Euthymia in Bipolar Disorder

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Bipolar Disorder
Read Time: 6 Minutes
Written by:Elizabeth Keohan, LCSW-C, MSW

Published On: January 24, 2023

Medically reviewed by: Reshawna Chapple, PhD, LCSW

Reviewed On: January 24, 2022

Updated On: November 2, 2023


Bipolar disorder causes intense mood swings that can range from exhilarating highs to devastating lows. Euthymia is a period of calm and tranquility that doesn’t involve these kinds of extremes. People with bipolar disorder sometimes experience euthymic phases, which can be best understood as stable periods without the mood disturbances typically associated with this condition.

What is euthymia, exactly, and how does it relate to bipolar disorder? Read on to learn more about this mood state and how it affects people living with any of the types of bipolar disorder: bipolar I, bipolar II disorder, or cyclothymia.

What is Euthymia?

The term euthymia was first introduced by Democritus, an ancient Greek philosopher. He described it as a state of personal satisfaction in which someone is at peace with what they have.

Psychologists define euthymia as a ‘normal’ and calm mental state. For people with bipolar disorder, it describes a stable mood that’s neither manic or depressive. Euthymia occurs between bipolar episodes and is also a baseline mood state for other mood disorders, such as borderline personality disorder (BPD) and major depressive disorder (MDD).

Some sources define euthymia as a highly positive and elevated mood state. While it’s a hopeful period for many, euthymia is not necessarily good or bad. Many people with bipolar see a dramatic reduction in symptoms when they’re in a euthymic mood, but it’s more accurate to look at euthymia as a neutral state rather than a positive one.

Understanding euthymic moods in bipolar disorder

Bipolar disorder is a mental health condition that can cause dramatic shifts in a person’s mood and energy levels. While it’s characterized by highs and lows, bipolar euthymia is a state that exists in the middle of those two extremes. People often report feeling in control of their emotions during these states.

iconExpert Insight

“It may seem surprising, but euthymia — a stable mood — is plausible with a diagnosis of bipolar disorder. When you learn to be so observant and analytical of moods, shifts, and emotions, it can be hard to reassure yourself that you’re in a balanced way. It’s important to remember, though, that stability can be a result of attentiveness to medication, cumulative effort towards self care and routine, and a comprehensive treatment plan.”
Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan

Euthymic periods are sometimes brief, but they can potentially last for years. One study found that nearly 40% of participants stayed euthymic for 2 to 5 years, while almost 12% went 6 to 10 years without a depressive, manic, or hypomanic episode.

Even though euthymia is often described as a state of tranquility, someone in an euthymic bipolar mood can feel sad, excited, or frustrated at times. Euthymia doesn’t mean that a person is cured of bipolar or that they won’t experience any symptoms of depression or mania. It’s simply a stable period in which they don’t meet the criteria for another mood state.

It’s not unusual for people to experience positive emotions while euthymic, but others may feel emotionally flat or be less responsive to outside stimuli. However, many people do report that they have more control over their emotions or find it easier to manage stress while in this state. It’s common for people to state they feel as if they respond well to treatment for bipolar disorder during the euthymic state.

iconExpert Insight

“It’s more than OK to be present with the tranquility that you’re feeling. It doesn’t indicate a cure, but periods of euthymia can last for months, or years in some cases, while it remains important to stay connected to supports and providers.”
Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan

Signs of a Euthymic Mood

People with bipolar disorder (BD) can experience euthymic BD in different ways, which can make the moods difficult to recognize. 

iconExpert Insight

“Euthymia is often thought of as a state of calm or stability, oftentimes between episodes of depression or mania. It’s more commonly observed if there are no disturbances in terms of mood and is largely considered positive or tranquil. The absence of mania or hypomania also indicates euthymia.”
Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan

Euthymic moods can provide a respite from the negative symptoms of bipolar disorder, and many people experience pleasant emotions while in this state. The following feelings are all common signs of euthymia:

  • Happiness
  • Optimism
  • Tranquility
  • Contentedness

However, some may experience anxiety or anhedonia, which is a reduced ability to feel pleasure, while in a euthymic mood.

Experiencing euthymia with anxiety

Anxiety is a common issue for people with bipolar disorder. Even when someone’s in a stable mood state, they may still struggle with symptoms of anxiety. In fact, an increased feeling of calm could even make them more aware of these anxious feelings.

According to one study, almost 35% of people with bipolar met the diagnostic criteria for anxiety disorder while in a state of euthymia. Although these symptoms can cause distress, euthymia often makes it easier to manage and treat anxiety for some people.

Experiencing euthymia with anhedonia

Someone in a euthymic mood won’t experience severe depressive symptoms, but they may experience anhedonia. When someone has anhedonia, it’s harder for them to feel positive emotions. In some cases, someone might not feel much emotion at all.

Experts believe that bipolar disorder influences reward processing in the brain. Studies show that people with bipolar are less responsive to potential rewards even while in a euthymic state. For some, this could make it difficult to show interest in the things they usually enjoy.

Different types of euthymia

Even though euthymia is a stable state, people can still experience it in many different ways. Someone may have euthymia with one or multiple effects. Types of euthymia include:

  • Euthymia with congruent affect: Someone with this type of euthymia has emotions that are situationally appropriate.
  • Euthymia with reactive affect: This type of euthymia allows someone to respond appropriately to what’s happening around them.
  • Euthymia with restricted affect: Someone with a restricted affect may choose to limit their emotions or struggle to express what they’re feeling.
  • Euthymia with blunted affect: When someone is in the euthymic state, they may not have a strong emotional response to what’s happening around them.

Learning more about how you experience euthymia can help you track your mental state and manage bipolar symptoms more effectively. Even though the signs of euthymia vary from person to person, you can still learn to recognize what euthymic moods look like.

Getting Help for Bipolar Disorder

For many people with bipolar disorder, euthymia is a welcomed period of calm and emotional stability. When it comes to how to deal with bipolar disorder, the highs and lows make the condition difficult to treat. Some people find that they’re more responsive to treatment when they’re in a euthymic state. This means therapy for bipolar disorder and medication can be more effective and beneficial in helping them manage their condition.

There’s no cure for bipolar, but with therapy and possibly medication for bipolar disorder, you can learn to live with this challenging mental health condition. The right tools can be powerful in helping you deal with mood swings and identify issues that need to be addressed.

If you’re currently in a euthymic mood and you’re ready to seek help, connect with an online therapist at Talkspace today to learn more about how you can navigate bipolar disorder. It’s not the easiest condition to address, but you can do it, and the online therapy platform Talkspace can be your partner along the way.

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Elizabeth Keohan

Licensed Talkspace Therapist, Elizabeth Keohan has enjoyed working with clients in communities from Washington DC through rural Maine over the course of her career. While she has worked extensively with those experiencing anxiety and depression, she embodies a unique comfort working with the bereaved. Elizabeth combines a compassionate, holistic approach with Cognitive Behavioral Theory (CBT), to help clients counter their somatic response to stress, anxiety, mood, grief and loss.

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