Megalomania is a type of behavior or self-perception of a person when a person significantly overestimates his significance, genius, importance, wealth, his strength, his role in something, even to the point of irrational omnipotence. In psychiatry, megalomania has several other names: delusions of grandeur and megalomania.
In everyday life, the term “delusions of grandeur” is often used incorrectly. This is what they say about a person who exhibits inappropriate behavior, increased motor activity, accelerated speech and thinking.
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In modern psychiatry, megalomania is not considered a separate disease. Doctors most often consider this disorder as a manifestation of some other mental disease. For example, delusions of grandeur may be a symptom of mania or one of the signs of paranoia. In the latter case, megalomania develops in a severe form with psychotic symptoms.
Megalomania develops with manic-depressive psychosis, paranoia and an inferiority complex. The main feature of this disorder is that a person concentrates his attention on his personality, on his exclusivity and importance for society. The patient commits actions and deeds that will speak of the super-importance of a person; he will tell everyone about his genius and uniqueness.
Reasons for the development of megalomania
The main causes of megalomania are the development of another mental disorder in a person - manic-depressive psychosis or paranoia. Also, such mania can be accompanied by schizophrenia, various types of neuroses, and affective psychoses. Also, a similar condition can occur in a person after suffering a traumatic brain injury or as a complication of progressive paralysis.
There are several main reasons for the development of delusions of grandeur:
- Hereditary predisposition (as a rule, if one of the parents has delusions of grandeur, then the child may also develop a similar disorder);
- Chemical dependencies (drug addiction and alcoholism);
- Previous syphilis;
- Heightened self-esteem.
Treatment options
In order for a person to get rid of his unrealistic, irrational beliefs, it is important for the doctor to take a responsible approach to the diagnosis and identify exactly what underlying mental disease is occurring. It is very important to start treatment with treatment of the underlying disease - schizophrenia, bipolar disorder, manic-depressive psychosis, and so on .
If this is not done, it will be impossible to cope with manic delusions of grandeur. At the same time, with correctly prescribed treatment for the underlying illness, the signs of megalomania recede on their own, gradually, as a matter of course.
Psychotherapy is very important for treatment.
Cognitive-behavioral and rational approaches are used - these techniques allow a person to gradually understand the errors of his judgments, and under the sensitive guidance of a psychotherapist, erroneous statements are replaced with an adequate perception of oneself.
Medicines also have a place, but only if the doctor considers that they are necessary (as part of the treatment of the underlying disease). If a megalomaniac is overly excited, moves too much, or makes a huge number of unnecessary movements, small doses of tranquilizers over a short course may be recommended so that drug addiction does not develop.
Antidepressants and antipsychotics may also be recommended.
Where to treat a person - in a psychiatric hospital or at home - the doctor will tell, since only he knows against the background of what underlying disease the erroneous delusional statements about his own genius, about his superiority appeared.
Mild forms of the disorder usually do not require hospitalization, but with delusions of grandeur at a severe stage or with severe concomitant depression, when the patient can cause irreparable harm to himself, it is more logical to treat in a hospital with round-the-clock supervision by medical personnel.
How successful treatment will be for megalomania also depends on the underlying diagnosis. In almost all cases, regardless of the underlying disease, doctors talk about the likelihood of relapses (in about 75% of cases, delusional ideas tend to return). the family climate and features of rehabilitation after treatment are of great importance
The patient needs constant medical supervision - he must be registered with a psychiatrist and visit him at least twice a year.
There are no methods for preventing delusions of grandeur; it is impossible to predict the onset of the syndrome and its development - this can affect everyone. If a person has already undergone treatment for megalomania, then help from relatives will be required to prevent relapses. It is important that a person lives in a favorable emotional climate and does not drink alcohol or drugs.
When the first signs of relapse appear (anxiety, nervous breakdowns, inadequate statements), it is important to immediately contact a psychiatrist. The disorder most often manifests itself in spring and autumn, like most other mental disorders. During off-season periods, the excitability of the nervous system increases.
