Grandiosity

The signs of grandiosity can vary in intensity and nature between people. Displaying signs of grandiose traits does not necessarily mean one’s attitude is problematic. However, when grandiosity is a chronic² part of one’s personality, it may pose certain challenges. People with grandiose traits or grandiosity may: 

• Believe they require excessive admiration, attention, and praise
• Overstate their accomplishments
• Express exaggerated or untrue stories about their accomplishments
• Dominate conversations and social interactions
• Disparage others’ beliefs and opinions
• Experience a preoccupation with power, money, and status 
• Display conceited or arrogant behaviors
• Have a displaced sense of self-entitlement
• Become agitated and hostile when confronted or challenged on their actions
• Have a lack of empathy or remorse when they hurt others
• Struggle to accept criticism from others

The internal experiences of individuals with delusions of grandeur may differ from those with healthy self-esteem. Not everyone with grandiose delusions is self-serving or behaves in a hurtful way toward others, but grandiose individuals may still believe they are: 

• More worthy than other people
• Gifted with superior beauty or intelligence
• Secretly affluent
• Predestined for fame, wealth, and greatness
• Underestimated and underappreciated by others
• Gifted with mystic or preternatural powers
• Concealing their secret identity as a powerful, eminent person
• Highly influential on famous or powerful people
• An indispensable source of advice and guidance for others

There are several potential causes of disproportionately grandiose behaviors and beliefs, from unhealthy attachment styles in childhood to severe mental health disorders. Below are a few possible causes of grandiosity:

• Mental health conditions. Various mental illnesses feature grandiose thoughts and behaviors as a symptom. For example, some delusional disorders,³ personality disorders, schizophrenia spectrum disorders,⁴ and bipolar disorder⁵ can be associated with grandiosity in some cases.
• Substance use. Excessive substance use may promote grandiosity during intoxication, and some individuals with substance use disorders may be more likely to show traits like grandiosity.
• Anxiety or post-traumatic stress disorder (PTSD). Research suggests a connection between grandiose narcissism and PTSD. Grandiosity may emerge in people with overwhelming anxiety, particularly those experiencing a sudden and traumatic life event. 
• Extreme isolation. Prolonged isolation has also been associated with and can intensify symptoms of mental illnesses, potentially including grandiose thoughts and behaviors. 
• Neurological conditions. Individuals with certain neurodegenerative diseases, such as dementia, may exhibit symptoms of grandiosity.
• Attachment style. Certain insecure attachment styles—such as preoccupied attachment—are sometimes linked with grandiose narcissism, and either or both could manifest as delusions, denial of emotional difficulties, and a desire for excessive praise and recognition. Although insecure attachment styles are often associated with low self-esteem and a negative self-view, people with this type of attachment style may use self-aggrandizing or arrogant behaviors as a means to gain approval from others and shield themselves from rejection.

For those struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Regardless of the cause, people with grandiose tendencies may exhibit similar grandiose characteristics due to similar inner cravings. For example, craving validation and recognition may cause people with grandiose tendencies to exploit or manipulate others to gain attention. Grandiose individuals may exaggerate or lie about their accomplishments to others because they want to believe they are important and revered.

Individuals with grandiose delusions may also exhibit arrogant and conceited characteristics because they have a disproportionate desire for acceptance from others. Grandiose individuals' desire for superiority can lead to difficulty accepting criticism or aggressive reactions when others challenge them. Individuals with grandiosity may also react to being vulnerable or threatened by disparaging other people’s beliefs and opinions.

A person with grandiose personality traits doesn’t necessarily have a mental health disorder. Similarly, while grandiosity is a common symptom of many conditions, grandiosity may not present as such for every person with a given mental health condition. 

If an individual’s grandiose thoughts and behaviors become problematic in daily life, it can be beneficial to seek support from a therapist with experience in diagnosing and treating mental illnesses with symptoms of grandiosity. Below are a few mental illnesses that may cause grandiosity as a symptom in some people diagnosed with the condition. 

Grandiose delusional disorder

While there are six types of delusional disorders, grandiose delusional disorder is the only type that can have symptoms of grandiosity absent of others. People with grandiose delusional disorder may also exhibit traits of megalomania and, in some cases, exhibitionism. 

Some individuals may have a more moderate manifestation of grandiose delusional disorder, making it easier to function and appear functional in daily life despite their grandiose delusions (GD). More acute forms of grandiose delusional disorder can be more disruptive to everyday functioning.

Mental health professionals diagnose grandiose delusional disorder and other delusional disorders using a set of criteria from the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-V), including the following: 

• Delusions lasting a month or more 
• Other unusual behaviors outside of the delusions 
• A lack of a diagnosis of schizophrenia.
• Episodes of mania or depression that are shorter than the delusional episodes, if present at all 
• Delusions not associated with substance use, a medical condition, or another mental health disorder

Narcissistic personality disorder (NPD)

Grandiose narcissism is a term used to classify a type of narcissistic personality disorder with prominent grandiose symptoms. Grandiose narcissism in the context of narcissistic personality disorder is often associated with high functioning and thriving in daily life but difficulties when the consequences of the problematic behaviors related to GD arise. 

There are ten types of personality disorders recognized in the DSM-V, each with its own set of criteria (although some may overlap with others). The diagnostic criteria for narcissistic personality disorder include a persistent, long-term pattern of grandiosity, a strong desire for admiration, and a lack of empathy developing by early adulthood. 

Five or more of the following symptoms must be present for a diagnosis of grandiose narcissism to be considered:

• An exaggerated sense of self-importance
• A belief that one is remarkable compared with others, regardless of achievements
• A belief that one can only relate to or associate with other remarkable people
• Excessive desires for reverence from others
• Preoccupation with fantasies of power, beauty, success, or dominance
• A strong sense of entitlement
• Willingness to exploit others for self-gain
• Lack of empathy for others
• Arrogant behaviors and attitudes
• Preoccupation with envy, both of and from others

Diagnosis of grandiose narcissism requires the symptoms to be unrelated to substance use, neurological dysfunction, or another mental health disorder.  

Other disorders sometimes associated with grandiosity

While they don’t include the term in their title, other disorders may feature grandiosity as a symptom. 

For example, studies suggest that some individuals with manic episodes due to bipolar I disorder or mixed episodic bipolar disorder may exhibit grandiosity.

Individuals living with schizophrenia may be susceptible to grandiose delusions because cognitive bias and hallucinations associated with symptoms of the disorder can reinforce and intensify disproportionate or grandiose self-regard.

Medications

 A psychiatrist or other healthcare professional may prescribe medication to treat symptoms associated with disorders featuring delusional symptoms of grandiosity (delusions of exceptionality), such as grandiose delusional disorder. These medications might include antipsychotics. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition, including grandiosity. The information in this article is not a replacement for medical advice or diagnosis.

For individuals experiencing symptoms of grandiosity, it may be beneficial to receive care from home. When severe symptoms like psychosis and grandiose delusions are not present, online therapy through a platform like BetterHelp may be helpful. With an online therapist, you can schedule sessions on your own time and receive support from a professional matched to your unique case.