Grandiosity in Bipolar Disorder

Table of ContentsView AllTable of ContentsPrevalenceCausesSigns and SymptomsGrandiosity in Other DisordersTreatmentFinal Thoughts

Table of ContentsView All

View All

Table of Contents

Prevalence

Causes

Signs and Symptoms

Grandiosity in Other Disorders

Treatment

Final Thoughts

Close

Grandiose ideations, orgrandiosity, are an exaggerated sense of one’s importance, power, knowledge, or identity—even with little evidence to support these beliefs. People withbipolar disorder(BD) may experience this symptom. Grandiosity can occur during both manic and hypomanic episodes.

Grandiosity vs. Delusions of GrandeurGrandiosity is not the same as having delusions of grandeur. Grandiosity is a feeling of being superior to others or inflated self-esteem. Conversely, delusions of grandeur are false beliefs ordelusionsof superiority not rooted in reality, such as someone believing they have found the cure for a significant disease.

Grandiosity vs. Delusions of Grandeur

Grandiosity is not the same as having delusions of grandeur. Grandiosity is a feeling of being superior to others or inflated self-esteem. Conversely, delusions of grandeur are false beliefs ordelusionsof superiority not rooted in reality, such as someone believing they have found the cure for a significant disease.

Prevalence of Grandiosity

The number of people with grandiose ideations is somewhat unclear, with research indicating that grandiosity is present in somewhere between 8% and 65% of the general population.That’s a different question than how common grandiosity is in people with bipolar disorder.

In a 2015 study of 149 patients diagnosed with bipolar disorder, more than half had thought content disturbances that were mainly grandiose and persecutory in nature.Research published in the journalBipolar Disorderssuggests that around 57% of youth with BD experience grandiosity.

Grandiose delusions occur in roughly two-thirds of people with bipolar disorder and one-half of people withschizophrenia.

Grandiose thoughts are also common in people withsubstance use disorders, particularly in those who use cocaine and amphetamines.Additionally, grandiosity is thought to be a possible facet ofpersonality disorders, particularlynarcissistic personality disorder.

Understanding Bipolar Disorder and Narcissistic Personality Disorder

Causes of Grandiosity

Grandiosity is one of the seven symptoms of a manic or hypomanic episode of bipolar disorder.Within the context of the disorder, grandiosity is considered amood-congruent delusionconsistent with a manic state.

During manic or hypomanic episodes, the brain’s chemistry and activity change in complex ways, leading to symptoms.

No one knows exactly why these changes happen. It’s also unclear why some people experience severe symptoms and others do not. Although grandiosity is a common feature of bipolar mania and hypomania, it does not occur in everyone with the disorder.

According to theDiagnostic and Statistical Manual of Mental Disorders(DSM-5-TR), the presence of grandiosity can be used in combination with other manic or hypomanic symptoms to confirm adiagnosis of bipolar disorder.

Signs and Symptoms of Grandiosity

As a symptom, grandiosity exists on a spectrum. It can range from inflatedself-esteemto sweeping delusions of grandeur. Grandiosity can be challenging to identify and pin down.

Examples of grandiosity include:

Grandiosity may not be recognized until it becomes extreme. Often, it’s the person’s friends or family members who realize that the behavior is inconsistent with the person’s usual demeanor.

Delusions of Grandeur

There is a subtle difference between grandiose delusions and delusions of grandeur. Grandiose delusions are less exaggerated than delusions of grandeur. For instance, a grandiose delusion may involve thinking you have more musical talent than you do, whereas a delusion of grandeur would be thatyou are the only onewho can keep world leaders safe.

People who experience delusions of grandeur, as well as those around them, do not always recognize it as being anything more than pompousness, arrogance, or boastfulness. If delusions occur during manic episodes, this is a clue that bipolar disorder is involved.

How to Recognize a Manic or Hypomanic Episode

Grandiosity in Narcissistic Personality Disorder

At times, it can be difficult to distinguish between grandiose thinking during a manic or hypomanic mood andgrandiosityas a facet ofnarcissistic personality disorder(NPD).

