Megalomania is a mental illness. Megalomania. Megalomania disease (schizophrenia). Signs of megalomania. What does "delusions of grandeur" mean?

Delusions of grandeur or delusions of grandeur are a feature of self-awareness and behavior of an individual, characterized by an extremely pronounced overestimation of one’s importance, fame, power, and political influence. Unprofessional term" megalomania "is usually used in everyday life and is erroneous. The term “mania” is applied to a state of inappropriately elevated mood, accompanied by increased motor activity, as well as an accelerated rate of thinking and speech. A person suffering from delusions of grandeur may, in fact, be an important figure.

Delusions of grandeur - This is a mental disorder, a form of delirium. A person suffering from this mental disorder is characterized by a painful desire to stand out from the general environment, to be exceptional, important. Patients with delusions of grandeur consider themselves special, possessing rare talents, power, wealth, etc. They are not aware of their mental problems, and therefore do not seek medical help.

Delusions of grandeur in modern psychiatry are not considered a separate mental disorder, but are considered as a symptom of it. Delusions of grandeur can occur against the background (manic-depressive psychosis), as well as various manias, progressive paralysis and organic brain damage.

Causes of delusions of grandeur can be:

• genetic predisposition;
• schizophrenia;
• neuroses, psychoses;
• brain injuries;
• children's moral injuries;
• history of syphilis.

The disease manifests itself in patients’ excessive concentration on their own “I”. They consider themselves brilliant, irresistible, etc. And it is impossible to convince them otherwise. These people require increased attention, admiration, and approval.

Delusions of grandeur do not always have pronounced symptoms, so only a highly qualified doctor can make a correct diagnosis. You should know that the usual heightened self-esteem can develop into delusions of grandeur. This risk is also higher in people who have a pathological desire for excellence and leadership.

Main manifestations delirium of grandeur:

• delusional ideas arise with clear consciousness;
• sudden mood swings;
• egocentrism;
• sleep disorders;
• excessively high self-esteem.

It is important to know that delusions of grandeur can be a manifestation of paranoid schizophrenia.

Treatment of delusions of grandeur

Treatment of delusions of grandeur depends on the clinical manifestations, and it must be comprehensive, that is, combine pharmacotherapy and non-drug treatment methods. Since the disease is a manifestation of some mental disorder, then, first of all, you need to start with the treatment of this disease. Pharmacotherapy involves the use of antipsychotics, and lithium preparations are prescribed for prevention.

The Mental Health clinic uses techniques that give good results in any clinical situation. If you notice that your loved ones are showing signs of delusions of grandeur, you should urgently make an appointment for a consultation at our clinic.

Don't hesitate to contact a specialist!

Megalomania, or delusions of grandeur (in everyday life - “delusions of grandeur”) is not an independent mental illness, but can be included in the form of delusions in other mental disorders (paranoia, schizophrenia, paraphrenia, manic syndrome, bipolar disorder ...).

Delusions, “delusions of grandeur,” come in the form of a grandiose-fantastic exaggeration or grandiose absurdity in a person’s self-awareness, thinking (speech) and behavior.

Typically, a person with some kind of psychotic disorder and “delusions of grandeur” inflates his importance too inadequately, almost to the point of omnipotence in any area of ​​life.

• Delusion of belonging: to a noble family, a famous dynasty..., a great nation...
• Delirium of wealth: a patient can be absolutely sure that he is very rich..., for example, a homeless person can consider himself a rich person if he has several thousand in his pocket - which looks plausible. Other nonsense can be clearly ridiculous and absurd, for example, a person can claim that he is the owner of gold mines all over the world...
• Delirium of ingenuity- this is when a person with delusions of grandeur is convinced that he has invented something extremely significant for humanity, for example, the elixir of youth, a time machine, a perpetual motion machine...
• Delirium of love- with this type of delusional idea, the patient can be sure that a very famous, noble, important person is in love with him...
• Delirium of reformism- such a person will confidently prove any theory he has developed, when implemented in life something very significant will happen for all humanity

Signs of megalomania

The main symptoms and signs of megalomania are based primarily on egocentrism sick.

