Excitement

 Excitement   Motor excitement   It is characterized by the playful dimension (game): the maniac is unstable, cannot sit still, he can   move objects, go from one place to another practically non-stop.   The physical resistance is often surprising, given the intensity of the efforts made and the energy   expended (it seems tireless, inexhaustible)   This excessive activity can lead him to excesses and push him into dangerous, noisy or scandalous activities.   Instinctual excitement   Behaviors of sexual disinhibition can be generative   Sometimesexhibitionism, forensic acts such as contempt or indecent assault.   Severe insomnia is seen without feeling tired. Hunger and thirst are increased but without   weight gain.   Diagnostic Criteria (according to DSM 5) of a manic episode:   A  clearly  defined  period  of  abnormally  and  persistently  elevated  mood  or  expansive  or  irritable  mood   and  associated  with  an  increase  in  goal-directed  activity  or  an  abnormal  and  persistent  level  of  energy   present   most   of   the   time   every   day   for   at   least   a   week   or   any   other   duration   if   hospitalization   is   necessary   During   this   period   of   mood   disturbance   and   increased   activity   or   energy   at   least   3   of   the   following   symptoms (4 if the mood is only irritable).   are present to a significant degree and represent a change from usual behavior:   1.   Increased self-esteem or ideas of grandeur   2.   Reduced need for sleep (e.g., subject feels rested after only 3 hours of sleep)   3.   Greater communicability than usual or desire to talk constantly   4.   Flight of ideas or subjective sensation that ideas are passing by   5.   Distractibility   (e.g.,   attention   is   too   easily   attracted   by   unimportant   or  insignificant  external   stimuli) observed or reported   6.   Increased   goal-directed   activity   (social,   professional,   academic   or   sexual)   or   psychomotor   agitation.   7.   Excessive  engagement  in  activities  that  are  pleasurable  but  have  a  high  potential  for  harmful   consequences  (e.g.,  the  person  engages  without  restraint  in  reckless  purchases,  inconsequential  sexual   behavior, or unreasonable business investments) 

 are present to a significant degree and represent a change from usual behavior:   8.   Increased self-esteem or ideas of grandeur   9.   Reduced need for sleep (e.g., subject feels rested after only 3 hours of sleep)   10.   Greater communicability than usual or desire to talk constantly   11.   Flight of ideas or subjective sensation that ideas are passing by   12.   Distractibility   (e.g.,   attention   is   too   easily   attracted   by   unimportant   or  insignificant  external   stimuli) observed or reported   13.   Increased   goal-directed   activity   (social,   professional,   academic   or   sexual)   or   psychomotor   agitation   14.   Excessive  engagement  in  activities  that  are  pleasurable  but  have  a  high  potential  for  harmful   consequences  (e.g.,  the  person  engages  without  restraint  in  reckless  purchases,  inconsequential  sexual   behavior, or unreasonable business investments)   (B)   The   mood   disturbance   is   sufficiently   severe   to   cause   marked   impairment   in   occupational  functioning,  social  activities  or  interpersonal  relationships,  or  to  require  hospitalization   to prevent harmful consequences for the subject or others, or there are psychotic features.   (C)   Symptoms   are   not   due   to   the   direct   physiological   effects   of   a   substance   (e.g.,   substance   of   abuse, medication, or other treatment) or a general medical condition   NB:  A  manic  turn  induced  by  antidepressant  treatment  (drug  or  electroconvulsive  therapy)  and  which   persists  at  a  symptomatic  level  exceeding  the  physiological  effect  of  this  treatment  is  sufficient  proof   of a manic episode and therefore of the diagnosis of bipolar I disorder.