Megalomania (also known as megalomania ) describes an overestimated sense of self-worth to an extreme degree . This concerns, for example, the delusional idea of ​​being an important person or figure (with a mission). Megalomania often occurs as a symptom of mental disorders from the circle of narcissistic or schizophrenic personality disorders.

What is megalomania?

Megalomania is a form of delusion and is therefore accompanied by the fact that those affected lose a connection to reality. They are not aware of the senselessness between their own experience and assessment of the situation and reality, while at the same time the affected persons do not realize any error of perception (ego syntony).

According to, Megalomania is merely a subspecies of delusion and can be further differentiated. Often it is a symptom of a narcissistic personality disorder, schizophrenia or manic depression at times of mania.

Even proof that the content of the delusion is a misperception will not change the subjective conviction of those affected. The megalomania is so pronounced that those affected consider themselves to be a religious or political figure. You may also be a great inventor or destined to redeem mankind. Correspondingly, megalomania can take very different forms, ranging from excessive self-overestimation to a readiness for martyrdom.

For historical reasons, a distinction must also be made between the madness of Caesar: This describes the belief in one’s own infallibility and the greed for universal significance of many leaders in monarchist or absolutist systems.

However, it is unclear here to what extent the mental illness itself is meant and to what extent the description of the historical figures is due to the personality cult and contemporary views. Correspondingly, in the case of madness in the sense of an illness, the Caesarian delusion is excluded, although this is also commonly referred to as megalomania.


The megalomania can best be explained in its origin as a mania. But here too, many triggers are considered unexplained. The only thing that is certain is that mania of all kinds is often associated with depression (and a corresponding imbalance in the hormonal balance).

Megalomania is always accompanied by an enormous feeling of elation, which speaks for a disturbance in the system of messenger substances. In most cases, the dopamine and norepinephrine levels are significantly increased in those affected.

In addition, the delusion – unlike the hallucination – is tied to a stimulus. In most cases, a more or less concrete point of reference can be identified. In the case of megalomania, this is often a historically or currently significant person with whom the sufferer identifies. The mechanisms that lead to the selection of the supposedly imitated person are not known.

However, people with illnesses who know megalomania as a symptom are particularly prone to delusions after drastic experiences. It can be a breakup, a career change, a death, and more. In principle, all major events are capable of negatively influencing a mental illness.

Symptoms, Ailments & Signs

Megalomania shows itself as a delusion in that the delusion is not contradictory, irrefutable and liveable for the person concerned. So the megalomaniac does not mimic a great personality, but actually believes that he is one. He may be (or was born to be) a great politician, a warlord on a mission, or just a genius.

The symptoms associated with this are correspondingly different. What they all have in common, however, is an increased sense of elation, a strong sense of self-esteem, a loss of empathy, an increased willingness to act and the development of paranoia. The latter is often fed by the belief of those affected that their mission would be hindered by others. According to the historical models, which are often used for the content of the delusion, this is logical in itself.

Megalomania can be divided into political delusions, religious delusions, omnipotence delusions, world improvement delusions and self-centered exaggeration delusions. The symptoms are different and range from representing a strong conviction to actually performing all kinds of activities to prove one’s own omnipotence. It is significant that even failure – no one listens or follows; Ideas turn out to be impractical; Actions fail – does not make the madman doubt.

There is also a tendency among megalomaniacs to disregard legal and societal norms. Long episodes of delusion (although it can also become chronic) are expressed in the fact that the entire life can be subordinated to delusion. The megalomania is occasionally more subtle: for example, when a delusion to improve the world leads to very limited conversational behavior.

The other symptoms of megalomania can be assigned to the diseases that cause the megalomania itself. This includes, for example, the depressive episodes in manic-depressive disorder, the disturbed perceptions in schizophrenia or the disturbed body awareness in very pronounced narcissism.

The symptoms of mania itself – i.e. the effects on the actions of the person affected – can be very different. They range from episodic megalomania (usually due to a trigger) to chronic megalomania that has completely taken hold of the person affected. Signs of megalomania can only be seen by outsiders, since delusion by definition does not allow one to question one’s own perception.

Relatives will find out that people who succumb to delusions show behavior that seems irrational. Those affected tolerate little or no contradiction or do not respond to it. Sometimes they try to prove the content of their madness. Accordingly, it can lead to actions that are viewed with great concern by those around you, such as preaching in the open street or presenting all sorts of supposed inventions.

In cases of manic-depressive disorder or schizophrenia, however, it is more common for the other symptoms of the illness to show up first.


The diagnosis of megalomania is based on the other disorders found and on the definition of delusions. If the person concerned is completely convinced of the content of his megalomania and shows appropriate behavior, the diagnosis is easy. However, a lot of value must be placed on the precise diagnosis of the associated suffering, since megalomania itself cannot be treated. Finally, in almost all cases, it arises from other mental disorders.

In addition, this form of mania still has to be examined for possible organic causes. This includes brain imaging. The talks with the person concerned are usually completed by talks with relatives. For the further course it is important that the megalomania is understood and correctly classified by the treating physicians.

