Mania of Majesty (delirium grandeur): symptoms and treatment

Mania of greatness (delirium grandeur, megalomania) is a mental disorder, expressed in extreme exaggeration of its significance or significance of its actions, views, abilities, etc. Such a state can be a symptom of many mental disorders. And the person himself denies the fact that something is wrong with him, believing that the people around him should appreciate him and listen to his opinion. That is why the megalomania is never diagnosed when the person turns to the doctor himself — usually, such people are brought to the specialists by relatives who are tired of living in a constant atmosphere of exaggeration of reality and fantasy reality.

It should be said that they suffer from such a mental disorder as megalomania, mostly men, although women are sometimes prone to this ailment. They also appear in a lubricated form and often take the form of erotomania — the certainty that some famous person (politician, singer, actor, etc.) is burning with passionate love.

From a medical point of view, megalomania is not quite the correct name for this pathology. The disease has other names — megalomania or delirium grandeur, which is more suitable for describing this mental disorder, because delusions of grandeur may not be a real psychological problem if the state of a person in such a disorder does not contradict social and moral norms. For example, a person who knows a lot about his business, and strives to achieve the highest levels of skill in it, can also be accused of megalomania, but this does not mean that he has psychological problems. At the same time, delirium of grandeur or megalomania is manifested in the fact that a person ascribes to himself non-existent merits and overestimates the importance of insignificant things and deeds.


There are three stages of this psychological disorder, like megalomania. At the first stage, a person tries to stand out among others, showing them their importance and proving the importance of their ideas or actions. This is the most innocuous stage, which, as the pathology progresses, takes on aggressive forms, especially in men.

The second stage of such a violation, as megalomania, is characterized by a rise in symptoms and marked clinical manifestations. And at the third stage, on the contrary, there is a regression of the disease — a person feels emptiness, unclaimedness and uselessness. Often in the third stage, depression occurs, and a person can try to commit suicide. In addition, the third stage of the pathological disorder can be characterized by the development of dementia.


The signs of such a pathology as delirium grandeur, are not a manifestation of a particular disease, because it in itself is a symptom of a mental disorder. However, there are predisposing factors, the presence of which provokes this disorder in people. Such predisposing factors include:

  • head injury;
  • neuroses and psychoses of various genesis
  • schizophrenia
  • genetic predisposition to mental disorders
  • history of syphilis
  • Moral trauma in childhood.

In addition, people with high self-esteem are also susceptible to the development of a mental disorder such as megalomania, which can occur under certain conditions. For example, when an overestimated child’s self-esteem is encouraged by parents and even more overstated — in such cases the child may think that he is the best that does not correspond to reality.


The main sign of such a disorder, as megalomania, is the excessive concentration of attention on one’s own self and its opinion. People with this mental disorder consider themselves to be the most beautiful, the most intelligent, irresistible, important, irreplaceable, etc. They demand that others admire them and show their respect, down to servility. If they do not receive proper attention, they may have aggression directed at people, which often leads to physical violence.

Sometimes the signs of such a violation, like delusions of grandeur, can be erased, but the person behaves extremely strange, which allows others to suspect that he has a mental disorder.

There are certain symptoms of megalomania that are common to all people suffering from this disorder. Such symptoms include:

  1. regular mood swings, from euphoria to severe depression
  2. inability to perceive criticism in their address
  3. inability to perceive someone else’s opinion, up to the complete denial of the possibility of alternative opinions;
  4. Increased activity
  5. Insomnia associated with increased activity or a lot of ideas and thoughts

When the disease occurs without treatment for a long time, depression and exhaustion develop. Patients in this condition may be prone to suicide.


In order to establish the violation and its causes, the doctor should interview the patient and his relatives, which will provide a complete picture of the onset of the disease and the nature of its course. It is also important for the doctor to learn the history of the patient’s life, and to establish whether he suffered from any mental disorders, and whether there were any psychic deviations from his relatives in the past. The risk groups include people who suffer from alcoholism or drug addiction, people who have had syphilis in the past, or who have a history of mental disorders.


Mania of greatness is not treated, because it is not a pathology in itself, but only represents a symptom of a mental illness. Therefore, treatment should be to treat the underlying mental disorder, as well as to eliminate the symptoms of a disorder such as megalomania. In particular, in case of aggression, patients are prescribed tranquilizers, and in case of depressive states, on the contrary, neuroleptics.

Specific psychotherapy also helps to reduce the severity of the manifestations of this mental disorder. But in some severe cases, at the stage of severe clinical symptoms or at the stage of regression with severe exhaustion and depression, people are treated in a hospital.