Such a person can either make his interlocutor laugh with his ridiculous and inadequate statements about his importance and significance, or he can also make him angry (when he is too intrusive, focusing on his EGO).

It becomes impossible to communicate with an egocentric person who is fixated only on his own “I” in every possible way. His megalomania manifests itself in almost everything.

The only way to interact with him- this is to agree with his delusional ideas and support his Ego (but this is only so as not to provoke a conflict and his aggression, which may arise as a result of your parrying his ideas).

Under no circumstances should you try to convince a person with delusions of grandeur - this is absolutely useless, and sometimes even dangerous, because an egocentric person hears only himself, and your logical and adequate arguments can anger him and lead to aggression.

Who might have delusions of grandeur?

As noted above, megalomania occurs as a symptom of another, underlying mental disorder (paranoia, schizophrenia, manic psychosis, etc.)

But you should know, that delusional ideas of greatness (or egocentrism), in a mild form, can be present in a healthy person, but with inflated self-esteem, arrogance, great self-confidence...

Some people may have e.g. paranoid accentuation of character is not a mental disorder, but the condition may border on neurosis, or borderline disorder. Such individuals may exhibit symptoms of both megalomania and persecution delusions, but their delusional ideas may still be subject to self-criticism and an adequate vision of the situation.

Although, people with a paranoid psychotype can have an unbearable character due to their egocentrism (their “I” is always in the center, higher and more important than others).

If a person has too high self-esteem, conceit, self-confidence, a constant desire to emphasize his “I”, and his “delusions” and “delusions of grandeur” are not too ridiculous and fantastic, then such a person can still be helped by psychological methods, because in the future, its accentuation can turn into a real personality and mental disorder.

In such people, delusions of grandeur often manifest themselves in alcohol intoxication ( cm. does a drunk tell the truth?)

Treatment of delusions of grandeur carried out by psychiatrists based on identifying the main diagnosis of a mental disorder - they usually use antipsychotics, tranquilizers, and anxiolytics.

Psychotherapy is used to maintain a more or less normal state.

There are a huge number of different diseases in the world. However, today mental illnesses, various diseases and deviations are still very little studied. In this article I would like to talk about exactly what

Illness or...?

When trying to define a concept, you may encounter many problems. After all, modern people use this phrase - “delusions of grandeur” - quite often in everyday life. It can be applied to bosses, show business people and other individuals whose behavior causes indignation among others. But in addition to its everyday use, such a phrase also exists in medicine. And it has a very clear designation.

About the concept

So, first of all, it’s worth understanding the concept itself. What is megalomania? If we consider the etymology of the word, then translated from Greek it is “too big”, “exaggerated”. Only after this can you draw certain conclusions for yourself.

If you strictly follow the medical dictionary, then it says that megalomania is a type of behavior and consciousness of a person when he too exaggerates his importance, mental abilities, talents, importance and power. As for science, this disorder is dealt with by the section of mental pathology, which most often defines this condition as a component of paranoia or a symptom

Where does the disease come from?

The reasons should also be considered. When does megalomania occur? It runs the risk of appearing if a person has progressive paralysis (or Bayle's disease), as well as cerebral syphilis. These diseases have several stages: from the onset to the development of the disease (from general weakness of the body to complete madness or even insanity).

Megalomania is a symptom that can either manifest itself or go unnoticed. This is especially true for syphilis. Here, this disorder manifests itself if the disease does not make itself felt for several years due to the fact that it occurs in a special, milder form (however, this happens in only 5% of patients). An interesting fact is that this state of the brain can also arise when a person begins to suddenly develop new ideas, an extremely painful reaction to various external stimuli is detected, and excessive eloquence may occur.

A few words about schizophrenia

Quite often, this disorder is a symptom of a disease such as paranoid schizophrenia. Megalomania in such a situation is a kind of obsession. The role in this situation is excessive selfishness and exaltation of one’s own “I”. Most often, a person is haunted by this mental disorder precisely during moments of hallucinations or a delusional state. It is then that the patient feels like an extremely important person.

