Feeling “normal” is not something that’s easy to describe with bipolar disorder. “What is normal?” is perhaps the most overused philosophical question, more a parody than actual soul searching. In BD, though, it is an important question. Bipolar disorder is a spectrum disorder. We swing between the two extremes of depression and euphoria (or dysphoria for some) so at some point we should hit the middle, the equilibrium, the normal. This point is what’s known as a “euthymic” state, but how normal is it really?
LaRae LaBouff lives in Maine with her husband and her dog. She’s an amateur photographer and enjoys traveling, reading, writing and roller derby.Due to personal experience with Bipolar Disorder, she delved into the literature and research of the human mind. She currently writes of her own life experiences both with Psych Central and on her personal site.
Editor: Saad Shaheed
I’m a nerd, so I’m going to go into the etymology of the word “euthymic” for a minute and then we can move on to what it means psychologically. It comes from the Greek “eu” meaning good or well and “thumos” meaning spirit or soul. Well soul. The phrase connotes much more than a point on a diagnostic pendulum or a word to be bandied about in statistics. Even if you are not religious or spiritual, most people have a sense of what constitutes their innermost being, what makes you who you are. So is that the part that is supposed to be well? If so, how does that relate to the brain?
I realize that I’m providing more questions than answers right now, but it’s important to find out what euthymia means to you. Bipolar disorder is a mood disorder and mood is pretty personal and subjective. Sure, we can be put into scanners and have our blood drawn and be probed with electrodes, and all of those things do provide some answers. Science helps us understand the physical aspects of the disorder to try and aid the more abstract features. This is how we get medication that helps us reach euthymia, but how does our doctor know which medications to prescribe and in what dosage? Well, for now, we have to tell them how we feel. It’s completely subjective.
At the same time, studies have been performed to determine characteristics of euthymic states. This is supposed to be when we’re without symptoms, when we get a break. However, most of the studies show that we’re still impacted by our disorder even then. Our cognitive function is still impaired. We can’t process memories as well as the general population (“normal” people). We have limited verbal processing and impaired ability to focus. If this is the case, why even bother calling it a “normal” state? Is that why we need a different term? Because we don’t ever actually get to be “normal”?
The sad fact is, we don’t. We can be at the point of equilibrium, but that’s actually the point where we have the most kinetic energy. We’re going to keep moving on the pendulum until something brings us back down, then it starts all over. Even when we’re not exhibiting our most extreme symptoms, our disorder still impacts our daily lives. The effects of a depressive or manic episode last long after the episode ends. The disorder impacts us physically, socially and intellectually even when we’re not at our worst. So far there is no way to stop the pendulum. The best way we can control it is through medication and therapy.
So why “euthymic”? Why do researchers and doctors have the audacity to say that our soul is well at any point during this awful, lifelong disorder? Well, it goes back to us. Since we’re the ones who subjectively decide our symptom severity, we get to decide when our souls are well.
My cycles are incredibly rapid. I rarely even notice a euthymic state until it’s passed. So, I have to make my own decisions on when I get to describe myself as “well.” I’ve basically decided it’s whenever I can feel at peace. I may be experiencing symptoms, and I most likely am, but finding peace is more under my control than relying on my underlying mood to do the job for me. It’s not about happiness or sadness. In fact, I’ve found that some of my most peaceful moments are during times of depression.
I don’t mean to imply that it’s a choice. You can choose to tryto feel a particular way, which I wholeheartedly encourage, but that doesn’t guarantee success. It does make it more likely, though. It’s worth a shot, right?
Having a term for the least-symptomatic time period is necessary. It provides a point on which to gauge further research, which we desperately need. The scientific community has decided on the word “euthymic” for this purpose.