One of the key ways to differentiate grandiosity in BD from grandiosity in NPD is the co-occurrence ofmania symptoms.When grandiosity accompanies any of these abnormal behaviors, bipolar disorder should be explored as a possible cause. Grandiosity can also occur inhypomania(a less severe form of mania), but it is usually less problematic and easily missed in diagnosis.

Another key differentiator is time.Personality disorderslike NPD are pervasive patterns of interactions with others. By contrast, bipolar mania or hypomania typically lasts for weeks to months and is not always present.

Treatment for Grandiosity

People experiencing grandiosity as a feature of BD may suffer consequences in their personal and professional lives. Grandiosity can make someone seem unforgivably arrogant and rude. This can affect relationships at home, with friends and family, and at work.

Grandiose delusions can impair judgment and compromise the ability to keep or maintain employment. Grandiosity rarely occurs on its own in people with BD. They need medications, psychotherapy, and social support to effectively resolve symptoms, including grandiosity.

If you have symptoms of bipolar mania, your healthcare provider may treat you with amood stabilizerand sometimes anantipsychotic drugto control your symptoms. If the behaviors are extreme or potentially harmful, hospitalization may be needed until your mood symptoms are under better control.

Treating Bipolar Disorder

Grandiosity is a trait that can be seen to a mild degree in the general population. However, a sudden jump in self-esteem and sense of self-importance may be indicative of a manic episode in bipolar disorder. This can turn into grandiose delusions or, more rare, delusions of grandeur. High levels of grandiosity can cause you to shift your everyday behaviors and attitudes, causing strife in your relationships and career.

If you or someone you know starts to experience grandiose thought patterns, psychiatric treatment is needed. There is no one drug or psychotherapeutic approach that treats grandiosity on its own. Instead, your healthcare provider will aim to resolve the abnormally heightened mood state that defines bipolar mania. By doing so, behavioral extremes like grandiosity will also be tempered.

What Is Therapy for Bipolar Disorder?

