a manic episode is defined by a distinct period of persistently elevated, expansive, or irritable mood lasting at least one week (or less if hospitalization is required). The mood is also accompanied by additional symptoms, such as inflated self-esteem or grandiosity, a decreased need for sleep, pressured speech, flight of ideas, distractibility, increased involvement in goal-directed activities or psychomotor agitation, and excessive involvement in pleasurable and high-risk activities.