Having a high self-esteem is a great thing—it means that you’re not only comfortable but confident in the person that you are. However, it is possible to be overly confident, otherwise known as cocky or arrogant, which isn’t such a great thing. Arrogance is characterized by one’s overestimation of his or her abilities; people who possess this quality often boast about their self-perceived talents and successes to a fault. But they can be made aware of this issue and easily resolve it, unlike another group of overconfident individuals: those who have delusions of grandeur.

A delusion of grandeur is one’s false belief in his or her own greatness or superiority. Not only do people who experience these delusions have a high self-esteem but they insist on their importance, despite proof that says otherwise. For example, an individual might falsely believe that they are the president’s right-hand man. They may recount details of the relationship and stress the importance of their role in the president’s doings, but they’ve actually never met the president and are unable to produce any evidence of the claimed relationship. Delusions can follow this scheme, whereas an individual believes they have a special relationship with a celebrity or person of authority, or they may follow a couple other common schemes: one belief being that they have a special destiny (typically involving power or fame), and another that they have a special relationship with a supernatural being such as God.

Identifying Delusions of Grandeur

People who have delusions of grandeur genuinely believe that they’re of great importance—that their mere existence is a gift to the world. In their minds, they aren’t making this stuff up. So how could one ever know that they, in fact, have these delusions of grandeur? These people typically experience these delusions of grandeur as a symptom of another, bigger issue like schizophrenia or narcissistic personality disorder. That means that they and/or their loved ones have likely been made aware of their delusions. Still, these delusions are their reality.

Treating Delusions of Grandeur

Again, delusions of grandeur typically present as a symptom of a mental illness; therefore, it’s important to first determine this underlying cause. Once that has been identified, a mental health practitioner can more easily and more effectively recommend a specific treatment method—this could be talk therapy, medication (e.g., antidepressants, antipsychotic medications), or even a combination of the two. Furthermore, it’s important that delusions of grandeur are determinedly the matter at hand and the individual’s overconfidence and self-perceived greatness aren’t just that.

Is It Possible to Have Delusions of Grandeur, But Not a Mental Illness?

Delusions of grandeur are not always explained by mental illness—so if you don’t have a mental health condition, you can still have these misbeliefs. But why? What causes them? Answering this question can be tricky. But there are a few possible explanations that offer a better understanding:

  • You have anatomical abnormalities in your brain. Research suggests that abnormalities in the amygdala, fronto-striatal circuits, and parietal cortices can cause an individual to have delusions.
  • You’ve injured your brain and subsequently triggered delusions. If you have sustained a brain injury or multiple brain injuries (especially to the frontal lobe), then you may be more likely to experience delusions.
  • You could be experiencing delusions of grandeur as a result of drugs. It is possible to have delusions of grandeur after using or abusing drugs. Typically, these drugs are stimulatory agents that affect one’s dopamine levels which can provoke stimulant-psychosis.
  • Your genetics may be to blame. Some researchers believe that polymorphisms of genes in regards to dopamine receptors can cause delusions of grandeur. They also hint at a connection between schizophrenia and certain genes.