Yes. Because at the point when I got diagnosed, I wasn’t able to discern between what was bipolar and what was me. I thought, “You’re telling me there’s something wrong with me, and that’s the best part of me. I’ve always been told I’m creative and talented and have all these gifts, and now you’re telling me, ‘that’s just hypomania, that’s all it is.’” And that was really hard. That’s probably why I did really resent the diagnosis. I thought, “If you’re telling me that’s a problem, then I’m a problem.” I was not able to look back and see any normal; it was all highs and lows and highs and lows. That affected my response, “That’s everything; that’s all I am.”
What did treatment look like for you when you first got the diagnosis?
First, it was amazing that this religious community still accepted me. Because I had asked questions about other religious communities, and they were very clear that they did not take people who were on antidepressants, so the buck stopped there. Thankfully, the religious order I sought entrance into has their own doctors, their own psychiatrist who I actually worked with, who diagnosed me. It was great. Normally you enter postulancy (the first step in entering religious life) right away. But the community asked me to do a year of “pre-postulancy”; it’s like preschool for religious life. It was a year to work on making a gradual lifestyle change into religious life. They told me, “It’s going to be way too difficult to go from where you are now to religious life, and you’ll miss your vocation—if this is what you’re called to.”
But before going to Germany (where the order’s pre-postulancy is located), I met with their psychiatrist every day for a month to work on some things, like developing a routine and sleeping better. The psychiatrist said to me, “You’re young. You can have a very normal life. But you’ve got to work on some things first.”
Was learning how to have routine to prepare you for religious life? Or to help you manage bipolar?
I think both. I’ve written about how I lost any sense of routine when I was in college, and I never realized how much I thrived growing up every day, going to school from 8 to 3. Then all of a sudden you’re thrown into college where maybe you have class Monday, Wednesday, and Friday from 3 to 5 and Tuesday labs from 1 to 4, and then good luck with the rest of your day. I didn’t realize that I was just a fish out of water in that context. I didn’t know how to structure my day, and I was trying to live up to the college life. So I kind of had to be re-trained in that, both because that’s part of religious life, but also as a person managing bipolar.
What is it about routine that makes it so important for a person managing bipolar?
For me—especially being a mother—routine means you know what is going to come next. Sometimes, and I think this is true for a lot of people dealing with mental illness; the feeling of helplessness, of being out of control, is very disabling. And so if I can have routine, that’s going to give me some type of control. Because even if I’m not in control of something right now, for example, I know that I am going to leave work at 5 o’clock. If I can just get through this, I can see the finish line, I know that that will happen. And that allows me to embrace whatever is happening right now rather than freaking out. Instead of reacting, I’m able to respond to whatever is happening right now.
Routine is also just biologically important. We’re made to sleep at night and get up during the day. You have the circadian rhythm that is very important. Anyone who has sleeping problems (and the feeling of a decreased need for sleep is a symptom of manic and hypomanic episodes) will tell you it’s very difficult when you’re off with that.
You ultimately discerned out of religious life. What was it like going back into a secular setting and managing bipolar?
It was hard for reasons other than the bipolar. By then I kind of had a good hold on it. I did have to deal with the stigma of bipolar a little more, but by then I had a totally different understanding of what bipolar was, and I had no problem telling people what that meant to me.
Including when you started dating?
Yep. I knew I’d have to tell whoever it was, some time soon. Not on the first date, but I surely wasn’t going to date someone for a year and then say, “Oh by the way . . .” Because this is going to be a big thing. Now being married for five years, I realize even more clearly that you and your spouse are going to bear each other’s crosses, so they deserve to know what they’re going to deal with. And you hope that that’s reciprocated. It’s just part of being honest. Also, I guess I wasn’t too afraid of sharing it, because I had a lot of confidence that the man God was leading me to would not be scared off by that, but would help me and would want to get to know me rather than just seeing this girl with bipolar. They’d still see Talia, they’d still see me.
Did you have any fears about motherhood specifically around bipolar?
I think I had more concerns about being a stay-at-home mother. Even when my husband and I were dating, we knew that if we had kids, I’d really like to stay at home. But the big caveat was that if I could not mentally handle staying at home, we’d have to deal with that when it comes. I knew going into motherhood that I needed to have some kind of routine.
But as anyone who is a mother will tell you, it seems like there is no routine once you have kids. But there is; you just have to try hard. There is a routine, though it might not be what you think. It’s not a schedule—8 o’clock this happens, 9 o’clock this happens—but it’s a rhythm. And as long as you have that, it will help.
Has living with bipolar in any sense prepared you for motherhood?
Yes. First, having bipolar has helped me realize we all carry crosses or burdens, but that doesn’t mean they have to be an obstacle to a flourishing life. In fact, in a mysterious and kind of ironic way they can actually help you flourish. Because although it is a challenge, it’s a challenge that you work through. I learned not to be afraid of these challenges, but to use them as a gateway for flourishing.
