This period must last at least one week unless hospitalization is required. The disturbance must be sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization, or it is characterized by the presence of psychotic features. The elevated mood of a manic episode may be described as euphoric, unusually good, cheerful, or high, and is recognized as excessive by those who know the person well. Individuals may give advice on matters about which they have no special knowledge. Despite the lack of any particular experience or talent, the individual may embark on writing a novel or composing a symphony.
Grandiose delusions are often common.
Manic speech is typically pressured, loud, rapid, and difficult to interpret. Individuals may talk for hours on end. If the person's mood is more irritable than expansive, speech may be marked by complaints, hostile comments, or angry tirades. Expansiveness, unwarranted optimism, grandiosity, and poor judgment often lead to an imprudent involvement in pleasurable activities such as buying sprees, reckless driving, foolish business investments, and sexual behavior that is unusual for the person. The individual may also dress in a different manner.