Symptomatic picture of megalomania
This disease has several forms of development. At an early stage, others may not even notice that a person has any problems. It may simply seem to people that a person loves himself very much and actively demonstrates this to others. As the disease progresses, the condition gradually changes, the disorder progresses, and striking symptoms appear, the first of which are depression and irrational thinking. If the situation worsens, the condition can lead to the development of dementia.
A person suffering from delusions of grandeur does not understand the irrationality of his judgments and the irrationality of his behavior. The patient is confident that he is right in everything, that he is truly unique and that those around him should agree with his opinion in everything.
There are cases when, during delusions of grandeur, delusional disorders and obsessive thoughts of instilling in others one’s own importance do not appear too pronounced. And the main symptom is increased human activity. This condition can be observed in bipolar disorder, in which phases of depression alternate with manic episodes. The manic phase is characterized by increased activity and self-esteem, the patient’s confidence in his own importance and exclusivity, a surge of strength and energy, lack of sleep and fatigue. In this state, a person overestimates himself and his capabilities and demands the same attitude from others.
The symptomatic picture of this disorder is characterized by emotional instability, excessive activity is sharply replaced by passivity, apathy and depression. A good mood suddenly becomes depressed, a person is overcome by deep sadness, a feeling of uselessness and worthlessness. Such mood swings are uncontrollable. Patients cannot stand criticism, ignore any comments addressed to them by others, and become aggressive for no reason.
People with delusions of grandeur suffer from insomnia due to constant nervous agitation; they constantly experience anxiety, which occurs for no reason and cannot be controlled. In severe cases of the disease, a person suffers from deep depression, he has thoughts of suicide, and there is severe mental and physical exhaustion.
Special attention should be paid to the severe form of the disorder, the main manifestation of which is severe depressive disorder with suicidal tendencies. The causes of depression in this case may lie in bipolar disorder, which has phases of mania and depression. Depression can also develop in a person against the background of the fact that he ceases to consider himself better than everyone else and begins to understand that he cannot live up to what he tells others about himself. The collapse of ideas about one's own uniqueness and exclusivity is very difficult for patients. Depression can also be a manifestation of severe mental and physical exhaustion.
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COST OF TREATMENT
Megalomania is characterized not by non-acceptance of other people's criticism, but by a categorical denial of any point of view of others. Sick people often commit dangerous acts and do not react in any way to the advice of others.
Women suffer from delusions of grandeur less often than men. In addition, in the stronger half of humanity, the disorder manifests itself much more clearly, and is more difficult to treat. Men, trying to prove their importance and exclusivity to others, often resort to physical violence.
The manifestation of megalomania in women often takes the form of erotomania. They tend to believe that they are the object of someone's love affairs and sexual fantasies. Such thoughts become obsessive and are completely unfounded. As a rule, women's thoughts are directed towards some famous public figure.
Symptoms and diagnosis
Psychiatrists refer to megalomania as a qualitative disorder of thinking, which means that the “error” occurs at the stage of logical information processing. A person’s beliefs, his conceit, bordering on madness, do not correspond to reality, but it is impossible to convince a person already at the initial stage of megalomania - he believes, he is convinced.
At the peak of the disorder, the patient performs all his actions and thoughts from the position of who he considers himself to be - a king, ruler, president, the greatest scientist, and self-criticism is completely absent.
This is no longer pride, not a mild delusional mood, but a real lack of self-control.
The signs of such a disorder are numerous and characteristic; they are difficult to confuse with other mental disorders even for a layman.
For people with delusions of grandeur, the internal focus is always focused on themselves - they are confident that they are superior to others in some characteristic or in general.
It is difficult to say in advance how a megalomaniac will behave. Much depends on how interesting his personal experience is, what education he received, what memories he perceives as his own.
In the end, much depends on who the patient will identify with - the cruel Emperor Nero or the great lover Casanova.
an aggressive style of behavior , an orderly tone, the promise of inhuman torture and punishment for disobedience, and sometimes physical cruelty will prevail
In the second case, a person begins to behave like an avid ladies' man , not letting any woman pass by, so as not to give compliments or try to touch.
All conversations will be conducted from the perspective of who the sick person thinks he is.
It is quite obvious that the behavior becomes inadequate; the person’s reasoning does not lend itself to normal logic. But in each case, it becomes important for the patient to “draw others into the game.”
