Delusions of Grandeur: Definition, Types, & Treatments

What Are Delusions of Grandeur?

Delusions of grandeur are false beliefs about importance, power, or abilities.¹ Individuals experiencing ideas of grandeur see themselves as special, chosen, or destined for greatness.² Delusions often occur with various disorders, like bipolar, addiction, or schizophrenia.^2,3

“There are about a dozen types of delusion seen across cultures, and delusions of grandeur (sometimes called grandiose delusions) are one such type,” says Dr. Ian Jeffrey Gold, professor of philosophy at McGill University and specialist in the philosophy of neuroscience and psychiatry. “In general, grandiose delusions are beliefs that one is a very special or important person or 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.”

Types of Delusions of Grandeur

Every type of delusion of grandeur involves false or inflated beliefs about oneself. However, illusions of grandeur can present in different ways. Some manifestations can be more difficult to detect than others.

Types of grandiose delusions include:^3,4,5,6

• Special powers or abilities: People experiencing feelings of grandeur may believe they have magic or psychic abilities, Olympic-level athletic skills, or extremely high intelligence.
• Religious delusions: People with a mix of grandiose and religious delusions may believe they are “chosen” by, can communicate with, or are a reincarnation of God.
• Superiority to others: Grandiose delusions often involve feeling better than others, including being intellectually, morally, or physically superior.
• Invincibility: Grandiosity can sometimes cause people to believe they are invincible. They may think others cannot harm, injure, or kill them, which may lead to reckless behavior.
• Social status: Some people with grandiose delusions may believe they belong to a higher social status. They may think they are celebrities or become preoccupied with fantasies of wealth, power, or fame.
• Special purpose or mission: Many people with delusions of grandeur believe they have a “calling” or life mission they must complete. They may become obsessed with this idea.

Symptoms of Grandiose Delusions

Grandiose delusions can vary depending on the person, cultural factors, religion, and lived experiences.^4,5 However, a shared symptom associated with grandiose thinking includes false beliefs of superiority. These ideas can contribute to various complications and negatively affect mood, behavior, and ability to function.^6,7

Symptoms associated with grandiose delusions include:^3,4,6,7

• Unwillingness to consider evidence against their false beliefs
• Anger, defensiveness, or hypersensitivity when questioned
• Grandiose beliefs take up a lot of time, energy, and attention
• False beliefs cause negative effects on mood or behavior
• Behaving as if the belief is true, even acting in bizarre or impulsive ways
• A strong personal or emotional attachment to the belief
• Information is only selectively processed to confirm the belief
• 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 of grandeur 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.^2,4

Dr. Gold adds, “”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,”

Possible causes and risk factors for delusions of grandeur include:^1,3,4,5,8

• Traumatic experiences, stressful life events, or life 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
• Effects of a prescribed or illicit substance
• Certain personality traits, including a tendency toward paranoid thinking
• Problems with executive functioning, memory, or cognitive skills
• Increased sensitivity to threats

Delusions of Grandeur & Associated Conditions

People with delusions of grandeur often have another mental illness or substance use disorder that can partially explain their distorted thoughts. Different symptoms can change the content of delusions and influence when and how they present.

Mental health disorders associated with delusions of grandeur include:^2,3,7

Substance Use Disorders

The effects of alcohol, cocaine, stimulants, and other substances can cause boosted mood, energy, confidence, and delusional thinking. For example, a person may believe they have special powers or feel invincible when under the influence of a drug. These grandiose ideations may cause them to make dangerous or reckless decisions.

Bipolar Disorder

Bipolar delusions of grandeur often occur during manic episodes. Boosted mood, energy, and confidence levels coupled with decreased sleep can make individuals more prone to delusional thinking. However, these delusions tend to subside during depressive episodes.

Schizophrenia

About half of those with schizophrenia report delusions of grandeur, often alongside visual or auditory hallucinations. Grandiose delusions in schizophrenia may include beliefs of possessing psychic powers or telepathy.

Delusional Disorder

Grandiose delusions associated with delusional disorder do not stem from depressive or manic episodes, schizophrenic symptoms, or drug use. Typically, these individuals can think clearly and rationally but may hold a firm, irrational belief that they are special or unique in some way. For example, grandiose thoughts may manifest as someone believing they are an alien or can 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 others, and act entitled or arrogant. Their grandiose behavior may seem more “realistic” but does not accurately reflect their skills, abilities, or achievements.

Narcissistic individuals are more vulnerable to criticism or slights, making them more likely to become angry, defensive, or hostile when offended.

Traumatic Brain Injury or Neurological Disorders

People with a brain injury or neurological disorder, like Parkinson’s or dementia, may develop delusions of grandeur. In this case, grandiose thoughts often result from being confused about identity. Some individuals may mix up details about their own lives with movies or stories.

Trauma or Stress-Related Delusions

In some instances, people who have experienced traumatic events or chronic stress may develop psychosis. Some may believe God is communicating with, punishing, or teaching them something. Other delusions may be attempts to make sense of their trauma.

Delusions of Grandeur & Trauma

Some researchers believe 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.⁴

While some trauma survivors blame themselves for what happened, a person with delusions of grandeur may even develop an alternate reality for themselves. Believing they are important, unique, and special provides emotional validation and protects their self-esteem.^1,2,5

One study found people who report grandiose delusions also describe their fantasies as being highly meaningful, significant, and important to them.² 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 challenging to treat, especially when people become aggressive if challenged. Treating the root cause will often help reduce delusions of grandeur. Therapy, medication, or a combination can be beneficial.^2,8

“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 you are concerned about their well-being and want to help,” says Dr. Gold. “Be aware, however, that it is sometimes not possible to change someone’s mind about the need for treatment. Perhaps the cruelest part of having a delusion is that it blinds you to the fact that you are unwell.”

Supportive or cognitive behavioral therapy (CBT) can be especially effective, and individuals struggling with schizophrenia or mood disorders may also benefit from SSRIs* or certain antipsychotic drugs.^2,8 Choosing a therapist, counselor, or psychologist is essential for positive outcomes, and you can start your search on an online therapist directory. You do not have to cope on your own–help is available.

*This medication has a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

How to Respond to Delusions of Grandeur

Encourage your loved one to seek treatment if they struggle with delusions of grandeur. 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 you think they are in distress and want them to feel better. Delusions can often be treated quite effectively by a combination of medication and psychotherapy.”

Final Thoughts

People with delusions of grandeur believe they are more powerful or hold special talents and abilities. These ideations can lead to problems in their relationships, work, and daily functioning. Most people with delusions have an underlying psychological or neurological condition that may be treatable with therapy, medication, or a combination of the two.