Mania A manic episode is defined as ≥ 1 week of a persistently elevated, expansive, or irritable mood and persistently increased goal-directed activity or a noticeable increase of energy plus ≥ 3 additional symptoms: Inflated self-esteem or grandiosity Decreased need for sleep Greater talkativeness than usual Flight of ideas or racing of thoughts Distractibility Increased goal-directed activity Excessive involvement in activities with high potential for painful consequences (eg, buying sprees, foolish business investments) Manic patients may be inexhaustibly, excessively, and impulsively involved in various pleasurable, high-risk activities (eg, gambling, dangerous sports, promiscuous sexual activity) without insight into possible harm.