In mania, which symptom indicates relapse and requires clinical attention?

• A. Increased appetite.
• B. Loss of interest.
• C. Insomnia and irritability.
• D. Weight gain.

Answer: (C)

Relapse in mania is best signaled by rising arousal with sleep disruption. Insomnia shows that the person’s brain is not winding down despite increased activity, and irritability reflects heightened arousal and agitation. Together, these symptoms often indicate mood escalation toward mania and call for clinical attention to adjust treatment, evaluate safety, and address adherence or triggers. Increased appetite or weight gain and loss of interest are more typical of depressive phases or medication effects, not relapse to mania, so they don’t serve as the clear relapse cue.