In mania the mood is elevated to a level out of keeping with the patient's circumstances/character. Symptoms include grandiose ideas and over confidence, loss of social inhibitions, increased energy resulting in over activity, pressure of speech, decreased need for sleep, short attention span and marked distractibility.

Psychotic symptoms can additionally be present, for example delusions (usually grandiose), hallucinations (usually voices speaking directly to the patient), excitement, excessive pacing or running around and moving from one idea to the next (flight of ideas). 

A diagnosis of mania is made when symptoms last for seven days or more. Hospital admission or intensive community management is always considered in such cases. 

Mania-like symptoms can be the result of using stimulant drugs, such as cocaine, khat, ecstasy or amphetamine, so it is important to clarify if any agent has been taken. Medications such as corticosteroids (especially in high doses), levodopa and prescribed stimulants (e.g. methylphenidate) can also cause manic-like symptoms.