Criteria for mania in children have been established on the basis of criteria for mania in adults. Mania in children is an episodic disorder characterized by marked irritability and agitation, a considerable increase in activity level, push of speech, sleep disturbances, distractability, and noticeable mood instability that persists for longer than one month. Euphoria is frequently present in children with mania and is manifested as an adamant denial of any illness or problem. Previous reports have not stressed the characteristic appearance of depressive symptoms, such as hopelessness and helplessness, crying spells, death wishes, and beliefs of persecution, all of which can occur during the manic episode in children.