Most common cases

However, more often than not, in addition to the options described above, such a mental disorder can arise as a result of a person’s strong dissatisfaction with his own person. The irritant may be appearance, lack of education or unsatisfactory place of work, as well as many other factors. In such a situation, a person tries to correct the situation himself using the methods available to him: go to study, change jobs and improve his appearance. However, all this will already be accompanied by a certain overestimation of one’s own importance and too sharp exaltation of what was recently a disadvantage.

In this case, it is worth noting that delusions of grandeur are difficult to discern and are almost impossible to identify unless you seek medical help (which happens extremely rarely). But even after definition, this disorder (if we talk only about its presence) is not considered to be something special that deserves much attention in the section of mental disorders.

Clinical picture

When considering this mental disorder, it is also important to find out what signs of megalomania exist. As has already been said, this state of mind is difficult to discern. However, the following symptoms can become beacons for its definition: bad mood, witticisms that the patient throws at others.

To determine this disorder in the early stages of its occurrence, it takes quite a lot of time. This will require several tests, as well as observation by a specialist, who will draw the necessary conclusions after a certain time. Most often, this deviation manifests itself with a sharp change in mood, as well as if a person is almost always in an anxious state.

The following symptoms may also be characteristic of patients: talkativeness, increased activity and even sexual preoccupation. At the same time, such people have a pronounced concentration on their ideas and positive aspects. They completely reject and are not even interested in other people's opinions about themselves. It is also worth noting that with such a mental disorder a person may experience aggression. It is directed mainly at close people. The patient becomes a tyrant at home, not embarrassed by assault and other manifestations of his “importance.”

Treatment

What treatment can a person with delusions of grandeur receive? You will not be able to get rid of this mental disorder on your own; for this you will need the help of a specialist. To do this, a person must seek help from a psychologist, who in some cases can redirect for treatment to another doctor - a psychiatrist.

It is worth noting that you can cope with this disorder if you carefully follow all the recommendations of your doctor and complete all sessions on time. In such a situation, drug treatment is simply not required, and there will also be no need to admit the patient to a hospital. However, if megalomania is part of a more complex disease, antipsychotics may be prescribed or the patient will most likely be admitted to a hospital, where he will receive comprehensive treatment not only for megalomania, but also for the disease that led to the appearance of this disorder.

It is not always the case that a person who considers himself Napoleon suffers from delusions of grandeur. Most likely this is one of the varieties of delusional-hallucinatory syndrome. But a person who believes that he has found a cure for all diseases is very likely to subsequently receive exactly this diagnosis.

Megalomania is a mental disorder that manifests itself in extreme exaggeration of one's abilities, capabilities, popularity, wealth, influence, and other things. It is a symptom of a number of diseases.

Megalomania is also characterized by patients’ denial of the unnaturalness of their condition; they are firmly confident in their abilities, exceptional mission and important role.

Personality characteristics of the patient

All thoughts of a patient with delusions of grandeur are concentrated on his exclusivity and value to society. Accordingly, all his conversations, actions, thoughts are aimed at recognizing this value, at notifying as many people as possible about his existence and uniqueness. The patient cannot believe that there are people in the world who do not know about him and his great ideas. He is confident that everyone around him is obliged to extol and admire him, and spread his views. Megalomaniacs cannot be convinced that their ideas are not really that important. They strive to captivate as many people as possible.

The disease of delusions of grandeur does not always manifest itself so clearly, with pronounced delusions and attempts to impose one’s opinion on as many people as possible. Its symptoms may also include:

