What is megalomania and how does it manifest itself in adults?

Megalomania is a mental disorder in which the patient feels like a great person without having any objective basis for this. Many people think that megalomania is when a person considers himself Napoleon. In fact, not every “Napoleon” has delusions of grandeur - for the majority we can only talk about delusional-hallucinatory syndrome.

Now, if the patient believes that it was he who found the cure for all diseases, took over (or will take over) the world, there is a high probability that he really has delusions of grandeur. The patient himself will zealously deny his painful condition - he will be firmly convinced that his abilities are true, great roles and missions are destined for him.

Delusions of grandeur: patient personality traits

Every thought of a patient with delusions of grandeur is focused on his true value to society and the exclusivity of his ideas. As a result, his every act and every conversation, every thought and every action will be aimed at recognizing this very great value in society, alerting the maximum number of listeners about the existence of the patient and his exclusivity.

Such a patient cannot simply believe that there are still people on the planet who, due to their illiteracy and wretchedness, do not know about him, his ideas and great plans. He sincerely believes that everyone must admire and praise him, set him as an example and love his ideas as their own. It is difficult (almost impossible) to convince the patient that the ideas he voiced are not so important and wonderful, and that things are ordinary. A person with delusions of grandeur will attract more and more listeners into his circles.

Symptoms and signs

The signs that appear at certain stages of the development of this disorder help to understand what megalomania is.

1. At the 1st stage - initial manifestations: the signs of the disorder are almost invisible to others, the patient tries to stand out from the social environment as a somewhat remarkable and outstanding person.
2. At the 2nd stage - progression of the disorder: activation of delusions of grandeur, when the patient obsessively convinces everyone of his special position, genius, influence, etc.
3. At the 3rd stage - pathological development: a clear worsening of symptoms in physical and mental terms, attempts to commit suicide (suicide) may be observed, and dementia may develop.

Symptoms of CF most often include the following:

• increased activity, which manifests itself in behavior and emotions (the patient is fussy, inappropriately cheerful, talkative beyond measure, sleeps little, hardly gets tired);
• excessively inflated self-esteem (people around them expect and demand a respectful, even servile attitude towards themselves) while preventing even the slightest criticism of oneself;
• erratic mood (either it is overly elated and optimistic, or it is obsessive, suspicious and aggressive);
• inadequate response to criticism (either completely ignoring compelling arguments about mistakes and miscalculations made, or aggressively defending one’s “infallibility”);
• unconditional belief in the fallacy (bias, banality, stereotypes, lack of independence) of the ideas and opinions of others in comparison with one’s own views;
• in physiological terms: sleep patterns are disrupted (it becomes short-lived, superficial and anxious, the patient often wakes up), after a phase of excessive activity comes a phase of exhaustion (not only physical, but also mental).

In men

Features of megalomania in men are manifested in the predominance of aggressive emotions, which is realized in behavioral reactions:

• in the psychological sphere - despotism, emotional pressure, tyranny as a character trait;
• in the physical sphere - by demonstrating one’s superiority in strength, domestic violence (beatings, etc.).

Boasting, disregard for the opinions of other people, exaltation of one’s own opinion are also characteristic of men with CF.

Among women

Statistically, megalomania is recorded much less frequently in women (compared to men). A woman with CF can be distinguished by:

• by the desire to prove that she looks the best (even if there are no objective reasons for this);
• by perfectionism in assessing one’s achievements (“I did it perfectly, others are simply far from me”);
• for “unsurpassedness” in raising children and managing everyday life (in the interpretation of the woman with megalomania herself).

Symptoms of pathology with megalomania

Not every patient’s pathological condition (in fact, megalomania itself) will manifest itself quite clearly and actively, accompanied by strong delusional ideas and attempts to convey and impose one’s own views on others. Symptoms of the pathological process may also include other manifestations:

1. Excessive activity of the patient. The most striking symptom of megalomania is the patient’s active promotion of his ideas, hypertrophied energy and the absence of a visible feeling of fatigue.
2. The patient is bothered by frequent and unreasonable mood swings. In a person, stupor can be replaced by excessive excitement, a depressive state can be sharply replaced by euphoria, and so on. Such changes are practically not controlled by the patient himself and occur outside his will and power.
3. High self-esteem of the patient. A person believes that his ideas are of high value, and he himself is an exalted bearer of invaluable knowledge. At the same time, the patient demands the same recognition and respect from his environment.
4. The patient is unable to adequately perceive the reality around him, to perceive reality. Every remark will be received with hostility, advice will be ignored or sharply and very rudely suppressed.
5. The patient is simply not able to perceive someone else’s opinion and position - he will deny any criticism and every alternative opinion existing in his environment.
6. The patient is regularly bothered by insomnia - it is caused by excessive activity, which is always accompanied by delusions of grandeur. A person with a “manya” is prevented from falling asleep normally by obsessive thoughts about his greatness.

