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Mania, or a manic episode, is defined by the American Psychiatric Association (APA) as a period of at least one week of elevated, euphoric, irritable, or expansive mood, accompanied by at least 3 of the following:

• Inflated self-esteem or grandiosity
• Increased energy levels
• Decreased need for sleep
• Increased talkativeness or pressured speech
• Racing thoughts or flight of ideas
• Distractibility
• Increased activity or psychomotor agitation
• Excessive involvement in pleasurable activities that have high potential for painful consequences

In addition, to meet the criteria of a manic episode, the mood disturbance must cause a significant impairment of occupational and social functioning as well as either:

• Necessitate hospitalization for the safety of the patient or people close to the patient
• Include psychotic features of delusions or hallucinations.

The symptoms cannot be related to other any medical condition or be the result of medication side effects or substance abuse.

Depression, or a depressive episode is defined by the APA as at least a two-week period with depression or irritable mood, diminished interest, loss of pleasure in most activities, or a change from previous functioning, plus at least 4 of the following:

• Feelings of worthlessness or inappropriate guilt (may be accompanied by delusions)
• Sleep disturbance (increased or decreased amount)
• Fatigue or loss of energy
• Decreased concentration or indecisiveness
• Significant weight loss without dieting, weight gain, or change in appetite
• Psychomotor agitation that is noticeable by other people
• Suicidal ideation or thoughts of death in general

In addition, in order to meet the criteria of a depressive episode, the symptoms must cause significant impairment of social and occupational functioning, must not be related to any other medical condition, must not be due to side-effects of medication or substance abuse, and must not be accounted for by bereavement.

Hypomania, as defined by the APA, is similar to mania in that it involves an elevated, expansive, or irritable mood, but differs in being generally of a shorter duration with a minimum of four days.

Like mania, hypomania must be accompanied by at least three of the following symptoms:

• Inflated self esteem
• Decreased need for sleep
• More talkative than usual
• Racing thoughts
• Distraction by unimportant or irrelevant stimuli
• Increased agitation or activity
• Excessive involvement in pleasurable activities that have a high potential for harm to the patient or to others

In addition, to meet the criteria of hypomania:

• There must be a change in functioning observable by others
• The episode must not be severe enough to require hospitalization
• The episode must not cause marked impairment in social or occupational functioning
• There must not be evidence of psychosis
• The episode must not be related to any other medical condition, or be the result of medication side effects or substance abuse.

Hypomania can be deceptive since patients may be experiencing an elevated mood, making them feel as though they are functioning well and are being more productive than usual. But this feeling can usually not be sustained and may either escalate into a full-blown mania or deteriorate into depression.