• Increased activity of the patient. Since a manic episode of bipolar disorder often manifests itself as delusions of grandeur, the symptoms can be combined. The most striking manifestation of this combination is the very active promotion of ideas to the patient, his energy, and the absence of a feeling of fatigue.
• Frequent mood changes. Excitement gives way to stupor, euphoria to depression, vigorous activity to passivity. These changes are very poorly controlled by the patient or occur outside his will.
• Extremely high self-esteem of the patient. In addition to the incredible value of ideas, the patient exalts himself as their bearer and demands a respectful, subservient attitude from those around him.
• Inability to take criticism. All comments that in any way discredit the patient’s ideas are, at a minimum, ignored, and often very rudely suppressed.
• Failure to accept other people's opinions. Often, patients not only deny any criticism addressed to them, but also any alternative opinion in general. They also do not take other people’s advice, even when the patient’s actions are stupid, dangerous or simply contrary to common sense.
• Insomnia. Mainly associated with increased activity, which is characterized by delusions of grandeur. Symptoms may include difficulty falling asleep due to influxes of thoughts and ideas, or less need for sleep due to excessive energy.
• More often, delusions of grandeur occur in men. They are characterized by great aggressiveness in conveying their ideas, which can transform into physical aggression. Men with delusions of grandeur are more active, persistent, expansively expanding their areas of influence, and strive to neutralize all opponents.
• Megalomania in women is characterized by a milder course; attacks of aggression practically never occur in them. The main motive of megalomania in women is to become the best in some area of ​​life or in the maximum of them. Often the disease takes the form of erotomanic delusion, in which a woman claims that some famous man is in love with her or has had sexual intercourse with her.
• As a result of megalomania, depressive episodes and suicidal tendencies are often observed.

Risk factors for delusions of grandeur

Statistical studies and the main causes of the disease allow us to identify the following groups of people who have an increased likelihood of developing delusions of grandeur:

• People with a diagnosed mental disorder, especially schizophrenia or manic depression;
• Men;
• People with alcoholism or drug addiction;
• People who have a history of syphilis;
• Traumatic brain injuries in childhood;
• Severe mental trauma.

Periods of mania

The disease megalomania occurs with a characteristic alternation of symptoms:

• In the initial stage they are weakly expressed, the disease resembles an accentuation of character.
• The stage of developed manifestations with characteristic delirium, expressed ideas of greatness.
• Stage of decompensation with a predominance of depressive symptoms, extreme physical and mental exhaustion.

Certain types of megalomania

Some types of delusions are characterized by a very vivid and typical picture, which includes delusions of grandeur. Psychiatry distinguishes them into separate forms.

Paraphrenic delirium. This is a variant of megalomania with fantastic features, accompanied by mania of persecution and influence, depersonalization, and a syndrome of mental automatism against the background of manic or euphoric affect.

Basically, this variant of megalomania is an evolution of a paranoid or paranoid state, accompanied by delusions of influence. The symptoms of the disease are accompanied by ideas of grandeur, fantasies that confirm the patient’s exclusivity, and a tendency to interpret events in favor of one’s own exclusivity. Fictional stories appear about your great past or present. At the same time, delusions of grandeur take on an extraordinary scope and completely implausible forms. The delusion of persecution persists, transforming in accordance with the ideas of greatness.

“Patients with this form of the disease claim that they have a special, “galactic” mission, that their ideas can save humanity, open the way to space, and cure all diseases. The patient can claim that all passers-by recognize him, and even vehicles or trees on the street wish him good luck and offer help. At the same time, delusional ideas of persecution are expressed - that he is being monitored from space, they are threatening to destroy him with radiation unknown to science, and the like.”

Messianic delirium. It is not so common, but many patients with this delusion have become widely known. They claim to be a new incarnation of Jesus Christ or the reincarnation of a deity from a more exotic cult. A number of them manage to gather fans and believers around themselves and become the founders of a new sect.

It is characterized by the delusion of a confrontation between two forces - good and evil, different religions, angels and demons, political parties, people and evil spirits. The outcome of the confrontation is seen by patients as tragic, up to and including the destruction of humanity or the entire Earth. The patient, in his opinion, stands on the verge of opposing forces, preventing them from destroying the world, which is where megalomania manifests itself. Symptoms are especially characteristic of the acute period of schizophrenia. Such patients can be extremely dangerous to others.

Depression as a consequence of megalomania

Often the outcome of megalomania is a deep depressive disorder with suicidal tendencies. There are several reasons for this phenomenon.

