Delusions of grandeur are false beliefs held by an individual in which they believe with full conviction that they are a celebrity, person of high rank, omnipotent, and/or a powerful entity – despite significant evidence to the contrary. Imagine waking up one day thinking that you’re the president of the United States, despite the fact that you’re homeless and living on the streets. This would be an example of a grandiose delusion – your perceived sense of importance becomes inflated for no legitimate reason.
The grandiose delusions are often associated with fictional, religious, or supernatural themes. A person suffering from delusions of grandeur may believe that they deserve public recognition as the human incarnation of Jesus Christ. Individuals afflicted with these types of delusions often have diagnosable psychiatric conditions such as: bipolar disorder, delusional disorder, or schizophrenia.
What are delusions of grandeur? Definition.
Below is a technical breakdown of the terms “delusion,” “grandeur” and the phrase “delusions of grandeur.” By defining each term separately from the phrase, it may help some people realize that grandeur is not always associated with delusions.
Delusion: This is a term used to describe a false belief that is held with full conviction, despite significant contradictory evidence. In other words, it is a belief held despite irrefutable logical, rational, and/or scientific evidence in opposition to a particular belief.
Grandeur: This is a term that signifies being impressive, awesome, or magnificent. A professional athlete may be described as “grandiose” in regards to being of significant talent. In reference to a professional athlete, highly-skilled person, celebrity, or president – the associated grandeur is not delusional.
Delusions of grandeur: This is phrase that is utilized to describe a specific delusion (“false belief despite significant contradictory evidence”) in which a person believes they are grandiose (“impressive, high ranking, or superior to others”).
What causes delusions of grandeur?
It is difficult to pinpoint a specific cause for delusions of grandeur. There is significant evidence associated with brain lesions, specifically to the frontal lobe and grandiose delusions. That said, a variety of other factors may play a role including: drug use, genetics, medical conditions, neurotransmitter concentrations, and receptor density.
Brain anatomy: Delusions may be a result of anatomical abnormalities in the brain. Research has suggested that the amygdala, fronto-striatal circuits, and parietal cortices are most likely to play a role in the development of delusions. Anatomical abnormalities can lead to processing errors in these regions, which can perception and make an individual more prone to delusions.
Brain injuries: Those that have endured a brain injury or multiple brain injuries may be more prone to delusions. Although injuries to any area of the brain may increase delusional susceptibility, the frontal lobes are most commonly linked to delusions of grandeur.
- Frontal lobes: Individuals that have lesions in the frontal lobes are known to be increasingly susceptible to delusions of grandeur.
- Temporal lobes: Those with lesions of the temporal lobes may be more likely to experience delusions of grandeur.
Drugs: Those that have used or abused drugs may experience delusions of grandeur as a side effect. This is particularly common in cases of drug-induced psychosis. Those that experience delusions of grandeur upon ingestion of drugs often have taken a stimulatory agent that affects dopamine. The drastic increase of dopamine may provoke a stimulant-psychosis characterized by elevated mood and grandiose delusions.
It should also be mentioned that some individuals may be susceptible to experiencing grandiose delusions during drug withdrawal. An example of a drug that is known to induce mania is that of levodopa (L-Dopa), a medication utilized among those with Parkinson’s to treat cognitive impairment. Most drugs that cause delusions of grandeur tend to simultaneously induce a manic or hypomanic state.
Encephalitis: Those experiencing Japanese encephalitis, a condition characterized by brain inflammation, have been reported as exhibiting delusions of grandeur. These delusions were accompanied by other symptoms including: euphoria, assaultive behaviors, and sometimes seizures. It is possible that other cases of encephalitis may also result in delusions of grandeur.
Genetics: It has been suggested that certain genetic polymorphisms may result in delusions of grandeur. In particular, researchers believe that polymorphisms of genes related to dopamine receptors are the culprit. Some studies point out that paranoid schizophrenia and delusional disorders may stem from HLA (human leukocyte antigen) genes, which could influence grandiose delusions.
Hemispheric activation: In early studies of individuals with delusions, it was believed that the delusions were caused by overactivation or underactivation of a particular hemisphere. First, researchers speculated that right hemisphere impairment was the predominant cause of delusions. Upon further analysis, it appears that the actual cause of delusions stems from excessive activity in the left hemisphere.
