Grandiose Delusions
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • A delusion of grandeur is an erroneous or exaggerated belief in one's superiority, majesty, or greatness.
  • An individual may believe they are, for instance, famous, able to end major wars, or immortal.
  • Delusions of grandeur, also known as grandiose delusions, frequently occur alongside other mental health problems, like other delusions.

A delusion of grandeur is an erroneous or exaggerated belief in one’s superiority, majesty, or greatness. An individual may believe they are, for instance, famous, able to end major wars, or immortal.

Delusions of grandeur, also known as grandiose delusions, frequently occur alongside other mental health problems, like other delusions. Grandiose delusions are a manifestation of a psychological disorder. Individuals with these delusions are certain of their greatness and significance, and they will reject any attempts at convincing them that they are false.

Woman standing in a field and holding a cloud in her hands

Grandiose delusions are most often caused by bipolar disorder, depression, schizophrenia, substance use disorders, and delusional disorder. All of these conditions can be treated with therapy, and grandiose delusions should go away over time with the help of mental health professionals.

This article goes into more detail about delusions of grandeur, including examples, causes, and possible treatments.

People with delusions of grandeur believe that they are exceptional, incredibly competent, extremely accomplished, more significant than others, or even supernatural. The delusion may be chronic or it may occur intermittently.

Some individuals with delusions of grandeur also suffer other delusions, like a fear of being persecuted or strange religious beliefs.

Still, a delusion of grandeur is more than just a heightened sense of self-importance or a very high opinion of oneself. It signifies a considerable separation from reality. A person with grandiose delusions may keep believing in the delusion despite evidence to the contrary. (source: APA, n.d.)

There are various kinds of grandiose delusion. Over time, many individuals have delusions with a common theme.

The manifestations of delusions of grandeur are nearly endless. Among the most prevalent forms are:

  • An exaggerated sense of one’s significance, such as the ability to end a war.
  • A perception that one is well-known or holds a prominent position in society
  • A belief in one’s religious leadership
  • A conviction that one can live forever
  • An erroneous notion that injury or illness cannot hurt a person
  • A bloated perception of one’s intelligence
  • A conviction that one possesses supernatural abilities, such as the power to read minds

Culture can influence the nature of a person’s delusions. This is because culture influences a person’s knowledge and worldview. Something that is regarded as a delusion in one culture may not be regarded as such in another.

Scientists do not yet know the precise cause of delusional illness, as they do with many other psychotic conditions. Yet, researchers are examining the role of several factors that may influence the onset of the condition, such as:

Biological factors: Scientists are trying to figure out how problems in certain parts of the brain might cause delusional disorder. An abnormality of specific neurotransmitters in the brain has been associated with the onset of delusional symptoms.

Genetics: The fact that people with schizophrenia or a family history of delusions are more likely to have delusional disorder suggests that a genetic factor may be at play. As with other psychiatric conditions, researchers believe a propensity to acquire delusional conditions may be transmitted from parents to biological offspring. (source: NIMH, 2024)

Psychological and environmental factors: There is evidence that stress might promote delusional conditions. Substance abuse disorders and alcoholism may contribute to the disease. Some psychodynamic hypotheses for the genesis of delusional disorder include defense mechanisms related to ego and hypersensitivity such as projection, reaction formation, and denial. Social isolation, mistrust, envy, low self-esteem, and suspicion are a few other psychological elements that may cause a person to find an explanation for their feelings and, as a result, construct a delusion.

People with grandiose delusions often make up amazing stories in which they are the hero. They are unaware that their broad delusions are founded only on imagination, and they will continue to believe their delusions are genuine despite their loved one’s best efforts to persuade them differently until they receive treatment.

Each delusion possesses four primary characteristics:

  • The individual holding the belief considers it to be true, even though the prevailing norm and other individuals recognize it to be false.
  • When evidence contradicts the delusion, the individual with the delusion will not consider changing their mind or accepting different perspectives.
  • The delusional concepts are absurd, impossible, or implausible.
  • The delusion influences the individual’s daily life.

Delusions of grandeur can take on a variety of forms. Individuals with grandiose delusions may consider themselves to be:

  • Possessing superior intelligence or beauty
  • Destined to achieve greatness or to become wealthy and renowned
  • More significant than others
  • Misjudged and undervalued by family and friends
  • Having superhuman abilities
  • Secretly affluent or wealthy
  • They are connected to influential people who seek their counsel.
  • Already famous, but concealing their identities

Delusions of grandeur are different from egomania and narcissism because they are not based on self-serving beliefs but on false beliefs. Those who encounter these delusions perceive them as objective truths that would be unreasonable to deny. They do not go out of the way to attract attention, but rather act in ways that, from their perspective, are quite sensible.

Megalomania and grandiose delusions may be signs of grandiose delusional disorder if they are the only obvious signs of the disorder. This is one of six types of delusional disorder, and besides their strong confidence in their importance, individuals with this disorder may be quite ordinary. (source: NIMH, 2023)

If their problems aren’t too bad, they might be able to function normally, and their behavior and appearance might not show how big their dreams are. 

Even while more severe kinds of delusional disorders are more disabling and impair functioning in a variety of ways, the individual may appear normal for the majority of the time.

All sorts of delusional disorders are uncommon conditions. Two out of every 1,000 people will be labeled with a delusional condition, and less than one percent of those who seek mental health treatment will have a delusional disorder. So, most people who have delusions of grandeur that last for a long time will also have other disorders that make them feel this way.

Working with a person who has a grandiose mental health condition or grandiose schizophrenia is comparable to dealing with hallucinations, with the exception that more nonverbal techniques are necessary. You will need more time and patience to sit in silence, as delusions do not often fade away. The individual may not express them verbally as much, but they are typically pervasive.

