Someone pm'd me about how to recognize mania in a small child. This post is a portion of what I replied to her and figured it might be good to post here. I did not come up with this acronym - I have seen it in several articles on Medscape.com. But it is a handy acronym to spot specific symptoms of mania, with my own explanations or examples of how they would manifest in children after the letter's meaning. I use the initials when I chart to see more specifically the actual symptom that my son was having (instead of just marking "high" or "low" mood). DIGFAST D - Distractibility (inability to focus, easily switches from one idea or task to the next - leaving work undone) I - Insomnia (more accurately, the reduced need for sleep or sleep disturbances in general) G - Grandiosity (can be delusional or out of touch with reality like insisting that he is the President or that he can fly a plane... or milder, like being extremely bossy or wanting to control everything, trying to tell the teacher how to teach, refusing to accept instruction from you and insisting he knows how to do things you know he can't... my son at 3 would tell the teacher she wasn't teaching properly (he could read at age 3) and would tell me that he could cook Thanksgiving dinner for our entire family all by himself.) F - Flight of Ideas (racing thoughts usually manifested by the child appearing confused or talking about multiple topics (often with wild or outrageous themes or ideas) in rapid succession - goes along very closely with pressured speech "S" and grandiosity "G") A - Activities become goal-oriented (seems to contradict "D" but also a sx of mania - obsessive activities with an end result in mind, like doing puzzles obsessively, building with legos, doing housework or homework... adults very typically display this sx by rearranging furniture or redecorating frequently) S - Speech becomes rapid or pressured (things coming from the mouth seem garbled or going really fast as if to try to keep up with the thoughts coming from the brain - often sounds like stuttering and the child seems frustrated if he is interrupted or can't complete a thought before another one intrudes) T - Thoughtlessness (includes poor decision making, risk taking and hypersexuality. In a young child, this might be trying to jump out of a moving car, climbing too high in a tree, trying to fly like superman from too high heights, masturbating, touching private parts of others and laughing or finding it funny, choosing to disobey known rules without thinking through the consequences, wanting to buy everything in sight or melting down over not being able to buy something in a store...) In children, ALL of these symptoms are almost always accompanied by irritability and frustration.