Delusions are false but firmly held beliefs that can occur in people struggling with personality, mood, or psychotic disorders, as well as in the general population.1,2 Delusions of grandeur describe false or exaggerated beliefs about one’s own importance, purpose, abilities, or identity.3,4 When delusions are related to an underlying disorder, they may respond to treatments like therapy, medication, or a combination of the two.4,5
What Are Delusions of Grandeur?
Delusions are faulty or inaccurate beliefs that are held with strong conviction, even when these beliefs are challenged by others or when there is evidence to disprove them.1 Delusions of grandeur are one type of delusion seen in people who inflate their own importance, power, or abilities.3
“We don’t really understand the causes of delusions in general, though it’s quite likely that brain function, personal psychology, and social circumstances all play a role,” says Dr. Ian Jeffrey Gold, professor of philosophy at McGill University, who specializes in the philosophy of neuroscience and psychiatry. “There are about a dozen types of delusion that are seen across cultures, and delusions of grandeur (sometimes called grandiose delusions) are one such type. In general, grandiose delusions are beliefs to the effect that one is a very special or important person, or that one has special knowledge or powers. The particular belief that someone has, of course, will depend on their particular history and personality, as well as their culture.”
People with grandiose delusions often see themselves as being special, important, chosen, or destined for greatness.4 People with grandiose delusions often suffer from an underlying condition like bipolar, addiction, or schizophrenia, and experience delusions as a result of these conditions.4,6 People with narcissistic personality disorder may also have delusions of grandeur, which include feeling superior to others, arrogance, and hypersensitivity to criticism.7
Types of Delusions of Grandeur
Every type of delusion of grandeur all involves false or inflated beliefs about oneself, but can present in different ways. Some can be more difficult to detect than others. Paranoid delusions about being persecuted or harmed and self-important delusions of being special, important or having unique abilities are among the most common.1,2
Here are some examples of different types of grandiose delusions people can have:1,2,4,8
- Special powers or abilities: People may believe they have magic or psychic abilities, olympic-level athletic skills, or that they’re incredibly intelligent
- Religious delusions: People with a mix of grandiose and religious delusions may believe they are “chosen” by god, can communicate with god, or even that they are a reincarnation of god
- Superiority to others: Grandiose delusions often involve feeling superior in some way to other people, including being intellectually superior, morally superior, or being better at a specific skill than other people
- Invincibility: Grandiosity can sometimes cause people to believe they are invincible and cannot be harmed, injured, or killed, which may lead them to act in reckless ways
- Social status: Some people with grandiose delusions may believe they belong to a higher social status, are a celebrity, or may be preoccupied with fantasies of wealth, power or fame
- Special purpose or mission: Many people with delusions of grandeur believe they have a special purpose, “calling” or life mission that they need to complete, and may become obsessed with this idea
Symptoms of Delusional Thinking
Approximately 10% of the general population has delusions, but the majority of people who report delusional thinking suffer from a mental health, neurological, or substance use disorder.1,3,6 These conditions often directly contribute to delusional thoughts, and may involve other changes in a person’s mood, behavior, and ability to function.8,9
Some of the symptoms of delusional thinking are:1,6,8,9
- Strongly held beliefs that are false, unlikely, or irrational
- Unwillingness to consider evidence the belief is untrue
- Anger, defensiveness or hypersensitivity when the belief is challenged
- The belief is central and takes up a lot of time, energy, and attention
- The belief causes negative effects on a person’s mood or behavior
- The person behaves as if the belief is true, even acting in bizarre or impulsive ways
- There is a strong personal or emotional attachment to the belief
- Information is only selectively processed to confirm the belief
It’s important to note that not all irrational, strongly held beliefs are delusional, even when they seem strange to others. A person’s culture, religion, and lived experiences can all influence their beliefs and the way they process and perceive information.1,2
Causes of Delusions of Grandeur
Delusions have several different neurological, psychological, sociocultural, and environmental causes. In many cases, people who struggle with delusional thoughts also have another mental health, neurological, or substance use disorder that makes them more susceptible to faulty thinking.1,4
Other factors that may play a causal role in delusional thinking include:1,2,3,4,6
- Traumatic experiences or stressful life events and transitions
- Neurological conditions like Parkinson’s disease or dementia
- Imbalances in essential brain chemicals like dopamine
- Social and environmental stressors like isolation, poverty, and immigration
- Genetic predispositions to mental illness, especially mood or psychotic disorders
- The effects of a prescribed or illicit substance
- Certain personality traits including a tendency towards paranoid thinking
- Problems with executive functioning, memory, or cognitive skills
- Increased sensitivity to threats (like in people with PTSD or anxiety disorders)
Additionally, people who have delusions of grandeur often have another mental illness or substance use disorder that can partially explain their distorted thoughts. Different disorders can change the content of delusional thoughts as well as influencing when and how they present.
Mental health disorders that can cause delusions of grandeur include:4,6,9
Substance Use Disorders
The effects of drugs like alcohol, cocaine, or other stimulants can cause boosted mood, energy, and confidence, as well as delusional thinking. For example, a person may believe that they have special powers or may even feel invincible when under the influence of a drug, which may cause them to make dangerous or reckless decisions.
In cases when the person only has delusions when intoxicated, grandiose delusions are often a direct effect of the drug.
