The phrase “delusions of grandeur” is often used in casual conversation to describe a person who imagines him or herself to be more important or more powerful than he or she really is, but it is more accurately used to describe a very real and potentially very serious mental health imbalance. Medically speaking, delusions of grandeur are manifestations of a psychopathological condition in which a person has fantasies of power, wealth, and omnipotence that can hinder social engagement and impair sound decision-making. People who suffer from this condition — which is sometimes also called “megalomania” — often also have an inflated sense of self-esteem, and may hold an obsession with grandiose or extravagant things or actions. Even when they are presented with evidence contradicting their delusions, they will still typically cling to their erroneous beliefs. Treatment is often possible through therapy and the use of certain anti-psychotic drugs, and with the proper care people who suffer from this imbalance are often able to lead functional and happy lives.

A mentally ill person who thinks he's Napoleon is an example of someone with delusions of grandeur.

Characteristics of the Condition

When a person has clinically recognized delusions of grandeur, he will often believe that he has extraordinary powers or may believe himself to be famous. He will typically assume that people around him know who he is, and may also believe that they are admiring him. One of the hallmarks of this condition is a sense of innate superiority, be it through physical abilities, wealth, or personal connections. Some of the most extreme forms of the disorder cause people to believe that they are famous historical figures. The mentally ill person who truly thinks that he is Napoleon may be one of the most common media references made to this delusion.

Cognitive therapy might help patients change patterns of delusional logic.

Patients who firmly possess such unrealistic beliefs may eventually harm themselves physically, mentally, or emotionally. A person who thinks he has special powers, for example, might jump off a building because he genuinely believes he can fly. Isolation from family and friends is also quite common.

Delusions of grandeur may be the sign of a serious mental health condition.

Primary Causes

It’s usually somewhat rare for these sorts of delusions to happen all on their own, which is to say, not as a symptom of some other, usually larger mental health imbalance. A number of different psychological conditions and disorders can include these sorts of delusions, though they attach perhaps most frequently to narcissistic personality disorder. Narcissistic personality disorder is a condition in which a person is extremely preoccupied with himself and has inflated feelings of self-importance.

People with delusions of grandeur are often seen as selfish and egotistical.

Megalomania is also sometimes found in patients with varying degrees of dementia and psychotic or depressive disorders, such as bipolar disorder and schizophrenia. In some cases, delusions of fame and fortune are accompanied by other more negative feelings, including those of persecution, in which the patient thinks others are out to get him. Issues with control may also surface, in which the patient believes an outside force is controlling his thoughts or actions.

Some drugs, especially phencyclidine (PCP) and amphetamines, may also contribute to or exacerbate episodes. This is especially dangerous because users who are high may believe they have powers that will enable them to perform dangerous feats that a normal human being could not, such as flying off a tall building or stopping an oncoming train with one hand.

Treatment Options

Treating this condition can be somewhat difficult since so much depends on the root cause or larger mental health condition at play. The first thing that any care provider will typically do is come up with a diagnosis for the underlying condition, and begin treatment for that. It’s often the case that the delusions will fade over time once things begin to rebalance. Talk therapy is used in many cases, although people with this condition often feel they do not need the help. When the megalomania is caused by chronic drug use, delusions and other psychological effects usually disappear over time once the chemicals and the effects of addiction wear off.

Problems of Public Perception

The term "delusions of grandeur" is often used non-technically and incorrectly, as are the names of many serious mental health conditions like “anti-social.” It is sometimes used to describe people who are disliked dictators of countries, prominent businessmen, or celebrities; these sorts of people are often seen to be selfish and egotistical. Misusing the term in this way can be dangerous, though, since it could mask or even underplay situations in which actual delusions present a very real psychopathological threat to a person's health.