MANIA OR HYPOMANIA 191 E. The client no longer demonstrates a pattern of bizarre, persecutory delusions and has verbalized not feeling personally threatened. 5. Lack of Sleep (4) A. The client desc ribed a pattern of attaining far less sleep than would ordinarily be needed. B. The client has gone through periods of time when he/she did not sleep for 24 consecutive hours or more because his/her energy level was so high. C. As the client's mania has begun to diminish, he/she has begun to return to a more normal sleeping pattern. D. The client is getting six to eight hours of sleep per night. 6. Psychomotor Agitation (5) A. The client was restless and agitated within the session and reports an inabi lity to sit quietly and relax. B. The client's high energy level is reflected in increased motor activity, restlessness, and agitation. C. The client's motor activity has decreased, and the level of agitation has diminished. D. The client demonstrated n ormal motor activity and reports being able to stay calm and relaxed. 7. Loss of Inhibitions/Self-Damaging Activities (6) A. The client reported a behavior pattern that reflected a lack of normal inhibition and an increase in potentially self-damaging ac tivities. B. The client's impulsivity has been reflected in sexual acting out, poor financial decisions, and committing social offenses. C. The client has gained more control over his/her impulses and has returned to a normal level of inhibition and soci al propriety. 8. Expansive/Variable Mood (7) A. The client gave evidence of a very expansive mood that could easily turn to impatience and irritability if his/her behavior is blocked or confronted. B. The client related instances of feeling angry when o thers tried to control his/her expansive, grandiose ideas and mood. C. As the client's expansive mood has been controlled, his/her impatience and irritable anger have diminished. 9. Lack of Follow-Through (8) A. The client described a behavior pattern t hat portrayed a lack of follow-though on many projects, even though his/her energy level is high, since he/she lacks discipline and goal directiveness. B. The client's lack of follow-through has resulted in frustration on the part of others. C. The clien t has begun to exercise more discipline and goal directiveness in his/her behavior, resulting in the completion of projects. 10. Disregard for Social Mores (9) A. The client's behavior pattern confirmed his/her disregard for social mores within academic, social, or employment settings. 