pathological mental process hypomanic episode This period of abnormal mood must be accompanied by at least three additional symptoms from a list that includes inflated self-esteem or grandiosity (nondelusional), decreased need for sleep, pressure of speech, flight of Ideas, distractibility, increased involvement in goal-directed activities or psychomotor agitation, and excessive involvement in pleasurable activities that have a high potential for painful consequences. DSM-IV-TR (american Psychiatric Association) Is defined as a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood that last at least 4 days.