Manic Episode or Bipolar Disorder: This condition is characterized by abnormally elevated or irritable mood, which can manifest as extremely high energy levels. The chronic nature of the symptoms suggests a possible underlying psychiatric condition.

Attention Deficit Hyperactivity Disorder (ADHD): ADHD is a neurodevelopmental disorder that can cause excessive restlessness, fidgeting, and an inability to stay still, which may be perceived as extremely high energy levels.
Hyperthyroidism: An overactive thyroid gland can lead to increased energy levels, among other symptoms like weight loss, palpitations, and heat intolerance.
Sleep Disorder (e.g., Sleep Apnea, Insomnia): In some cases, sleep disorders can lead to increased energy levels during the day as the body tries to compensate for lack of quality sleep.

Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of high blood pressure, rapid heartbeat, and excessive energy due to the excessive release of catecholamines (e.g., adrenaline).
Catecholamine-Producing Tumors (e.g., Paraganglioma): Similar to pheochromocytoma, these tumors can lead to excessive production of catecholamines, resulting in high energy levels among other symptoms.
Medication Side Effects (e.g., Stimulants, SSRIs): Certain medications can cause increased energy as a side effect. It's crucial to review the patient's medication list to identify any potential culprits.

McArdle Disease (Glycogen Storage Disease Type V): A genetic disorder that affects the body's ability to metabolize glycogen, leading to increased energy levels due to the body's reliance on alternative energy sources.
Familial Hypokalemic Periodic Paralysis: A rare genetic disorder that can cause episodes of muscle weakness and, in some cases, increased energy levels between episodes.
Chronic Amphetamine or Cocaine Use: Long-term use of these substances can lead to chronic elevated energy levels, although this would typically be accompanied by other signs of substance abuse.