Neurotransmitter concentrations: Those with abnormally high concentrations of certain neurotransmitters may result in delusions of grandeur. It is believed that high dopamine levels are responsible for causing delusions, especially among individuals with schizophrenia. For this reason, professionals administer atypical antipsychotics which act as dopamine antagonists.
Receptor density: The densities of receptors for neurotransmitters may play a role in facilitating delusional states. One theory is that certain regions of the brain lack adequate dopaminergic receptors, thus leading to an overabundance of dopamine and causing delusions and/or hallucinations. Those with reductions in receptor density, particularly of dopamine may be increasingly susceptible to delusions of grandeur.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/20198522
- Source: http://www.ncbi.nlm.nih.gov/pubmed/16786814
- Source: http://www.springer.com/us/book/9781493910700
Do delusions of grandeur serve a functional purpose?
Some believe that delusions of grandeur may serve a functional purpose such as helping a person cope with severely damaged self-esteem and/or depressive feelings. In most cases of grandiose delusions, an individual is not suicidal, thus it should be speculated that the delusions may be helping protect a person’s (potentially damaged) ego. In other cases, the delusions may not have a functional purpose, rather they may be a manifestation of a particular mood or a byproduct of hallucinations.
Defense mechanism: It is though that some people may experience grandiose delusions to protect their ego from severely low self-esteem and/or major depression. Those experiencing delusions of grandeur tend to experience a temporarily inflated sense of self-importance, thus counteracting the severely low self esteem or depressive emotions. For this reason, many therapists are warned to weigh the pros and cons associated with eliminating the grandiose delusions, as elimination may result in severe depression.
Expansive delusions: In some cases, the grandiose delusions may be a byproduct of hallucinatory experiences. In cases of schizophrenia, the delusions may not be mood-congruent, but may be related to the hallucination. These are classified as “expansive” due to the fact that they expand upon the hallucination such as hearing voices. An example would be a person experiencing paranoid schizophrenia and hearing a voice that tells them they are really Jesus Christ.
Mood-induced: Those with exaggerated emotions, such as an individual exhibiting bipolar mania may experience mood-induced delusions. In this case, the delusions are thought to be a direct result of the person’s mood, and may serve to express the euphoria that the individual is feeling. Someone experiencing grandiose delusions as a result of an inflated mood would be classified as exhibiting “mood-congruent” delusions.
Conditions associated with delusions of grandeur
There are a variety of psychiatric conditions associated with grandiose delusions. Predominantly, delusions of grandeur are exhibited among individuals with bipolar disorder and schizophrenia. It is speculated that any conditions associated with mania (or hypomania) can induce delusions of grandeur.
Bipolar disorder: It is estimated that up to 3/5 individuals with bipolar disorder will experience delusions of grandeur. Bipolar disorder is a condition characterized by transitions from a “high” mood (mania) to a low mood (depression). During the manic phase, individuals may feel a heightened sense of self-worth accompanied by delusions of grandeur.
In the case of bipolar disorder, grandiose delusions are considered “mood-congruent delusions” in that they manifest from the manic (or hypomanic) state. During manic or hypomanic phases, it is believed that brain activity changes, brain waves speed up, and neurotransmitter concentrations change; particularly levels of dopamine.
Delusional disorder: This is a psychiatric condition in which a person experiences delusions, but doesn’t have a mood disorder, psychosis, or a thought disorder. Additionally, the individual experiences these delusions without consumption of alcohol or ingestion of drugs. While not everyone with delusional disorder experiences delusions of grandeur, some individuals do.
Depression: Some individuals with major depressive disorder may end up experiencing delusions of grandeur. In fact, an estimated 21% of those diagnosed with major depression are thought to experience grandiose delusions. The grandiose delusions may be short-lived and/or related to neurochemistry and possibly medications.
Drug abuse: Those that abuse drugs may end up with delusions of grandeur as a result of drug-induced brain alterations. Many drugs are capable of altering concentrations of neurotransmitters, regional activity, and receptor densities. Long-term abuse may result in death of brain cells and/or a prolonged recovery period during which delusions of grandeur are experienced.
Narcissistic personality disorder (NPD): This is a personality disorder characterized by an inflated sense of self-worth and/or feel inherently superior to others. Not all individuals diagnosed with narcissistic personality disorder experience delusions of grandeur. Although many narcissists have grandiose fantasies or an obsession with power over others (megalomania) – this is not the same as a delusion. That said, it is still possible for someone with a narcissistic personality to exhibit grandiose delusions.
