Mania is a period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week or any duration if hospitalization is required. Symptoms of mania include: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, flight of ideas or racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for negative consequences. In order to meet criteria for mania typically a combination of at least 4-5 of these need to be present as well as impairments in functioning. Many of these symptoms also are present in the state of starvation and malnutrition therefore it is difficult to accurately assess as being a primary mood disorder while an individual is malnourished and/or underweight.

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