In men, delusions of grandeur are diagnosed much more often than in women - they are characterized by a greater manifestation of aggression in the process of conveying their own thoughts and ideas, which can result, among other things, in physical manifestations of aggression. Men are active and persistent, trying to neutralize everyone, even an imaginary rival, trying to challenge the greatness of the patient.

In women, delusions of grandeur occur in milder forms and attacks of intense aggression are very rare. The main motive of “great women” is to be the best in everything. Megalomania often takes the form of erotomania and delusion; women often invent intimate relationships with celebrities as indicators of their greatness. In women, megalomania is often accompanied by bouts of depression and suicidal tendencies, which practically never happens in men.

Scope and types of delusional ideas

A delusional idea is equivalent to a false judgment, which has the following characteristics:

- delirium that occurs against the background of illness,

- extreme determination of one’s importance,

- indisputability of ideas and actions.

Against the background of various forms of manifestation and occurrence of delusional ideas, several types stand out:

— delusion of persecution is a paranoid delusion when a person constantly has the feeling that he is being pursued, threatened and even wanted to kill,

- delusion of self-blame - a depressive type of delirium, which is clearly manifested in a feeling of guilt for an allegedly committed act. If this condition is neglected, it can lead to suicide,

- delusions of grandeur - manic delirium, which implies a clear overestimation of one’s personality. It is this condition that is often behind the destruction of relationships in families, at work and in society.

In science, the concept of “delusions of grandeur” is called megalomania or expansive delusion. This is a pathopsychological syndrome that is manifested by distorted self-perception and manifests itself through a global revaluation of one’s own personality.

Factors and risks of developing megalomania

Based on statistical data, the main “risk groups” for megalomania are identified:

1. Patients with mental pathologies, especially with a predominance of schizophrenia and manic-depressive psychosis.
2. Men with alcohol or drug addiction.
3. Patients who have suffered head trauma or severe mental experiences (especially in childhood).

During the pathological process, patients alternate between the following stages:

• Mild symptoms.
• Full-blown manifestation of pathology (delusional manifestations).
• Period of decompensation (depression, physical/mental exhaustion).

Diagnostic methods

To diagnose delusions of grandeur, the Young test, . It includes eleven questions, each of which has five answer options. This test assesses the patient's mood, energy level, activity level, sleep quality, mental stability and level of irritability, thought disorders and quality of speech, attention to one's own appearance and neatness, and sexual activity.

Another important point is the patient’s recognition or denial of pathological changes in his behavior.

Testing gives a fairly large number of false positive results. Therefore, the psychiatrist conducting it must compare the data obtained during the Young test with information that the patient himself or his relatives can tell him, as well as with the clinical manifestations of the disease that arise during the conversation with the patient.

Note! A patient suffering from delusions of grandeur requires treatment from a psychiatrist. A psychotherapist and a neurologist can also provide valuable assistance to such a patient.

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.

Bipolar affective disorder

• Life with BAR

The disease can begin with both depressive and manic phases.
More often, bipolar disorder begins with a depressive phase, during which people turn to a specialist. In the hypomanic phase, patients become overly active, they are characterized by high mood, a lot of ideas, they are not afraid to take risks, many of them successfully start a business. But when moving into mania, they become more and more restless, irritable, conflictual, and ideas of greatness may arise that were not characteristic of a person before. Often, patients with bipolar disorder do not realize the severity of the situation. Until a certain point, the presence of a hypomanic phase does not bother them. On the contrary, many are happy - they feel full of ideas, strength, and efficient enthusiasts. When the depressive phase sets in, they quickly lose their high performance. Some patients try to bring it back with various stimulants - from tea, coffee and energy drinks to narcotic drugs. Doing this is dangerous, since taking stimulants provokes an increase in the alternation of phases. At the same time, drug dependence may develop.

• Phases and symptoms

The symptoms of bipolar disorder in manic and depressive phases are different. The behavior of patients in the manic phase often does not correspond to generally accepted norms - for example, they may laugh at tragic events. During the manic phase, the patient goes through several stages.