• Delusions of grandeur often appear during the manic phase of bipolar disorder. This period naturally gives way to a depressive episode. And the more pronounced mania was observed in the patient, the more difficult it is for him to endure the period of loss of strength.
• Over time, the patient's grounds for delusions of grandeur disappear. The patient sees that his ideas are of no use, a woman, confident in her exceptional beauty, enjoys less and less success with men, the cure for all diseases cannot cope even with a common cold. The time of collapse of ideas of greatness is extremely difficult for patients, even to the point of suicidal attempts.
• Extremely wasteful use of the body's resources during an active episode of megalomania leads to their depletion and a sharp decline in vitality. During this period, the patient becomes disillusioned with all his ideas, and may demonstrate symptoms of “inside out” mania - convincing everyone of his insignificance, insignificance, and uselessness.

A depressive episode at the end of mania can reach significant severity, even suicide. Therefore, timely recognition and treatment of the disorder is extremely important.

In clinical psychiatry, megalomania is defined as a form of psychopathological condition or one of the varieties of affective syndrome in which a person has a false belief that he has outstanding qualities, is omnipotent and famous. Often possessed by delusions of grandeur - in the complete absence of any objective grounds - he so overestimates the importance and significance of his personality that he considers himself an unrecognized genius.

In addition, there may be illusions of having close relationships with famous people or fantasies about receiving a special message and a special mission from higher powers, the meaning of which no one understands...

Epidemiology

According to international studies, megalomania in drug addiction and substance abuse occurs in 30% of cases, in patients with depression - in 21%.

With bipolar mental disorder, this pathology develops in patients under 20 years of age in 75% of cases, equally in men and women, and in people 30 years of age and older (at the time of onset) – in 40%.

In addition, delusions of grandeur develop much more often in people who have a higher level of education, who are more emotional and prone to affectation.

Causes of megalomania

Psychiatrists admit that it is difficult to determine the specific causes of megalomania. Some consider this mental disorder to be an extreme manifestation of the narcissism syndrome; others associate it with bipolar affective disorders (in the stage of increased excitability) and argue that most often megalomania is a symptom of the paranoid type of schizophrenia.

Obviously, this is close to the truth, since almost half (49%) of people suffering from this form of schizophrenia are obsessed with delusions of grandeur. In addition, comorbidity (i.e., a combination of pathogenetically interrelated diseases) of the syndrome of narcissism and bipolar disorder is noted: approximately 5% of patients with bipolar disorder have narcissistic personality disorder. Moreover, both diseases potentiate each other, and then megalomania can be diagnosed (59%).

Among the main causes of megalomania are also:

Lesions or anatomical abnormalities of the brain, particularly in the frontal lobe, amygdala, temporal lobe, or parietal cortex.

A genetically determined increase in the concentration of neurotransmitters or a change in the density of dopaminergic receptors in the brain. That is, the pathogenesis of mental pathology is associated with the fact that in some areas of the brain there is an excess of dopamine neurotransmitters with a simultaneous deficiency of its receptors, and this leads to overactivation or inadequate activation of a particular hemisphere (as studies have shown, most often this is the left hemisphere). Among the causes of megalomania, 70-80% are genetic factors.

Neurodegenerative diseases (Alzheimer's disease, Huntington's disease, Parkinson's disease, Wilson's disease), although the percentage of patients who, with these diagnoses, may develop a mental disorder in the form of secondary megalomania is relatively small.

Drug addiction, since narcotic substances cause drug-induced psychosis (very often with delusions of superiority and omnipotence).

Use of certain medications. In particular, this applies to Levodopa (L-dopa), used to treat cognitive impairment in Parkinson's disease; withdrawal of this drug changes the monoaminergic function of dopamine mediators.

Risk factors

The following psychological and emotional risk factors for the occurrence of this pathological mental state are called:

Severe depressive disorders (in which megalomania becomes a protective mechanism of the psyche);
-obsession with achieving the highest educational development and socio-economic status;
-living alone for a long time, lack of family relationships.

