3+ of the following: inflated self-esteem, decreased need for sleep, more talkative.

• A. Inflated self-esteem
• B. Decreased need for sleep
• C. More talkative
• D. All of the above

Answer: (D)

In mania and hypomania, there are several symptoms that cluster together as evidence of abnormally elevated energy and mood. The three items listed are all recognized signs: inflated self-esteem reflects grandiosity, decreased need for sleep shows a shift in energy requiring less rest, and being more talkative indicates pressured or rapid speech. When three or more of these symptoms occur, they meet the criterion for a manic or hypomanic episode. Since all three symptoms are present, the correct choice is the option that includes all of them.