Bipolar Disorder Symptoms Understanding Euthymia in Bipolar Disorder By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on September 19, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD LinkedIn Twitter Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print MoMo Productions/Getty Images Euthymia in bipolar disorder is a term used to describe a relatively stable mood state, where you are neither manic/hypomanic nor depressed. However, some dictionaries have offered variations of the definition which can be confusing when used in the context of a mental illness. To complicate matters even further, a significant number of people diagnosed with bipolar euthymia will show signs of depression or anxiety, casting into doubt as to what the term actually means. Varying Definitions The confusion in the definition of euthymia begins with the root word itself. In Greek, the prefix eu- means "good or well," while -thymia is derived from the Greek word "thymus," meaning "mind." This would suggest that a person in a euthymic state is in a good state of mind. Other dictionaries have expanded the definition to suggest a positive or even elevated mood state, not unlike that used to describe euphoria. When used in philosophy, in fact, euthymia describes a state of gladness, good mood, and serenity (in reference to one of the root goals of human existence). The same definition cannot be applied to medicine. When used in a clinical context, euthymia is not so much a good state as it is a neutral one in which you may neither be particularly happy nor sad. You may not even feel "good" per se but will at least be in a state where you are better able to function on a daily basis. With that being said, some people with euthymia will feel markedly improved. However, others will experience signs and symptoms suggestive of depression or anxiety. Euthymia and Anhedonia It is not uncommon to be diagnosed as euthymic and have symptoms of anhedonia, a mood state defined as the reduced ability to feel pleasure. Anhedonia may be experienced physically, wherein you get no pleasure from touching, eating, or sex, or socially, where you are disinterested in or unable to gain pleasure from social situations. Symptoms of anhedonia include: Withdrawing socially Putting on a "good face" for others Finding excuses not to see people you know Having negative feelings about yourself or others Expressing yourself less verbally or non-verbally Loss of sex drive (libido) A persistent feeling of physical unwellness Anhedonia is not depression per se but is rather a core symptom of depression and other mood disorders, including schizophrenia. Some people will describe anhedonia as "emotional flatlining." Unfortunately, there is no consensus as to the appropriate treatment of anhedonia or any drugs that specifically target anhedonia as a condition. With that being said, people with anhedonia often benefit from increased social support as well as the combined use of antidepressant drugs and psychotherapy. Wellbutrin (bupropion), an antidepressant used to treat bipolar depression, may be useful in improving libido. Euthymia and Anxiety Euthymia and anxiety can also co-occur in people with bipolar disorder. The type and severity of anxiety symptoms can vary from person to person and may be characterized by one or several of the following disorders: Agoraphobia Generalized anxiety disorder (GAD) Obsessive-compulsive disorder (OCD) Panic disorder Post-traumatic stress disorder (PTSD) Social anxiety disorder (SAD) The anxiety disorder may have been pre-existing alongside bipolar disorder, or it could something that developed after (or in response) to bipolar treatment The co-existence of euthymia and anxiety disorders is not all that uncommon. In fact, according to research from the Harvard Medical School and the Douglas Mental Health University Institute in Montreal, 34.7 percent of 2,102 people who met the diagnostic criteria for bipolar euthymia also met the diagnostic criteria for one or more anxiety disorders. As opposed to anhedonia, which has no established course of treatment, anxiety disorders would be treated after a diagnosis according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association. Cause It is unclear why some people with bipolar euthymia experience anhedonia, while others experience anxiety or no symptoms at all. In recent years, a number of psychologists have suggested that our very understanding of euthymia may be askew, wherein the absence of disease is often construed as having good mental health. This is especially true with regards to euthymia. A bipolar person in a euthymic state will often not be willing or able to alter their current mood state after the resolution of an acute manic or depressive episode. It may that he or she fears "tipping the boat" and has become less responsive to outside stimuli, either consciously or unconsciously. Whatever the cause, the resulting inflexibility can make it difficult to adapt to various situations or sensations. Without the ability to adapt, the person will be less able to experience pleasure and have a general tendency to experience negative emotions more frequently, intensely, and readily. As such, euthymia is not necessarily an indication that a treatment has "worked" but is rather the state by which the course of treatment may need to be monitored and adjusted. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Pavlova B, Perlis RH, Mantere O, et al. Prevalence of current anxiety disorders in people with bipolar disorder during euthymia: a meta-analysis. Psychol Med. 2017;47(6):1107-1115. doi:10.1017/S0033291716003135 Fava GA, Bech P. The concept of euthymia. Psychother Psychosom. 2016;85(1):1-5. doi:10.1159/000441244 Winer ES, Jordan DG, Collins AC. Conceptualizing anhedonias and implications for depression treatments. Psychol Res Behav Manag. 2019;12:325–335. doi:10.2147/PRBM.S159260 National Institutes of Mental Health. Anxiety disorders. Stange JP, Alloy LB, Fresco DM. Inflexibility as a vulnerability to depression: a systematic qualitative review. Clin Psychol (New York). 2017;24(3):245–276. doi:10.1111/cpsp.12201 Additional Reading Mann-wrobel MC, Carreno JT, Dickinson D. Meta-analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables. Bipolar Disord. 2011;13(4):334-42. doi:10.1111/j.1399-5618.2011.00935.x By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.