They should be admired, loved, respected, valued, and worshiped. The worst thing is when megalomaniacs begin to demand that they be served, that their loved ones fulfill their dirtiest whims and demands.
For men and women diagnosed with “delusions of grandeur,” an important manifestation is instability of moods—either they are in joyful euphoria, or for no apparent reason they plunge into depression and anxiety.
The early stages of the disease are characterized by excessively high self-esteem.
A person’s own opinion is of primary importance; in fact, other opinions do not exist, because the patient does not intend to listen to them.
He cannot listen to constructive criticism addressed to him, as well as the advice of others for him is an empty phrase, which, moreover, is often annoying . At this stage, megalomaniacs are active, mobile, full of energy, but at the same time they often experience severe anxiety, which they cannot explain, and there are moments of incredible absent-mindedness.
Already at the initial stages, physiological disturbances occur - sleep becomes “ragged”, a person often wakes up, and cannot fully rest at night. Aggression increases, especially in men.
Delirium acquires universal proportions already at the peak of the disease. The patient stops being shy and begins to openly declare that he is the ruler of the Galaxy, the incarnation of Napoleon, God, or a new superhero with superpowers, whose task is to protect all people on the planet from an unprecedented threat from outer space.
At the same time, the patient behaves quite naturally, at ease, he is dominated by euphoria and excitement.
If a period of anxiety occurs, the behavior still remains active.
If delusional disorder of wealth or noble origin is more common in men, then erotic delusions of grandeur are more common in women. Disappointment in one's own beliefs (the third stage of mania) is already considered a complication, since it is during this period that a person can be in serious danger.
The more global the delirium, the greater its scale and scope, the stronger the depression will be at the end.
A psychiatrist diagnoses megalomania. A family history is necessarily collected (which relatives suffered from which mental illnesses, whether they were alcoholics or drug addicts), and the work of the central nervous system is necessarily assessed, for which a neurologist is involved and a CT or MRI of the brain is done.
is of great importance . It is carried out several times starting from the first treatment. The specialist will listen carefully to why the patient believes that he is the Savior or the Emperor of the Galaxy; usually at this stage even interns do not have any difficulties, because megalomaniacs willingly share their “life story” and are happy to answer clarifying questions.
And already at this stage, a specialist can understand by the nature of the delirium what concomitant disease a person may have - with progressive paralysis, the delirium is absurd, and with schizophrenia, it is fantastic.
Next, special testing is carried out, which uses standard tests to determine the type of thinking, tests for memory and attention, and performance.
How to Identify a Hypomanic Episode
Identifying a hypomanic episode can be difficult, especially if mania is not something you have experience with.
For someone to be diagnosed with hypomania, they had to experience at least three of the following symptoms for several days. The symptoms will persist rather than simply conveying feelings.
- Increased self-esteem;
- Decreased need for sleep, lots of energy after very little rest;
- Talking more than usual or talking very quickly/excitedly;
- Quick thoughts;
- It is very easy to get distracted;
- Become more goal-oriented than usual and strive to accomplish a lot;
- Doing things without considering the consequences (eg, unprotected sex, gambling, excessive spending);
Although a hypomanic episode should not cause major disruption to a person's daily life, it will be clearly noticeable to friends and family.
For example, you may notice that a usually shy friend suddenly becomes very talkative and outgoing, or a relative who usually procrastinates becomes very goal-focused, staying up all night to get things done.
Clearly identifying a hypomanic episode is important as it allows the person experiencing the episode to access the help and support they may need.
Aristocrat
If the patient imagines himself to be a born aristocrat, belonging to a noble family, then a delusion of a special origin is determined. An unhealthy imagination creates the image of a child born into a family of famous people, for example, writers or rich people. The delirious person talks about his wealth, shares the presence of many valuables.
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Despite the condition, the narration sometimes occurs in a fairly truthful manner. But more often than not, it looks ridiculous and emotional. The degree of delirium starts from several hundred thousand dollars and can reach castles filled with jewelry.