In addition, foreign psychiatrists associate risk factors for the development of secondary megalomania with vitamin B12 deficiency, thyrotoxicosis and carcinoid syndrome in the presence of neuroendocrine (catecholamine-producing) tumors.

Symptoms of megalomania

Some symptoms of megalomania were named at the very beginning of the publication. It remains to add that - in addition to the conviction of his extraordinary abilities and deep knowledge - a person believes in his own invulnerability and believes that he does not need other people.

The first signs may manifest themselves in the form of a constant desire to be the center of everyone's attention, the need for admiration, as well as recognition and assertion of one's superiority over others. That is, the ability for objective self-esteem disappears and emotional egocentrism begins to develop.

In most cases, megalomaniacs are pathologically boastful and behave in a pretentious and effusive manner. Their mood changes very often and for no reason, energy gives way to irritability and outbursts of anger. There is a decrease in the need for sleep and rest, disturbance of appetite (overeating or refusal of food), as well as tachypsychia - jumping from one thought to another, accelerating the rate of speech.

Conflicts with others are perceived by patients as the reluctance of others to recognize the unique qualities of their own personality (which exist only in the patient’s imagination). Some patients believe that they are kings, great generals or inventors, or direct descendants of famous people. Compared with narcissism syndrome, patients with megalomania tend to be more active and aggressive.

Stages

As the symptoms of megalomania progress, three stages of this psychopathological condition are distinguished:

Initial (its first signs were listed above);
-progressive stage (accompanied by auditory hallucinations and confabulation);
- stage of extreme severity - paranoid delusions of grandeur or psychosis with fantastic hallucinosis, attacks of aggressiveness, decreased mental abilities.

Complications and consequences

Consequences and complications are associated with disruption of human behavior and functioning in society. At the same time, according to most psychiatrists, patients suffering from delusions of grandeur have a lower risk of suicidal thoughts and attempts.

Diagnosis of megalomania

The main diagnosis of megalomania involves identifying this pathology using a special Young test, which was developed by a group of foreign psychiatrists.

In the so-called Young Mania Rating Scale (YMRS) eleven five-choice questions included.
Questions concern:
- level of mood, motor activity and energy level;
-sexual interests;
-duration and quality of sleep;
-degree of irritability;
-assessment of speech, thinking disorders and the content of the patient’s conversations;
-explosive or aggressive behavior;
- features of appearance (neatness or carelessness in clothing, etc.), as well as the degree of awareness of the presence of the disease or complete denial of any changes in behavior (in most cases, such conditions are characterized by egosyntonicity, that is, the patient perceives his behavior from the point of view of his own standards).

The psychiatrist compares the test results (and, as practice has shown, it has a fairly high level of false assessments) with the symptoms that the patient or (most often) his relatives complain about, as well as with those clinical signs that appeared and were identified by the doctor during the conversation with the patient.

Differential diagnosis

In psychiatry, differential diagnosis is very important, since both schizophrenia and bipolar disorder are mental disorders with loss of contact with reality and psychotic behavior. And it is necessary to clearly identify maladaptive personality traits in order to avoid misdiagnosis and find specific approaches necessary for treatment.

Treatment of delusions of grandeur

Treatment of megalomania is carried out to improve the patient’s condition, since it is impossible to cure this mental pathology.

Some patients may benefit from individual sessions of cognitive behavioral therapy, which is aimed at correcting irrational thinking and inappropriate behavior. Others are more helped by interpersonal or interpersonal therapy, aimed at developing algorithms for resolving conflict situations in which the patient finds himself.

For circadian rhythm disturbances associated with bipolar disorder, social rhythm therapy, a type of behavioral therapy, is used.

For patients suffering from severe megalomania, psychotropic drugs are needed - neuroleptics and antipsychotics that stabilize the mental state.

Also, in the treatment of this pathology, the patient’s conscious adherence to all medical prescriptions (complex therapy) is of great importance.

The prognosis depends on the severity of the disease and the intensity of its manifestation. In any case, megalomania is a sign of abnormal, inadequate mental activity of a person.