• A. A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture.

AND

• B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.

AND

• C. The disturbance is not better explained by another mental disorder.

AND

• D. The disturbance does not occur exclusively during the course of a delirium.

AND

• E. The disturbance causes clinically significant distress or impairment in social, occupational,or other important areas of functioning, or necessitates hospitalization to prevent harm to self or others, or there are psychotic features.