The megalomania Constitutes a mania or delusion of grandeur related to some personal aspect. AND The individual suffering from this mental disorder has extremely exaggerated and unrealistic thoughts and ideas about their personal abilities.
It is a well-defined alteration in terms of its symptomatology but presents some controversy as to its pathogenesis, diagnosis and treatment.
In this article we will review its main characteristics and clarify its properties in order to be able to understand and detect this mental disorder well.
What is meant by megalomania?
The word megalomania derives from Greek roots in which,"megas"means big and"mania"means obsession.
Thus, etymologically we can already see how the term megalomania refers to an obsession with greatness.
This analysis of the origin of the word already directs us towards the characteristics of this psychological alteration, which Is defined in psychiatry as the delusional overestimation of one's abilities.
Thus, megalomania is a psychological condition in which there is an obsession or delusion of grandeur in one of the following personal aspects: capacity, physical strength, fortune, social origin, and grandiose and unreal projects.
In this way, a megalomaniac person is characterized by having thoughts and ideas distorted with respect to his own abilities, overestimating his characteristics and having a highly overvalued idea of himself.
Contextualization of megalomania
The first figure in incorporating the term megalomania into the world of psychology and psychiatry was Sigmund Freud .
The Austrian neurologist commented that megalomania was part of the neurotic features of omnipotence in adults.
Likewise, Freud affirmed that megalomania constituted Personality traits Of the adult who were forged in childhood, affirming that this type of thoughts are part of the process of development of people.
Later, Freud posited megalomania as an obstacle to psychoanalysis, since it was difficult to establish patterns of functioning that could lead to thoughts of omnipotence and overestimation.
In this vein, the Kleinian psychoanalytic side interpreted megalomania as a mechanism of psychological defense.
In this way, the megalomania person would develop a series of overvalued thoughts regarding their personal capacities with the objective of avoiding the anxious and depressive states that would originate to him to interpret his personal characteristics from a realistic point of view.
As we see, features and megalomaniac symptomatology has caused some controversy since the beginning of psychopathology.
However, leaving aside psychoanalysis and the developmental pathways of this psychological condition, it is clear that megalomania is a frequently presented disorder of interest in the world of mental health.
Is it a mental disorder?
Megalomania per se does not have to constitute a mental disorder, although in many cases it can be classified as such.
This first explanation of megalomania can create some confusion, so we will clarify it.
As we have seen, megalomania constitutes a delusional overestimation of one's own abilities.
However, this overestimation that the person performs on himself can have different levels.
So it can range from an obsession to interpret oneself as better than it is, to a frank delirium in which the person is not able to see himself in a realistic way.
In the second case, that is, when megalomania is a frank delusion in which thoughts are totally distorted and have no contact with reality, megalomania is a delusional disorder.
On the other hand, in the first case, that is, when megalomania is a simple obsession with personal qualities but contact with reality is maintained, megalomania may not constitute a psychological alteration and may be defined as a personality trait or Psychological attribute.
However, megalomaniac obsessions will also be considered as a mental disorder in the moment they affect in the life or in the functionality of the person.
Thus, megalomania does not constitute a mental disorder that is present in current diagnostic manuals but a psychological condition that may be associated with a mental disorder.
In other words, megalomania is a symptom rather than a mental disorder per se. S E can be associated with three main disorders: personality disorder, Delusional disorder And bipolar disorder.
How is a megalomaniac?
Megalomaniacs believe that they have a greater capacity than they actually have and that makes them reach positions of power or greater influence.
Thus, the main characteristic of megalomania is not to believe that one is very good but to believe that oneself is better than it really is.
A person can be really brilliant in something and be interpreted as such in that personal sphere.
This would not be the case of a person with megalomania, since people suffering from this condition have a frank obsession or delirium to believe themselves better than they are and to overestimate their qualities well above reality.
In this way, a person with megalomania can be shown with great aplomb and self confidence , Since the interpretations they make about their own qualities, although they may not be realistic, are interpreted and believed in them with great conviction.
However, when an in-depth analysis of personality Are detected that can be individuals with many deficiencies and with a Feeling of inferiority Or emptiness from the first bonds of the parents.
This analysis would correlate with the Kleinian positions we discussed at the beginning of the article.
When delirium appears there is no feeling of insecurity
However, it must be clarified that although megalomania may be born as a defense mechanism to avoid feelings of inferiority or emptiness, once the megalomaniac delirium appears the person ceases to be aware of their feelings of inferiority.
Put another way: even though psychoanalyzing the person can be objectified that megalomania has developed as a psychological defense, the person who possesses this type of delusions does not interpret it as such.
The thoughts of overvaluation that a person with megalomania does not act as a cover for their doubts or insecurities in a conscious way, since the individual has adopted his delusions of omnipotence as the only way of thinking and self-interpretation.
Megalomania and personality
Megalomania, previously, constituted a personality disorder In which the person had thoughts of overvaluing their personal capacities and characteristics.
