mania

Meaning: Mania is a mood episode of abnormally elevated, expansive, or irritable mood with increased energy or activity, lasting about a week or more (or any length if hospitalization is needed). Typical features are decreased need for sleep, grandiosity, pressured speech, racing thoughts, distractibility, and impulsive risky behavior such as spending sprees. Severe episodes can include psychotic features such as delusions.

On the MCAT: A passage describes days of little sleep, inflated self-confidence, and rapid speech, and asks for the diagnosis. A manic episode indicates bipolar I disorder; depressive episodes are common but not required for that diagnosis. Bipolar II requires hypomania plus a major depressive episode. Questions may contrast these with major depressive disorder, which involves depressive episodes without mania or hypomania.

Common confusion: Hypomania is not just brief mania. It is milder, lasts at least four days, and does not cause marked impairment; if psychosis or hospitalization is present, the episode counts as manic. Also, mania is a mood-disorder feature, not schizophrenia, even when delusions appear, because the disturbance centers on mood and energy rather than a chronic loss of contact with reality.