sleeping (hypersomn ia) may experience prolonged sleep episodes at night or increased
daytime sleep. Sometimes the reason that the individual seeks trea tment is for the dis-
turbed sleep.
Psychomotor changes include agitation (e.g., the inabili ty to sit still, pacing, hand-
wringing; or pulling or rubbing of the skin, cl othing, or other objects)  or retardation (e.g.,
slowed speech, thinking, and body movements; increased pauses before answering;
speech that is decreased in vo lume, inflection, amount, or variety of content, or muteness)
(Criterion A5). The psychomotor agitation or retardation must be severe enough to be ob-
servable by others and not repres ent merely subjective feelings.
Decreased energy, tiredness, and fatigue are common (Criterion A6). A person may re-
port sustained fatigue without physical exertion . Even the smallest ta sks seem to require