1. Build a friendship based on mutual trust

Do not use logic, reason, or question the delusion. Trying to debunk the delusion is ineffective and will just foster mistrust. (source: NHS, n.d.)

Assure the individual that they will not suffer any harm.

Never leave the person alone; always practice openness and deal with them with honesty.

Encourage the person to talk about their fears, worries, and feelings of insecurity. Offer protection and care to keep the person from hurting themselves or others.

Acknowledge the necessity of acceptance of the false belief.

Focus on establishing a trustworthy relationship with the individual rather than attempting to control their symptoms; maintain your composure.

2. Determine the nature and/or content of the delusion (source: MedlinePlus, n.d.)

Try to empathize with the individual and understand the motivation behind their delusion.

Rephrase what the person is saying or trying to say to clear up any confusion about the delusion being described.

Without arguing or agreeing, examine the delusion’s logic or reasoning. For example, “Who should I inform if the CIA is bugging me?”

If the person is not psychotic, don’t ask questions about the delusion to see if it is true or to make it worse. For instance, never ask, “How is the CIA today?” to an individual who is feeling well.

Determine what could be the central theme of delusions.

Determine the dominant emotion and/or tone of the delusion. (source: StatPearls, 2025)

3. Assess and evaluate how the delusion is impacting the individual’s life

Assess if and how a person’s delusions are affecting their life. For instance, are they unable to perform or participate in routine day-to-day activities?

Determine whether the delusion is affecting the individual’s relationships with others.

Assess if the individual has acted based on their delusion.

4. Evaluate the severity, duration, and frequency of the delusion

Document the frequency, intensity, and duration of an individual’s delusions in a journal. (source: NICE, 2014)

Evaluate if their delusions typically occur at a specific time of day or are associated with specific activities. This could help you avoid circumstances that could provoke delusions or paranoia.

Some delusions are transient and short-lived, while others are more persistent and last for a long time.

5. Make an effort to divert or distract the individual from their delusion.

Does the individual always confront you with delusion? If so, simply listen in silence and then provide direction for the current task.

If the individual appears unable to stop speaking about the delusion, ask them gently whether they remember what you had been doing and if it is time to continue that activity.

If the person is adamant about sharing their delusion, simply listen in silence until there is no need for further discussion. (source: NIDA, n.d.)

Note that it is important to reassure the person that they are okay as a person during the delusion.

Try to demonstrate empathy and reflect on the person’s emotions. If you talk about facts and specifics, the other person may pull away and see you as a critic. By helping without judging and in a way that neither confirms nor disproves the delusion, the person may feel better and trust your care. Consider the following while you speak with the individual:

1. Pay close attention to the person’s feelings.

2. Discuss your perspective on the delusion

3. Communicate your care for the individual

4. Propose therapy together, but do so strategically (source: SAMHSA, n.d.)

5. Keep an open mind and ask the individual why they believe what they believe.

6. Avoid being upset and expressing frustration to the individual

7. Educate yourself about irrational beliefs or thinking fallacies

Treatment of delusions of grandeur might be difficult. The individual experiencing these delusions may enjoy them. Also, because people with delusions really believe their delusions, they are often hard to treat.

The treatment of delusions depends primarily on the underlying reason. The physician must differentiate between extravagant fancies and moderate or realistic desires.

Medications: Medications are prescribed to manage psychotic symptoms and regulate the patient’s mood. However, drugs may not be sufficient to control the disease on their own. (source: WHO, n.d.)

Behavioral therapy: Certain forms of talk therapy may help reduce grandiose delusions. People can learn to recognize and change unhelpful ways of thinking and acting with cognitive behavioral therapy.

Inpatient rehabilitation programs for delusional disorders, schizophrenia, bipolar disorder, substance use disorders, and major depression are holistic and comprehensive. This means that they aim to treat all mental health symptoms, including delusions, using methods that have been proven to work.

Each cause of grandiose delusions has its own treatment strategy. Regardless of the primary disorder, however, the management of grandiose symptoms is a complex and intricate process.

Therapists won’t deal with grandiose delusions right away because doing so could cause a lot of pain, a lot of confusion, and a huge loss of self-esteem.l try to break down the delusions slowly, at a pace that won’t stress the patient out but will keep them fully involved in their recovery as they learn more about reality.

Drugs like antidepressants (for depression), antipsychotics (for schizophrenia), and mood-stabilizing agents (for bipolar disorder) may be given in addition to treatment. These may or may not help with the grandiose beliefs, but they may be needed to treat other symptoms of the disorders that cause them.

Conquering grandiose delusions and the conditions that produce them takes time and effort. People who are caught in delusional fantasies might eventually reconcile with reality with the help of their loved ones, allowing them to determine their destinies and no longer be governed by false perceptions.

  1. Delusional disorder: Causes, symptoms, types, & treatment. Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/9599-delusional-disorder.
  2. Steps for working with delusions. BC Schizophrenia Society. Available at.
  3. Delusions of grandeur: Types and symptoms. Medical News Today. MediLexicon International. Available at: https://www.medicalnewstoday.com/articles/321649.

FAQs

Can Delusional Condition Be Prevented?
There is no recognized prevention for delusional conditions. Yet, early detection and treatment can help reduce the impact on the individual’s life, career, family, and relationships.
What Potential Problems Are Associated With Delusional Disorder?
If untreated, delusional disorder may result in:
Depression is frequently a result of challenges related to delusions.
Social exclusion or isolation
Legal difficulties, such as harassing or stalking the individual involved in the person’s delusion, could result in an arrest.
Harming oneself or others. This is especially prevalent among envious and persecutory types of delusions.

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