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sheffield JM, Brinen AP, Freeman D.Paranoia and grandiosity in the general population: Differential associations with putative causal factors.Front Psychiatry. 2021;12:668152. doi:10.3389/fpsyt.2021.668152Nascimento M, Marinho M, Sobreira G, et al.Bipolar disorder: What kind of disturbances of thought content and perception are observed?Eur Psychiatry. 2015;30(S1)820. doi:10.1016/S0924-9338(15)30641-6Van Meter AR, Burke C, Kowatch RA, Findling RL, Youngstrom EA.Ten-year updated meta-analysis of the clinical characteristics of pediatric mania and hypomania.Bipolar Disord. 2016;18(1):19-32. doi:10.1111/bdi.12358Isham L, Griffith L, Boylan AM, et al.Understanding, treating, and renaming grandiose delusions: A qualitative study.Psychol Psychother: Theory Res Pract. 2019;94(1):119-140. doi:10.1111/papt.12260Iqbal M, Levin C, Levin F.Treatment for substance use disorder with co-occurring mental illness.Focus. 2019;17(2):88-97. doi:10.1176/appi.focus.20180042American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Muneer A.Mixed states in bipolar disorder: Etiology, pathogenesis and treatment.Chonnam Med J. 2017;53(1):1-13. doi:10.4068/cmj.2017.53.1.1Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional themes across affective and non-affective psychoses.Front Psychiatry. 2018;9:132. doi:10.3389/fpsyt.2018.00132Additional ReadingSeverus E, Bauer, M.Diagnosing bipolar disorders in DSM-5.Int J Bipolar Dis. 2013;1:14. doi:10.1186/2194-7511-1-14.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sheffield JM, Brinen AP, Freeman D.Paranoia and grandiosity in the general population: Differential associations with putative causal factors.Front Psychiatry. 2021;12:668152. doi:10.3389/fpsyt.2021.668152Nascimento M, Marinho M, Sobreira G, et al.Bipolar disorder: What kind of disturbances of thought content and perception are observed?Eur Psychiatry. 2015;30(S1)820. doi:10.1016/S0924-9338(15)30641-6Van Meter AR, Burke C, Kowatch RA, Findling RL, Youngstrom EA.Ten-year updated meta-analysis of the clinical characteristics of pediatric mania and hypomania.Bipolar Disord. 2016;18(1):19-32. doi:10.1111/bdi.12358Isham L, Griffith L, Boylan AM, et al.Understanding, treating, and renaming grandiose delusions: A qualitative study.Psychol Psychother: Theory Res Pract. 2019;94(1):119-140. doi:10.1111/papt.12260Iqbal M, Levin C, Levin F.Treatment for substance use disorder with co-occurring mental illness.Focus. 2019;17(2):88-97. doi:10.1176/appi.focus.20180042American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Muneer A.Mixed states in bipolar disorder: Etiology, pathogenesis and treatment.Chonnam Med J. 2017;53(1):1-13. doi:10.4068/cmj.2017.53.1.1Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional themes across affective and non-affective psychoses.Front Psychiatry. 2018;9:132. doi:10.3389/fpsyt.2018.00132Additional ReadingSeverus E, Bauer, M.Diagnosing bipolar disorders in DSM-5.Int J Bipolar Dis. 2013;1:14. doi:10.1186/2194-7511-1-14.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Sheffield JM, Brinen AP, Freeman D.Paranoia and grandiosity in the general population: Differential associations with putative causal factors.Front Psychiatry. 2021;12:668152. doi:10.3389/fpsyt.2021.668152Nascimento M, Marinho M, Sobreira G, et al.Bipolar disorder: What kind of disturbances of thought content and perception are observed?Eur Psychiatry. 2015;30(S1)820. doi:10.1016/S0924-9338(15)30641-6Van Meter AR, Burke C, Kowatch RA, Findling RL, Youngstrom EA.Ten-year updated meta-analysis of the clinical characteristics of pediatric mania and hypomania.Bipolar Disord. 2016;18(1):19-32. doi:10.1111/bdi.12358Isham L, Griffith L, Boylan AM, et al.Understanding, treating, and renaming grandiose delusions: A qualitative study.Psychol Psychother: Theory Res Pract. 2019;94(1):119-140. doi:10.1111/papt.12260Iqbal M, Levin C, Levin F.Treatment for substance use disorder with co-occurring mental illness.Focus. 2019;17(2):88-97. doi:10.1176/appi.focus.20180042American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Muneer A.Mixed states in bipolar disorder: Etiology, pathogenesis and treatment.Chonnam Med J. 2017;53(1):1-13. doi:10.4068/cmj.2017.53.1.1Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional themes across affective and non-affective psychoses.Front Psychiatry. 2018;9:132. doi:10.3389/fpsyt.2018.00132

Sheffield JM, Brinen AP, Freeman D.Paranoia and grandiosity in the general population: Differential associations with putative causal factors.Front Psychiatry. 2021;12:668152. doi:10.3389/fpsyt.2021.668152

Nascimento M, Marinho M, Sobreira G, et al.Bipolar disorder: What kind of disturbances of thought content and perception are observed?Eur Psychiatry. 2015;30(S1)820. doi:10.1016/S0924-9338(15)30641-6

Van Meter AR, Burke C, Kowatch RA, Findling RL, Youngstrom EA.Ten-year updated meta-analysis of the clinical characteristics of pediatric mania and hypomania.Bipolar Disord. 2016;18(1):19-32. doi:10.1111/bdi.12358

Isham L, Griffith L, Boylan AM, et al.Understanding, treating, and renaming grandiose delusions: A qualitative study.Psychol Psychother: Theory Res Pract. 2019;94(1):119-140. doi:10.1111/papt.12260

Iqbal M, Levin C, Levin F.Treatment for substance use disorder with co-occurring mental illness.Focus. 2019;17(2):88-97. doi:10.1176/appi.focus.20180042

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

Muneer A.Mixed states in bipolar disorder: Etiology, pathogenesis and treatment.Chonnam Med J. 2017;53(1):1-13. doi:10.4068/cmj.2017.53.1.1

Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional themes across affective and non-affective psychoses.Front Psychiatry. 2018;9:132. doi:10.3389/fpsyt.2018.00132

Severus E, Bauer, M.Diagnosing bipolar disorders in DSM-5.Int J Bipolar Dis. 2013;1:14. doi:10.1186/2194-7511-1-14.

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