Bipolar Disorder
Approximately two thirds of people with bipolar disorder have delusions of grandeur, usually during manic episodes. During manic episodes, they experience a boost in their mood, energy, and confidence levels, and also may not be able to sleep for days at a time. This can make them more prone to delusional thinking, but these delusions will tend to subside during depressive episodes.
Schizophrenia
About half of people with schizophrenia report delusions of grandeur, which often also include visual or auditory hallucinations. During a psychotic episode, they may hear voices in their head, or come to believe that they have psychic powers to communicate with others telepathically.
When delusions of grandeur occur in people with schizophrenia, they usually do not correspond to changes in mood. In fact, people with schizophrenia are much more likely to have a ‘flat’ affect or seem emotionally stunted.
Delusional Disorder
People with delusional disorder do not have any depressive or manic symptoms, are not showing signs of schizophrenia, and are not under the influence of drugs, but still report delusions. Typically, they are able to think and reason clearly on other topics, but may hold a firm, irrational belief that they are ‘chosen’, special, or unique in some way.
For example, they may believe they are part alien, or that they have the ability to recall past lives or access special knowledge from other dimensions.
Narcissistic Personality Disorder
People with narcissistic personality disorder often hold an unrealistically high opinion of themselves, believe they are superior to other people, and act in ways that are entitled or arrogant. Their delusions of grandeur may seem more “realistic” than other delusions, but still do not accurately reflect their skills, abilities, or achievements.
Narcissistic individuals are more vulnerable to criticism or slights than other people with grandiose delusions, and may be more likely to become angry, defensive or hostile when offended.
Traumatic Brain Injury or Neurological Disorders
People who have a brain injury or suffer from a neurological disorder like Parkinsons or dementia may develop delusions. It’s also common for them to experience changes in their mood and behavior along with delusional thoughts about themselves, the world, and other people.
A delusion of grandeur in this case is often the result of being confused about who they are, or mixing up details of their own life with movies they’ve seen or stories they’ve heard.
Trauma or Stress-Related Delusions
In some instances, people who have experienced traumatic events or who are under a lot of stress may develop psychosis. In many cases, the delusions, hallucinations, and other psychotic symptoms will resolve on their own.
These may include grandiose thoughts that God is trying to communicate with them, punish them, or teach them something, or other delusions that are an attempt to make sense of what happened to them.
Understanding Delusions of Grandeur
Some researchers believe that delusions of grandeur play an important emotional function. People who experience traumatic events in childhood seem to be more at risk for delusions of grandeur, and may have developed an inflated view of themselves as a defense mechanism.1
While many trauma survivors blame themselves for what happened, a person who has delusions of grandeur might not do so, and may even be able to develop an alternate reality for themselves. Believing that they are important, unique, and special provides emotional validation to a person in a relationship or environment where they could not get this from others, while also providing emotional benefits and protecting their self-esteem.1,2,4
This aligns with research that found that people who describe grandiose delusions also describe their delusions as being highly meaningful, significant, and important to them.4 This would also explain why they become so defensive when this self-concept is challenged or criticized by others.
Treatment for Delusions of Grandeur
Delusional thinking can be difficult to treat, especially because people who suffer from delusions tend to hold their beliefs with strong conviction when challenged. When delusions are the result of an underlying mental health, neurological, or substance use disorder, treating the root disorder will often help to reduce the delusions.4,5
Most of the time, treatment involves therapy, or a combination of therapy and medication. Supportive therapy and cognitive behavioral therapy (CBT) have been effective for some people with delusions. The most common underlying conditions for people with delusions are schizophrenia or mood disorders like bipolar or depression. Individuals with these conditions may also benefit from SSRI antidepressants as well as certain antipsychotic drugs.4,5
How Can You Support Someone With Delusions of Grandeur?
If someone you care about is struggling with delusions, it’s important to encourage them to seek treatment. The first step is often to get an assessment from a licensed therapist, counselor, or psychologist to confirm a diagnosis.
Dr. Gold encourages, “The most useful way to help someone with delusions of any kind is to encourage them to get help by talking to a health professional and, ultimately, a psychiatrist. Be supportive; tell them that you think they are in distress and that you want them to feel better. Delusions can often be treated quite effectively by a combination of medication and psychotherapy.”
People with serious delusions or who are considered a danger to themselves or others may be recommended for more intensive treatment in an inpatient hospital or intensive outpatient program. If you are concerned that a loved one is at risk of harming themselves or other people because of their delusions and they are unwilling to get help, it may be necessary to consider getting them committed involuntarily. You can find out more about this process here.
It’s important to remember that people who have delusions often will not respond well when you challenge one of their delusional beliefs. Gold mentions, “People who are delusional are very resistant to giving up their beliefs, so challenging or arguing with them tends to be unhelpful. Focus on the fact that you are concerned about their well-being and want to help. Be aware, however, that it is sometimes not possible to change someone’s mind about the need for treatment. Perhaps the cruellest part of having a delusion is that it blinds you to the fact that you are unwell.”
Final Thoughts
People who have delusions of grandeur believe they are more powerful, important, or hold special talents and abilities. Instead of having an accurate idea of their strengths and weaknesses, their view of themselves is inflated, irrational, and not aligned with reality.3,4 This can lead to problems in their relationships, work, and daily functioning, and may also lead to poor or reckless decision making.2,3 Most people with delusions have an underlying psychological or neurological condition which may be treatable with therapy, medication, or a combination of the two.4,5