But the bipolar itself also has helped me to learn how to adapt in very acute situations as a mother. One of the things about being a mom, is that sometimes you don’t have control over your kids’ emotions. You may think: “We always take a nap after lunch.” But for whatever reason the kid does not want to take a nap, he’s crying, and you think, “I don’t know how to deal with this.” But I do! I know sometimes our emotions just are what they are, and you just ride them out, but you don’t let them overpower you. I think I’m able to adapt better, especially in dealing with little kids who are emotional and can’t control that yet. I’ve learned from my own experience with bipolar how to not let those emotional swings get the best of the day and how to help my children process their feelings, acknowledge them, and then we move on. So, yes, I think it’s helped in being a mother to little ones.
Are there any common misconceptions you think people have about bipolar or mental illness in general?
I think the biggest misconception is that people think of bipolar as they think of cancer: you either have it or you don’t. I think it’s more like high blood pressure. We all have blood pressure. Some people have higher blood pressure than others, and there’s a line above which the scientific community has agreed a person may need to be medicated. It’s the same thing with bipolar: we all have mood swings. Some people have a little bit more mood swings than others, and at some point, depending on how it manifests itself, it probably needs to be medicated. But the medicine is just a small piece of the pie. Everything else—the daily routine, processing my feelings, working on cognitive distortions (the things we habitually tell ourselves that just aren’t true)—we all should be working on that. We all have physical health and we all have mental health. Lots of people work on their physical health even when they’re not sick; a lot of people need to work on their mental health even when they’re not sick.
People also often relate bipolar with “crazies.” I think that’s because bipolar often does go undiagnosed and is only diagnosed when a really bad effect manifests itself, like trying to commit suicide, or alcoholism, or drug abuse, all those things which are actually secondary to the actual problem. That was something that I struggled with too when I was diagnosed: “How can I be bipolar when I don’t drink in excess?” I thought. “I’m not promiscuous . . . I’m a good person!” It made me realize what the stigma is. I think a lot of people are very afraid of bipolar, and I don’t think it’s something you have to be afraid of. It just means I have more mood swings than the normal person.
What have you found to be some of the most helpful ways friends and family can support you?
I don’t know that my friends and family help me with my bipolar any differently than they would if I didn’t have it: the grandparents being able to babysit every once in a while; friends being able to get together for a coffee. Just being a friend, a true friend. The biggest person who has to help me with my bipolar is my husband because he sees it.
But if friends and family were asking for advice on how to specifically support me in living with bipolar, they might ask, “How are you sleeping?” “How have your moods been?” Though “how are you?” kind of encompasses that.
What is not helpful or intrusive?
It’s not helpful to blame everything I do on bipolar: “Oh you’re having a bad day? Oh it’s because you’re bipolar.” “Oh, you got really mad at that person? It’s the bipolar.” I see it as something I have, not something I am. I don’t tell people “I am bipolar”; I’m very clear that I have bipolar. As long as I manage it, my life is pretty normal.
People sometimes worry that going on medication will change their personality. Did you have that fear? And now that you’re managing your bipolar, has that fear been disproved for you?
Yes, I had that fear for a while. I think one reason people with bipolar often take their medicine and then stop taking their medicine is because they feel good, and they want to continue to feel good. But with that comes again this distortion of, “I never really had a problem.” You have to stay connected to reality, to see, “No, I will probably come crashing down again soon.” What I have learned is that I’m still able to be creative and I still feel like myself on medication. And the more I am able to realize I don’t have to depend on a manic state to be creative, I can take comfort in that.
But I do want to say there is a little bit of sacrifice there. There is a bit of sacrifice when it’s 10 o’clock at night, and I’m in the middle of working on something and in a state of flow, and I choose to keep my routine and go to bed. I do sacrifice a little bit of that productive “manic juice,” but it’s worth it. Because I’m able to stay in reality.
We all have questions we would like others to ask us but that are left unsaid. What question do you wish friends would ask you and how would you answer?
“How is bipolar helping you to become a better person?” I wish people would look at it that way rather than, “Oh, you have bipolar, how are you dealing with it?” or, “Oh you poor thing, there’s nothing you can do, sorry!” Because that’s not motivating at all.
Here at Verily, we love our Daily Doses—quotes or phrases that remind us that the world needs more of who we are. Do you have a mantra or phrase that helps you to have hope in the hard days?
Especially as a mother, one thing that I always keep in mind is this prayer by Alphonsus Liguori, who was a Catholic bishop and spiritual writer. The prayer is called “There is only one thing necessary,” and that’s my mantra. In the midst of chaos or frustrating times, I tell myself, “There is only one thing that is necessary and that is to love God with my whole heart and my whole soul.” That brings me a lot of peace, and it’s very freeing.