A. At least one week of abnormally and persistently elevated, expansive or irritable mood (may be less than one week if hospitalization is required).
B. During the period of mood disturbance at least three of the following have persisted in a significant manner (four if mood is irritable):
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. The patient has been more talkative than usual or feels pressure to keep talking.
4. Flight of ideas (jumping from topic to topic) or a subjective sense of racing thoughts.
6. Increased goal-directed activity or psychomotor agitation.
7. Excessive involvement in pleasurable activities with a high potential for painful consequences (ie, sexual indiscretion)
D. Symptoms must have cause marked impairment in social or occupational functioning, or have required hospitalization to prevent harm to self or others, or psychotic features are present.
E. The symptoms cannot be caused by a medical condition, medication or drugs.
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