However, nowadays this diagnostic entity no longer exists and the megalomaniacal traits are framed within what is known as narcissistic personality disorder.
As we will see below this personality disorder is characterized by many symptoms of megalomania that we have been commenting until now.
However, it should be borne in mind that by megalomania is meant a series of thoughts concerning the interpretation of omnipotence and overvaluation of personal abilities, and does not refer to all the characteristics of narcissistic disorder.
Thus, as discussed above, megalomania constitutes a series of symptoms that can be included within narcissistic personality disorder, but megalomania and narcissism are not entirely synonymous.
Narcissistic Personality Disorder
People with Narcissistic personality disorder Are characterized by exaggerated feelings of self-importance, believe that they are always right, and demonstrate greatness in their beliefs and behaviors.
These early characteristics of narcissistic disorder correspond to the term megalomania, so narcissists are megalomaniacs.
However, people with narcissistic disorder also have a strong need for admiration, lack feelings toward others, need to be the center of attention, and tend to take advantage of others for their own purposes.
These latter characteristics of narcissistic personality disorder do not form the definition of megalomania.
Thus, megalomania defines a large part of the narcissistic symptoms, but not all.
Megalomania and delusional disorder
As we speak of delirium, we have to keep in mind that there is very probably a delusional disorder.
In this sense, megalomania can make a delusion when the thoughts of overvaluation are totally distanced from reality.
In these cases, the delire itself makes a delusional disorder with megalomaniac content.
This diagnosis can be made independently of the personality of the person with megalomania.
That is, thoughts of omnipotence and overestimation of abilities may be accompanied by a pathological personality (such as narcissistic disorder) or not.
In either case, if the thoughts of omnipotence are delusional, the picture will be configured as a delusional disorder.
Megalomania and schizophrenia
Megalomania may also appear in another mental illness such as schizophrenia .
Schizophrenia is a neurodevelopmental pathology characterized mainly by the presence of delusions, hallucinations and disorganization.
Thus, within the delusions that appear in the schizophrenia can be connoted megalomaniac delusions.
Usually, in these cases, delusions of megalomania correspond to illness (to schizophrenia) and are not usually pathological personality traits.
However, whatever the pathology to which megalomania is associated (personality disorder, delusional disorder, or schizophrenia), it is only one symptom of mental disorder.
Megalomania and bipolar disorder
Finally, the other mental disorder in which megalomania can be witnessed is bipolar disorder.
Bipolar disorder is a mood disorder in which the person may present depressive states and states opposed to depression, that is, manic states.
In both states (depressive and manic) the affective disorder can be accompanied by alterations of the content of the thought, that is, delusions.
The delusions that occur in bipolar disorder can be very varied and one of the variations may be megalomania.
Magalomaniac delusions usually appear more during the manic phases than during the depressive phases, since the exaltation of the mood can be accompanied by an overestimation of personal capacities and delusions of grandeur.
As we see, the role of megalomania in this disorder is the same as that developed in delusional disorders.
In these cases the megalomania is not usually linked to a narcissistic personality and is understood within a delirium of greatness caused by the euphoria corresponding to the manic state.
Treatment of megalomania
Megalomania is usually a psychological disorder that is difficult to treat mainly because the person with this condition is not usually the one who visits a psychologist or psychiatrist.
In fact, a person with megalomania will rarely interpret that they have a problem or will be aware that their thoughts or delusions are distorted and cause them problems.
Pharmacological treatments
However, there are treatments, mainly pharmacological that allow to mitigate the intensity of delusions.
In this case, antipsychotic drugs such as quetiapine, clozapine, risperidone or olanzapine are the most effective drugs that reduce intensity or even eliminate delusional thoughts.
Psychological therapies
Also, psychological therapies that increase adherence to pharmacological treatment for people who are not aware of their disease and therefore do not believe that they require to take any drugs are also important interventions for megalomania.
In cases where megalomania is accompanied by a narcissistic personality disorder the treatment is difficult, since these mental alterations are very complicated to intervene.
In general, the Cognitive behavioral therapy Can help to work on the cognitive distortions of the patient.
This type of therapy can help correct grandiose self-image, exaggerate the importance attached to personal assessment, detect and discuss maladaptive beliefs, and train the patient in developing desirable attitudes.
References
- Valiente Ots, C. (2002). Hallucinations and delusions. Madrid: Editorial Synthesis.
- "New approaches for intervention in first episodes of psychosis"José Luis Vázquez-Barquero and Benedicto Crespo-Facorro. Ed. Elsevier-Masson (2007).
- Perris, C. and McGorry, P.D. (Eds.) (2004). Cognitive psychotherapy for psychotic and personality disorders: Theoretical-practical manual. Bilbao: DDB
- Eguíluz, I, Segarra, R. (2005). Introduction to Psychopathology . Barcelona: Ars Medica.
- Hamilton, M. (1986). Clinical Psychopathology of Fish . Madrid. Interamerican.
- Vallejo Ruiloba (2006). Introduction to psychopathology and psychiatry. 6th edition. Masson.