A distinct period (usually lasting at least 1 week) of abnormally and persistently elevated, expansive, or irritable mood accompanied by symptoms such as inflated self-esteem or grandiosity, decreased need for sleep, overtalkativeness or pressured speech, flight of ideas or feeling that thoughts are racing, inattentiveness and distractibility, increased goal-directed activity (e.g., at work or school, socially, or sexually), and involvement in pleasurable activities with high potential for painful consequences (e.g., buying sprees, sexual indiscretions, foolish business ventures).