What Is Euthymia?

Sufferers of bipolar disorder experience extreme moods that range from elation to desolation.. However, there's an in-between mood between the two extremes known as euthymia.

Written and verified by the psychologist María Vélez.

Last update: 21 December, 2022

Euthymia refers to a normal, calm, and reasonable state of mind. It’s a state where positive emotions and a balanced and adaptive perception of the environment predominate. This concept is used, especially in psychiatry, to describe the phase of normality that a patient with bipolar disorder goes through between manic or depressive episodes.

In these periods, patients experience a more adaptive, calm, and cautious behavior, without radical changes in mood. It’s a midpoint between the most euphoric joy and sadness. When this state of mind is present in a stable way, it’s considered that the disease is in remission.

Variations of mood

To better understand euthymia, it’s useful to know what variations can occur in the state of mind. Although it’s viewed on a continuum, it’s usually classified into five levels, which, if indicated quantitatively, could be understood as: -2, -1, 0, 1, 2.

• Mania (2). A state of mind well above the ‘norm’. A euphoric, elated mood that’s often accompanied by excitability, irritability, or talkativeness. Delusions of grandeur, hallucinations, or bizarre, disinhibited behavior may also appear.
• Hypomania (1). This euphoric state of mind doesn’t intervene in daily life as seriously as mania. Its intensity is milder. When someone is at this level, they don’t need to sleep or rest so much as they’re overflowing with joy. They may even be more productive than normal.
• Euthymia (0). As we mentioned earlier, euthymia is a balanced, centered, state of mind. This doesn’t mean that there are no ups and downs but they remain within functional and healthy limits.
• Hyperthymia or mild depression (-1). This is an abnormal decrease in mood. The person is sad, with inexpressive language, and a feeling of despondency. They also lose interest and the ability to enjoy experiences that they used to enjoy.
• Depression (-2). This level of mood is considered a mental disorder in which hyperthymic symptoms appear with great intensity. In fact, the feelings of sadness, hopelessness, or frustration are so deep that they seriously affect the person’s life, sometimes leading to suicidal ideation.

Bipolar disorder

Taking euthymia as a point of reference, different types of bipolar disorder are classified according to their levels of mood.

• Bipolar disorder type I could be considered one of the most serious. The sufferer has experienced at least one episode of mania and one or more episodes of major depression. According to the DSM-V manual, only the presence of the manic episode is necessary for its diagnosis. However, both usually appear.
• Type II disorder is characterized by the experience of an episode of major depression with at least one episode of hypomania. Because hypomania is sometimes difficult to diagnose, this disorder is often confused with major depressive disorder. Psychotic symptoms may appear during the depressive episode, but not in mania.

Finally, cyclothymia involves the appearance of multiple episodes of hypomania alternating with episodes of hyperthymia or mild depression.

Sometimes, these ups and downs, which are somewhat more radical than euthymia, are confused as being a trait of the sufferer. These variations affect the way they function and range in how frequently they occur, from several times a week to four times a year.

The state of euthymia

When someone suffers from bipolar disorder they usually have a drug treatment prescribed to help them control the symptoms. In addition, they should go to psychological therapy where they can learn to manage their emotions and predict the appearance of a new episode. Indeed, psychoeducation is essential so that the patient and their family know what’s happening to them.

Reaching a euthymic state of mind doesn’t mean that recovery is achieved, but rather a state of normalcy that’s healthy for the person and their environment. For this reason, professional help is essential. Even if it doesn’t manage to eliminate the disorder, it helps the sufferer to be more balanced and have a more functional life.