What Are Delusions of Grandeur?

Delusions of grandeur are more than just inflated self-esteem — they involve deeply held false beliefs about one’s identity, power, or importance. This guide explores what these delusions look like, what causes them, how to recognize the signs, and how to get help.

What are delusions of grandeur?

Delusions of grandeur are false beliefs that a person holds about their own importance, power, identity, or abilities. These beliefs go far beyond ordinary self-confidence or ambition. Someone with a delusion of grandeur might believe they are a celebrity, royal figure, or supernatural being or that they possess unique talents, knowledge, or possessions that others do not. These beliefs persist even when there is clear evidence they are not true, and they are often resistant to any attempt at correction.

These delusions can be deeply convincing to the person experiencing them. They may be completely unaware that their belief contradicts reality. While some cases are tied to mental health disorders, others might not meet full diagnostic criteria but still impact a person’s well-being and relationships.

What do these delusions look like?

A grandiose delusion can take many different forms, depending on a person’s background, imagination, and the nature of their underlying condition. The duration of a psychotic episode can also vary based on a variety of factors. Common variations include:

1. Believing in a special talent, object, or gift

A person might insist they have a one-of-a-kind ability that no one else possesses, such as the grandiose belief that one is able to speak with animals or read minds. They may also claim to own objects of immense importance or power — like a magical artifact or a previously undiscovered manuscript.

2. Thinking you are a famous or powerful figure

Someone might truly maintain the false belief they are a well-known celebrity, historical leader, or even a deity. In some cases, they may think the actual famous person is an imposter, and they are the real one.

3. Believing in a secret or exclusive relationship

They may insist they are in direct contact with world leaders, royalty, or other people of influence — even claiming to receive secret messages or instructions from them.

4. Religious or spiritual identity

A person experiencing religious delusions may believe they have a divine role or are chosen for a special spiritual purpose. They might identify as a prophet, messiah, or another sacred figure, regardless of religious background.

5. Persecutory delusions with grandiose themes

Sometimes, a person believes they are being targeted or monitored because of their supposed importance. For example, a person experiencing a persecutory delusion might say secret agents are following them because they “know too much” or that others are trying to silence them due to their divine mission or intelligence.

Grandiose thinking is not based on exaggeration or metaphor. They are taken literally and usually affect how the person behaves and interacts with others.

What makes a belief a delusion?

A grandiose delusion differs from typical beliefs or confidence in several key ways. For a belief to qualify as a delusion, especially a delusion of grandeur, it usually meets these four criteria:

1. Firm conviction

2. Grandiose thoughts that are resistant to logic or reasoning 

3. Delusional beliefs are often implausible 

4. These thoughts cause disruption of daily life

It’s also important to distinguish delusions from overvalued ideas, which are strongly held beliefs that may not be grounded in fact but are still somewhat connected to reality. For example, a gambler might believe they are unusually lucky — not entirely accurate, but not delusional. A delusion would be believing they’ve been chosen by fate to manipulate global financial systems.

What causes delusions of grandeur?

Delusions of grandeur often stem from underlying mental health disorders that involve disrupted thinking, perception, or sense of reality. These may include:

• Schizophrenia: A chronic psychotic disorder that affects how a person thinks, feels, and perceives the world. Delusions and hallucinations are common symptoms.
• Bipolar disorder: A mental health disorder wherein, particularly during a manic episode, people may experience grandiosity — inflated self-esteem or beliefs in their own special powers or abilities.
• Major depressive disorder with psychotic symptoms: In rare cases, extreme depression can include psychosis, such as delusional thinking or grandiose fantasies.
• Dementia and delirium: These conditions affect memory and cognitive processing, which can result in distorted beliefs.
• Narcissistic personality disorder (NPD): Individuals with NPD often exhibit an inflated sense of self-importance and entitlement. While not all narcissistic traits are delusional, in some cases — particularly when their self-image is threatened — grandiose fantasies may cross the line into delusion.

In addition to mental illness, substance use — such as alcohol, cannabis, stimulants, or hallucinogens — can trigger or worsen delusional thinking.

It’s important to note that not everyone who has delusions has a diagnosable disorder. However, if the beliefs are causing significant disruption or distress, professional evaluation for grandiose delusion is essential.

How to recognize delusions of grandeur

Recognizing these as delusional disorders can be challenging, especially since the person truly believes them. However, there are some signs and patterns to look for:

• Beliefs that seem disconnected from reality
• Lack of openness to alternative perspectives
• Behavior changes based on the delusion (e.g., quitting a job to pursue a ‘destined’ mission)
• Speech or actions that seem dramatically out of touch with their previous behavior or lifestyle
• Other signs of mental health issues, such as paranoia, disorganized thinking, or mood swings

Delusions are easier to identify when they occur alongside other symptoms or within the context of a known mental health condition. If someone has a history of bipolar disorder, schizophrenia, or narcissistic personality disorder and begins expressing inflated or implausible beliefs, delusions of grandeur may be present.

In some situations, these delusions are triggered by stress or substance use. Even if they pass quickly, they still require attention — especially if they repeat or escalate.

What can you do if you suspect you or a loved one are experiencing delusions?

If you or someone you care about may be experiencing delusions of grandeur, seeking professional help is the best first step. Here’s how you can take action:

1. See a psychiatrist

A psychiatrist is a medical doctor who specializes in mental health. They can perform a thorough assessment, provide an official diagnosis, and recommend a treatment plan. This plan may include medications like antipsychotics or mood stabilizers, as well as therapy.

2. Explore cognitive behavioral therapy (CBT)

CBT is a structured, evidence-based form of therapy that helps individuals identify and reframe distorted thoughts. For those experiencing delusions, CBT can assist in building awareness, reducing distress, and learning coping strategies — especially when combined with medication.

3. Avoid direct confrontation

Challenging someone’s delusional belief head-on often leads to defensiveness or conflict. Instead, approach the situation with empathy. Focus on how they’re feeling rather than whether the belief is true. You can express concern about their well-being without arguing about the content of the delusion.

4. Address substance use

If drugs or alcohol are involved, they may be contributing to — or even causing — the delusions. Treatment for substance use disorders should be integrated into the overall care plan. This may involve detox programs, support groups, or therapy focused on addiction recovery.

5. Know when to seek emergency help

If there’s a risk of harm to the person or others, don’t hesitate to call emergency services. Delusions can escalate quickly and become dangerous. Mental health crises are medical emergencies.

If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

6. Reach out for support

You don’t have to manage this alone. Mental health hotlines and organizations can provide guidance:

• NAMI HelpLine: 1-800-950-NAMI (Mon–Fri, 10 a.m. to 6 p.m. ET)
• Crisis Text Line: Text “NAMI” to 741741 for 24/7 support

How Charlie Health can help

If you or a loved one are struggling with delusions of grandeur, Charlie Health is here to help. Charlie Health’s Virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions, including delusions of grandeur, childhood trauma, and more. Our expert clinicians incorporate evidence-based therapies into person counseling, family therapy, and group sessions. With treatment, managing delusions of grandeur and other mental health concerns is possible. Fill out the form below or give us a call to start healing today.