Delirium of a scientist inventor
The disorder is characterized by the patient's belief that he is a great designer and innovator in the field of technology. These include the creators of medicines that will save humanity from all diseases. The patient places the emphasis not on the invention, but on her personality.
Delirium of love
Representatives of the weaker sex are more susceptible to the disorder. A woman believes that a high-ranking man, for example, a famous statesman or businessman, is in love with her. A high level of daydreaming leads to the creation of this kind of illusion.
The delirium of the great reformer
The patient considers himself a great revolutionary, capable of changing the economic situation or becoming a reformer of the social system. As a rule, such ideas are characterized by emotionality, but not concrete actions.
Antagonistic delirium is defined as the opposition between good and evil, light and dark, life and death. Delusions of altruism generate ideas in which the patient imagines himself as the savior of the world and humanity.
Delusions of grandeur against the background of other delusional disorders
Delusions of grandeur, which arise against the background of paraphrenic delusions, often acquire fantastic features and are combined with depersonalization, personality disorder and persecution mania. Katina can be supplemented by the patient’s unhealthy fantasies regarding his uniqueness. For example, a person can tell people about his super mission, that he must save the world or humanity from destruction, that he has a connection with the other world or space.
Delusions of grandeur can also arise against the background of messianic delusions, when a person considers himself a second Jesus and tries to lead the masses. There are cases in history when persons with messianic disorders became popular and organized almost sectarian associations.
The most dangerous to society are people with delusions of grandeur who suffer from Manichaean delusional disorder. Mania manifests itself in the fact that the patient considers himself a defender of the world from the forces of good and evil. Most often, such delusions occur in schizophrenia.
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How to deal with a person with delusions of grandeur?
This question is often asked by relatives and friends of people with this mental disorder. When communicating with such people, it is important to show your interest in the patient’s stories and in his life. It is necessary to show the patient that he is respected and valued, and at the end of the conversation, be sure to thank him for the interesting conversation and his importance. It is necessary to show the patient that they trust him, this will cause a reverse trusting reaction. A person will be able to be convinced of his significance and exclusivity, will calm down and will be able to avoid nervous excitement from personal experiences.
Treatment of megalomania in the clinic and at home
Any mental disorder that is accompanied by delusions of grandeur must be treated immediately before a depressive episode develops. Delusions of grandeur itself cannot be completely cured, but it is extremely important to cure as much as possible the underlying mental disorder against which the delusions of grandeur arose. It is important that therapy is carried out individually, and not according to some standard scheme. Depending on the severity of the disease, the rate of its development and the root cause of the disorder, therapy can be carried out in a 24-hour psychiatric hospital, in a day hospital and at home. Medical practice shows that inpatient treatment gives faster and more lasting results, and the patient, after discharge from the clinic, is almost ready for a full social life.
Treatment of megalomania at home and in a day hospital is possible if the patient’s general psychophysical condition is satisfactory and he is mentally ready to receive therapy at home independently or under the supervision of relatives and friends.
Glossary of terms
In this section we have collected all the terms that you might encounter in this article. Gradually, we will collect from these explanations a real dictionary of a narcologist-psychiatrist. If some concepts remain unclear to you, leave your comments under the articles on our site. We will definitely help you figure it out.
Delusional-hallucinatory syndrome
– a type of hallucinosis that is accompanied by delusions. In terms of content, this delusion corresponds to hallucinations, which is why the patient achieves strong confidence in the reality of fictitious (hallucinatory) events.
Treatment of megalomania in medicine
Patients with delusions of grandeur are treated at the clinic anonymously and without registration. Therapy is aimed at identifying the root cause of the disorder and reducing the severity of symptoms.
Depending on the cause that provoked the development of delusions of grandeur, patients may be prescribed antipsychotics, tranquilizers, and sedatives. A psychotherapist and clinical psychologist also work with each patient individually.
If a patient categorically refuses treatment at the clinic, clinic specialists can have a motivational conversation with him. The service of medical intervention is widely in demand in modern society. It allows a person to realize his problem and decide on therapy.
The cost of all services is fixed. Medical care is provided while maintaining patient confidentiality. The clinic is open 24 hours a day. Specialists receive patients at a medical facility and visit patients at home.
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