Hypomania

– the patient is constantly in high spirits, excited, speaks quickly, jumping from topic to topic, restless, restless, he has a strong desire to work, create, and communicate. The patient often becomes hot-tempered.

Manic phase.

In the manic phase, patients have a good appetite, sometimes they eat more than usual, sleep little, after which they feel cheerful and full of energy. Libido increases. At the peak of mania, all these symptoms reach the height of manifestation, activity becomes unproductive due to high distractibility, inability to concentrate, they often provoke conflicts, and problems with law enforcement agencies may arise.

Depressive phase.

It is characterized by daily fluctuations in mood - in the morning the patient wakes up already depressed and anxious, but in the evening the mood may increase slightly. Appetite is reduced, the patient loses weight. Interest and pleasure in activities that you previously enjoyed disappear. There is no strength to perform even the simplest necessary actions, you have to constantly “overcome yourself and force yourself to do what you used to do easily,” libido decreases. At the peak of the phase, ideas of worthlessness, guilt, delusions of self-blame, and depersonalization may arise. Due to the lack of feelings of joy and meaning in life, self-harmful behavior and suicide attempts are possible.

Phase change.

The most severe condition, as described by patients with bipolar disorder, is not even the peak of mania or the peak of depression, but the moment of change from one state to another. Sometimes a patient falls from the shining heights of mania rather quickly into the dark depths of depression. In addition to the feeling of the collapse of the world, a person often feels this event as physical pain. Even when the depth of emotion is small, when the change of phases is felt as a change of mood, it still causes serious inconvenience. Unreasonable mood swings exhaust both the patient and the people around him. It happens that in mania at the peak of libido, people with bipolar disorder fall deeply in love, get married or get married. The phase changes, and the partner of the patient with bipolar disorder ceases to recognize him, as if he had married one person, but had to live with a completely different, depressed one.

Somatized depression.

One of the varieties of the depressive phase is the so-called “latent or somatized” depression, which can be difficult to diagnose behind the façade of somatovegetative symptoms. Simply put, depression can “hide behind the masks” of various symptoms (pain of various localizations, sleep disturbances, changes in body weight, etc.), as well as diseases of the cardiological, urological, gastroenterological, etc. Therefore, it is often necessary to jointly treat somatic diseases with a specialist doctor and a psychotherapist.

• Social consequences

In general, bipolar disorder has a negative impact on a person’s social adaptation. If a patient with bipolar disorder is not treated and is not trained by a doctor to notice the occurrence of phases in a timely manner and promptly seek help, it is difficult for him to adapt to society. In a social sense, a depressive episode does more harm than a manic episode: patients do not go to work, do not go outside, stop communicating with friends and acquaintances, and withdraw into themselves. In the manic phase, although patients do strange things, they often work and even write books and paintings, give lectures, and make scientific discoveries.

• Treatment with medications

Treatment of bipolar disorder is a continuous “juggling” of different drugs. There is basic therapy - normatives that stabilize mood. There is therapy in the manic phase, there is therapy in the depressive phase. The choice of drugs is difficult, because most of them reinforce cyclicality: they treated depression with the wrong drug, and after 2 weeks the patient went into mania. Mania was treated with the wrong drug - the patient became depressed. A patient with bipolar disorder needs constant contact with a doctor.

• Psychotherapy

Psychotherapy is used to treat bipolar affective disorder. The task of a psychotherapist is to help the patient restore mental health, return to a normal lifestyle, teach him to recognize the onset of phases and promptly seek help from a specialist. The patient needs to learn to adapt to the symptoms of manic and depressive phases so as not to lose his professional skills and social connections. An important point is psychoprophylaxis, which can be carried out by the patient himself; its program will be individual depending on the person’s lifestyle.

In most cases, treatment is carried out on an outpatient basis, the patient remains socially active. In severe cases, hospitalization may be required; this decision is made by the psychiatrist at the appointment. The duration of hospital stay should be at least 2–3 weeks.

Causes

Mania is caused by the predominance of overexcitation processes in the brain, which triggers a cascade of complex physiological and chemical reactions in the nervous system, and, as a result, throughout the body.

Doctors identify several groups of causes for the development of mania:

1. Internal causes (endogenous). These include disorders of protein metabolism in the nervous system, immune disorders in brain tissue, genetic predisposition, hormonal disorders (during the postpartum period, menopause, adolescence).
2. Consequences of organic damage to the central nervous system due to injuries, poisoning, atrophic processes, neoplasms, impaired blood supply to the brain, etc.
3. Infections and poisoning.