Neurodegenerative diseases: Those with neurodegenerative diseases such as: Alzheimer’s disease, Huntington’s disease, Parkinson’s disease, and (a related condition) Wilson’s disease, may experience delusions of grandeur. Although the percentage of individuals that experience grandiose delusions as a result of neurodegenerative diseases is relatively small, it can occur. It is believed that circuitry damage, loss of brain volume, and neurotransmitter deficiencies play a role in causing these delusions among those with neurodegeneration.
PTSD: It is known that some people with PTSD experience manic and/or hypomanic symptoms that mimic those of bipolar disorder. These manic and hypomanic symptoms are a result of an overactivated sympathetic nervous system in which the stimulatory response inhibits the body’s ability to relax (i.e. the parasympathetic nervous system). It is already well-documented that psychotic symptoms (such as delusions) can manifest as a result of PTSD. It is totally feasible for delusions of grandeur to occur among individuals diagnosed with post-traumatic stress disorder.
Schizophrenia: It is estimated that up to 50% of all individuals with schizophrenia have experienced delusions of grandeur. Schizophrenia is a condition characterized by loss of contact with reality. Both hallucinations and delusions are characterized as positive symptoms of schizophrenia or experiences that don’t occur in normal, healthy individuals.
The delusions of grandeur experienced among those with schizophrenia are often related directly to the hallucinations that they report. If they hear a voice (auditory hallucination) or see an entity (visual hallucination), they may claim that they just talked to Jesus Christ. Of all diagnosable types of schizophrenia, delusions of grandeur tend to occur most frequently among those with paranoid schizophrenia.
A person with the paranoid subtype may believe that they are the CEO of a company, extremely rich, were sent on a special mission from Jesus Christ, is a celebrity, or ruler of a country. The more common delusions of grandeur among those with paranoid schizophrenia tend to have religious themes.
Delusions of Grandeur Symptoms
Below is a list of symptoms associated with grandiose delusions. Keep in mind that these are the symptoms as defined by the DSM-IV.
Grossly exaggerated belief of the following:
- Identity: Those with delusional grandiosity believe that everyone should know them and that they are famous. They may expect complete strangers to recognize them publicly or friends to treat them special due to the fact that they’re famous.
- Knowledge: A person believes that they have more knowledge or insight than other people. They may believe that they were blessed with this knowledge from a particular deity, or that they were born with genius level intelligence.
- Power: A person believes that they hold more power than others, even those in high ranking positions. Those with power-based grandiose delusions may believe that they are the king of a particular country, the president, or CEO of a large corporation. Some cases may involve the individual thinking that they possess supernatural powers such as the ability to change the weather with their thoughts.
- Self-worth: A person exhibits exaggerated self-worth, and believes that they are of higher rank or superior to others. They may act as if they should be first-in-line at a restaurant or should be given top priority over others due to their high degree of worth.
- Relationship (to Iconic Entities): An individual believes that they are related to someone of celebrity status (e.g. the son of Brad Pitt) or is related to a deity (e.g. the son of Jesus Christ). They may believe that they are related to famous people or are directly related to a spiritual leader.
Examples of delusions of grandeur
There are substantial differences in the degree of grandiosity linked with grandiose delusions in different patients. The delusional perceptions may be directly related to cumulative environmental stimuli. In other words, if a person watches a particular show a lot, they may think that they’re the host. If a person reads books about presidents, they may believe that they are in charge of a particular country.
- Celebrities: Some people may believe that they are famous celebrities such as actors, musicians, or TV show hosts.
- CEO of a company: In other cases, a person may believe that they’re the CEO of a large corporation and that they have millions of dollars in their bank account.
- Deities: Certain people may believe that they are a deity, sent from a deity to Earth with a special mission, or directly related to a deity. A common example is when people think that they are Jesus Christ.
- Fictional characters: A person may believe that they were blessed with the same powers as a comic book character like Superman or Batman.
- Inventor: There have also been some cases in which people thought they were famous inventors (e.g. Thomas Edison).
- Professional athlete: Some cases of grandiose delusions involve people believing that they are a professional athlete (e.g. Michael Jordan).
- Royalty: Experiencing grandiose delusions may make someone believe that they are a famous king, queen, prince, or princess. In other cases, a person may think that they just deserve to be treated like royalty.
- Ruler: Someone may believe that they are the president or ruler of a particular country.
