Grandiose Delusions in Schizophrenia: What They Are and How To Respond

If your friend or loved one is convinced they’re going to become the next president or that they’ve made an important discovery that’s going to change the world, they may be experiencing grandiose delusions. This is especially true if there’s no evidence that their beliefs are rooted in reality.

Hearing these grandiose claims can be confusing and frightening, especially if your loved one believes they have extraordinary abilities or special powers. Understanding what grandiosity can look like in schizophrenia and knowing how to respond may help you offer support while encouraging appropriate care.

What Are Grandiose Delusions?

Grandiose delusions, or delusions of grandeur, can cause a person to have false beliefs about their intelligence, influence, or power. They may also think they’re gifted, invincible, famous, or even God-like.

These types of delusions are common in people with schizophrenia and bipolar disorder. One study reported that about half of people with schizophrenia and two-thirds of people with bipolar disorder experience delusions of grandeur.

To the person experiencing grandiose delusions, their beliefs are often deeply meaningful. These beliefs may give them a sense of purpose and identity and help them make sense of difficult experiences.

Sometimes grandiose beliefs develop from negative circumstances and may give the person hope for a better future. These beliefs can even offer relief from low mood, rejection, and self-hatred.

The person with grandiose delusions also doesn’t realize their beliefs are false. When challenged or questioned, they can become angry or distressed. They may also disregard negative feedback entirely or interpret it more positively.

Grandiose Delusions vs. High Self-Esteem or Narcissism

Grandiose delusions in schizophrenia aren’t the same as being self-confident or having high self-esteem. Rather than having a positive view of their accomplishments and capabilities, people who have grandiose delusions have an exaggerated view of their greatness, importance, or purpose.

Likewise, delusions in schizophrenia can differ from the grandiosity seen in narcissistic personality disorder (NPD). Delusions of grandeur in schizophrenia are fixed, false beliefs about being unusually powerful, important, or special, such as believing you can fly or are a famous religious figure.

By contrast, grandiosity in NPD may appear more stable and is largely related to the ego or the need to feel admired.

There is also some overlap between schizophrenia and delusional disorder. However, schizophrenia can cause other symptoms that don’t happen with delusional disorder.

How Grandiose Delusions Affect Daily Life

Having grandiose delusions can significantly disrupt a person with schizophrenia’s daily life and negatively affect their well-being. Their sense of reality may be distorted, and they may struggle to maintain relationships, take risks that compromise their safety, or make poor decisions.

For instance, if your friend or family member believes they’re invincible or capable of walking on water, they may be injured while acting on those beliefs. They could also be at risk of sexual harm if, for example, they go home with a stranger they believe to be God. Delusions may also lead someone to drop out of school prematurely if they believe school is no longer necessary.

People with grandiose delusions can also become isolated from others, especially if they spend a lot of time thinking about or becoming engrossed in information related to their beliefs. One example is believing they’re Jesus, which may prompt someone to spend excessive time researching the Second Coming of Christ.

In one study, researchers found that more than three-quarters of people with delusions of grandeur reported at least one harmful effect from their beliefs in the past six months. Most people in the study also wanted help addressing their delusions.

Once delusions of grandeur are gone, the person may experience a sense of loss. They may feel embarrassed, sad, or depressed, especially if they feel like they’ve gone from being powerful and important to largely unimportant.

How To Respond to Grandiose Delusions

If your friend or family member is experiencing grandiose delusions, it can be difficult to know how to respond. You may find their beliefs confusing, or you may be worried about their safety. Still, there are ways to comfort them.

First, talk to them about what they’re thinking and listen to their responses without judgment or trying to fix the situation. This builds trust and helps them feel loved and supported — key elements in helping them get the care they may need.

Second, avoid discounting their beliefs, being overly critical, or acting annoyed. Although grandiose delusions are not based in reality, they feel very real to the person having them.

Their belief system may give their life meaning. It may also give them focus for the future and help them feel worthwhile or significant.

In fact, one team of researchers found that 69 percent of the people in their study said their grandiose delusions gave them a reason to live. This means that trying to change their belief system could be detrimental, especially if they haven’t first found meaning elsewhere. Instead, encourage them to talk with a mental health professional about their thoughts.

Here are some other ways to support your friend or family member:

• Try not to dismiss the delusions, but also don’t agree with what they’re saying.
• Aim for a calm response and keep your emotions in check.
• Offer comfort and try to soothe the person’s distress.
• Acknowledge that something seems wrong and remind them that help is available.
• Take threats of suicide or harm seriously and get help immediately.
• Distract them from their delusions by talking about something of interest to them.
• Invite them to spend time with you and others so they don’t become isolated.
• Take care of yourself, too, by talking with a mental health professional or joining a support group.

Join the Conversation

On MySchizophreniaTeam, people share their experiences with schizophrenia, get advice, and find support from others who understand.

If your loved one has experienced grandiose delusions, what responses have helped you support them? Let others know in the comments below.