In addition, other symptoms must be able to be separated from the delusion. The diagnosis can be correspondingly lengthy. As with many mental illnesses, many years often elapse between the onset of the illness and the diagnosis.


The complications that can arise in the context of megalomania are numerous and strongly dependent on how severe the pathological perception is. Some forms of megalomania are comparatively harmless and, in the worst case, can only mean a financial loss due to the excessive cultivation of a handicraft or journalistic hobby.

In more serious cases, the megalomaniac can get into all sorts of situations that endanger himself and others due to his delusions. Examples include situations in which the patient presents himself as a leader and tries to convince strangers of himself. The same applies to unsolicited preaching or other proclamations of messages. However, while in these cases the purely verbal level is rarely left, delusions of salvation or delusions of omnipotence mean a risk of completely absurd actions.

For example, the belief in one’s own infallibility can lead to the patient interfering in medical operations, on construction sites or elsewhere, or even taking action themselves. Accordingly, the megalomaniac can also cause immense damage if he gets the space to act.

Also, don’t underestimate the financial, professional, and social complications that come with megalomania. Many forms of delusion mean that those affected are unable to work when they become chronic. Social problems arise from a lack of acceptance of reality as well as from paranoia.

In extreme cases, megalomania leads to self-mutilation or suicide. This can occur, for example, when people believe they are religious martyrs or that their demise can be beneficial to those around them (or to humanity) in some other way.

When should you go to the doctor?

Basically, megalomania along with the other disorders associated with it is a case for a doctor’s visit. The focus here is on psychiatrists and other doctors who specialize in mental illness. The competencies of general practitioners, on the other hand, are quickly exhausted here.

The problem in this context is that the delusion as such is not seen as a problem by the megalomaniac. At best, therefore, other symptoms push him to see a psychiatrist, who then recognizes the megalomania. In many cases, excessive megalomania can also lead to family members taking the step to the doctor. This can sometimes (if there is a danger to life and limb) result in forced admission to a psychiatric hospital.

Treatment & Therapy

Megalomania is treated by treating the underlying condition. This also explains the importance of an accurate diagnosis. Medication is used where possible.

Neuroleptics help reduce the psychotic episodes (which seem to be responsible for some forms of megalomania). The therapy is usually hampered by the lack of insight on the part of the person concerned. Accordingly, coercive measures can be used in some cases.

In the case of known diseases, such as manic depression or schizophrenia, the treatment plan is designed according to these diseases. It can be assumed here that megalomania is also treated as a symptom.

A strongly manifested megalomania, on the other hand, is considered difficult or impossible to treat. If the person concerned cannot be brought to any insight and other symptoms do not mean that there is a strong need for action, megalomania can accordingly persist. In the case of organic causes (brain damage), neuroleptics can be used at best. However, no causal cure is to be expected here.

Outlook & Forecast

Due to the very different course of mental illnesses, it is difficult to make a standardized prognosis. In many forms of megalomania there is a certain probability of recurrence despite healing. This is especially true when key stimuli can convey the content of megalomania.

In principle, there are different probabilities of developing megalomania as a symptom for different mental illnesses. It is very common in narcissism and manic-depressive disorder.

Megalomania can also manifest itself for a lifetime. If it only leads to an obsession (e.g. for inventions, a hobby or a political orientation), the person concerned can live with it well, insofar as he is otherwise socially functional. Other forms of megalomania, which result in sometimes dangerous or highly irrational acts, mean a permanent burden. In addition, the prognosis depends primarily on the underlying disease.


There is no way to specifically prevent megalomania. Only the best possible protection of your own mental health can prove to be advantageous. However, due to the complexity underlying the development of most mental illnesses, this is only possible to a limited extent.


Megalomania only requires aftercare if there was a need for treatment. As a rule, megalomania has no clinical significance. However, if other people are harmed as a result or if the person concerned suffers from megalomania himself, follow-up care may make sense. The decisive question is whether a pathological overconfidence occurred in the context of a mental illness requiring treatment.

Megalomania is often the result of a mood disorder or mania. If a manic episode occurs, it makes sense to have a follow-up period after acute treatment. Since mania occurs in episodes, a reversal of megalomania can usually be observed in the phase between two manic episodes. Dealing with shame, inferiority, and regret isn’t easy when you’ve just felt great and energized. Those affected need help in the aftercare of an acute attack.

A slight form of megalomania, for example in a person with a neurotic disposition, has no clinical significance. At best, such people irritate. Although they offend with their exaggerated self-confidence, they usually do no harm. This is then called hypomania. Since this usually does not turn into mania, neither treatment nor follow-up care is necessary. Nevertheless, with the help of psychotherapy, these people can also achieve more realism in their self-assessment.

You can do that yourself

Due to the definition of megalomania, there are no ways in which those affected can help themselves. This would require an insight into the illness, which, however, cannot be given in the case of megalomania.

Only an attentive environment can act to encourage those affected to seek treatment as early as possible. Since in most cases it is a question of people suffering from mental illnesses, this is also desirable with regard to the course of these illnesses.


Megalomania Guide