Who is most likely to experience delusions of grandeur?
Some data has been compiled in regards to which conditions are most associated with delusions of grandeur. Understand that the list below does not include the percentage of individuals diagnosed with “delusional disorder.”
- Bipolar disorder: (59%) Approximately 3/5 individuals with bipolar disorder are thought to experience delusions of grandeur. There appears to be an association based on a person’s age. Nearly 3/4 individuals under the age of 21 diagnosed with bipolar disorder experienced delusions of grandeur upon onset, while only 2/5 individuals over the age of 30 have this experience during onset of the disorder.
- Schizophrenia: (49%) Nearly 1/2 individuals diagnosed with schizophrenia experience grandiose delusions. These delusions are most likely to occur among those with the paranoid subtype of schizophrenia.
- Drug abuse: (30%) Among those that have abused drugs, nearly 1/3 individuals has experienced delusions of grandeur. These delusions may have occurred while intoxicated or upon discontinuation (withdrawal) from a particular drug.
- Depression: (21%) Some statistics demonstrate that nearly 2/5 individuals with major depressive disorder may be prone to delusions of grandeur. While it would seem unlikely that a person could feel an inflated sense of self worth during a depressive phase, it has been reported.
- General population: (10%) Among the general population, it is thought that nearly 1/10 people experience thoughts of grandiosity, but these do not fit the DSM-IV criteria for delusions of grandeur.
In addition to specific mental illnesses, delusions of grandeur tend to be more likely based on socioeconomic status, educational advancement, marital status, and eldest siblings.
- Socioeconomic status: Grandiose delusions with supernatural or religious themes tend to occur more often among those of high socioeconomic status. Some reports suggest that all types of grandiose delusions are more likely to occur among individuals of higher social status.
- Educational advancement: In addition to social status, delusions of grandeur were found to occur at greater rates based on educational advancement. The more an individual has progressed through the educational system, the greater likelihood of grandiose delusions.
- Marital status: Those who are single tend to experience grandiose delusions at a greater rate compared to those who are married or in relationships.
- Older siblings: Research shows that the eldest siblings are most likely to experience grandiose delusions compared to the youngest ones.
- Men vs. Women: Rates of grandiose delusions are thought to be equal based on sex (male vs. female).
Delusions of Grandeur Treatment
Those that experience grandiose delusions may be treated with medication, therapy, and/or other medical intervention. If there is a specific condition that is causing the delusions (e.g. Parkinson’s), steps are generally taken to treat that condition rather than the delusional symptoms. Therapy is thought to be more effective for some individuals than others.
- Antipsychotics: Among those with schizophrenia, antipsychotics may be the preferred option for treating delusions of grandeur. These drugs work as dopamine antagonists, decreasing dopaminergic activation in the brain. In many cases, these will simultaneously minimize both delusions and any associated hallucinations.
- CBT: In some cases, CBT or cognitive behavioral therapy is used to help individuals cope with grandiose delusions. In a therapy session, a psychotherapist may use a technique known as “inference chaining.” This is a questioning tool that uses rationality and logic to help combat the delusional perception. Another technique known as “thought linkage” involves a therapist continuously asking a patient to explain jumping from thought-to-thought.
- Hospitalization: In cases where an individual may experience grandiose delusions as a result of drug abuse, hospitalization may be required to address physical symptoms. During this time a professional psychotherapist may attempt to address some of the delusions that are experienced until the individual comes down from their “high.”
- Mood stabilizers: Drugs that stabilize mood may be effective to treat delusions of grandeur among those with bipolar disorder. An example of a mood stabilizer is that of Lithium – a drug that works to prevent manic highs and depressive lows. By stabilizing the mood, an individual is less prone to experiencing mania induced grandiosity.
- Treating underlying medical condition: Any other medical condition such as a neurodegenerative disease, vitamin deficiency, tumor, or thyroid problem may contribute to delusions of grandeur. Once the medical condition is effectively treated, the delusions generally subside.
Have you (or someone you know) experienced delusions of grandeur?
If you or someone you know has experienced delusions of grandeur, feel free to share the experience and/or observation in the comments section below. Delusions of grandeur are the second most common type of delusion reported (to persecutory delusions), and thus are fairly common. To help others get an idea of the experience, you could mention the specifics of the grandiose delusion (e.g. I was the King of England). Also mention what you think may have caused the delusion of grandeur and how it was treated or overcome.