Grandiosity is a psychological term that refers to an exaggerated sense of one’s importance, abilities, or status. While anyone might occasionally feel unusually confident, grandiosity is more intense and persistent—often appearing disconnected from external reality.
In mental health contexts, it’s most commonly recognized as a symptom of manic or hypomanic episodes in bipolar disorder, where it can influence thoughts, mood, and behavior in significant ways.
This article is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, therapist, or other qualified health provider with any questions you may have regarding a medical or mental health condition. Never disregard professional advice or delay in seeking it because of something you have read on this site.
Signs of grandiosity in bipolar disorder
The symptoms of grandiosity can vary widely from person to person and often depend on the intensity of the manic or hypomanic episode. Some individuals may show several signs, while others display only one or two.
⚠️ Important: Experiencing one or two of these behaviors does not mean someone has bipolar disorder. A proper diagnosis must be made by a qualified mental health professional following a full clinical assessment.
Common Signs Include:
- Inflated self-importance or superiority
- Belief in special powers, talents, or a unique destiny
- Unrealistic confidence in one’s potential or goals
- Acting above rules, norms, or advice
- Risky behaviors, such as overspending or impulsive decisions
- Excessive self-focus in conversation
- Irritability when challenged or contradicted
Grandiosity is often more visible during manic episodes, but can also occur subtly during hypomania. In some cases, it becomes extreme enough to develop into delusions of grandeur. Once the episode ends, grandiose thoughts typically fade.
Example:
You’re scrolling through job listings when you see a senior leadership role that requires 10+ years of experience and an advanced degree.
You’ve just started your first job, but you’re certain you’d be perfect for it. After all, you’ve always known you were meant for big things.
You skim the qualifications—none of them worry you. In your mind, this is your next step. Why wouldn’t they hire you?
Noticing Grandiosity in Others
People experiencing grandiosity may not recognize changes in their thinking or behavior. Signs may become apparent to those close to them, especially if they:
- Seem unusually self-focused or dismissive of others
- Pursue unrealistic plans with intense energy
- React strongly when their ideas are questioned
- Show sudden changes in confidence or risk-taking
Noticing a shift from someone’s typical behavior, rather than judging based on a single trait, can help determine whether grandiosity might be a symptom of a larger mood episode.
Why Does Grandiosity Happen in Bipolar Disorder?
Grandiosity typically arises during manic or hypomanic episodes, which are driven by complex changes in brain chemistry, sleep, and stress.
During these periods, elevated dopamine and noradrenaline levels may fuel intense energy, impulsivity, and inflated self-esteem, making grandiose thoughts feel completely logical and true.
Factors like genetics, trauma, and disrupted sleep can increase a person’s vulnerability to these mood shifts.
While not everyone with bipolar disorder experiences grandiosity, it’s a common feature when manic thinking escalates beyond confidence into distortion.
What does grandiosity feel like?
Below are some individual accounts to illustrate people’s experiences with grandiosity:
“My grandiose thoughts were really focused on making things perfect. Like Stepford wife level, cooking, cleaning and errand runner. I could also go to school, teach my kid and earn money, while being a ‘good’ wife. I often got really aggressive when things didn’t come out. Followed by tears and exhaustion.”
‘Mina’
“I think often it’s just that you see things from an altered perspective. Often, that perspective will be hard to understand if you haven’t thought of it that way before and because the way your mind might try to interpret it, it might either sound/be grand. On the other hand, however, because of the new perspective sometimes you might just be able to understand something which is already there in an extremely insightful way if your mind thinks about in the right way.”
‘David’
“I would also have quite grandiose career ideas. I almost applied to be a nanny during one mania despite having almost zero childcare experience.”
‘Elle’
“I feel godlike almost. Incapable of being harmed. I often go to bars and pick fights… I deeply struggle with this sense of being untouchable when manic, not only in being a bully but also in terms of doing extremely dangerous things.”
‘Sam’
Grandiosity in Bipolar Disorder vs. Narcissistic Personality Disorder
Grandiosity can appear in both bipolar disorder and narcissistic personality disorder (NPD), but the underlying causes, timing, and patterns are quite different.
In bipolar disorder, grandiosity typically shows up during manic or hypomanic episodes and fades when mood stabilizes.
It’s often driven by elevated energy, impulsivity, and distorted thinking. Outside of these episodes, the person may feel regret or confusion about their behavior.
In contrast, NPD grandiosity is chronic and ingrained, not tied to mood swings. It reflects a stable pattern of viewing oneself as superior, needing admiration, and often lacking empathy. It doesn’t come and go with emotional states.
Example:
During a manic episode, someone with bipolar disorder might suddenly believe they're destined to become a famous tech founder and spend thousands launching a startup overnight, despite no prior interest in business. Weeks later, they may feel embarrassed or question their actions.
Someone with narcissistic personality disorder, however, might consistently promote themselves as a visionary entrepreneur, exaggerate achievements, and dismiss criticism—not due to a mood shift, but because it aligns with their ongoing self-image.
Grandiosity Vs. Delusions Of Grandeur
Grandiosity is not the same as grandiose delusions, also known as delusions of grandeur.
A delusion is a false belief held by a person, contradicting what is considered true. Grandiose delusions are one of the most common types of delusions people with bipolar disorder experience.
Delusions often have the following characteristics:
- The belief that the delusion is true, even when others know it to be untrue.
- The person will not listen to other viewpoints about the belief, despite contradictory evidence that challenges the delusion.
- The content of the delusion is impossible or implausible.
- The delusion impacts the person’s daily life.
People who experience delusions of grandeur may have beliefs such as the following:
- They have a unique talent, object, or ability unknown to others
- They are a famous person, and the real one is an impostor
- They have secret connections or work as a spy
- They’ve been chosen by a religious entity or that they are a spiritual leader
Impact of grandiosity
Grandiosity in bipolar disorder can become problematic in many different ways. It can affect a person’s ability to think rationally, preventing someone from considering more realistic perspectives.
Relationships with others
To those who do not fully understand the symptoms, grandiosity can make someone seem conceited and rude.
People may not want to spend time with the person expressing grandiose patterns, which could result in a breakdown of relationships, especially relationships that the individual relies on for social support.
Grandiosity could result in people becoming or feeling isolated once their manic or hypomanic episode has ended.
Employment
Grandiosity could also affect the individual’s relationships with those at work. If the individual reacts with anger when criticized, dismisses others’ accomplishments, and believes they are above the rules, this can create a negative work environment.
Grandiosity could also make the individual want to impulsively quit their job or make elaborate switches in career plans, which can impact employment if carried out.
Putting themselves at risk
Grandiosity could also create the potential for physical harm, such as getting into fights if they react angrily and then are confronted or criticized.
The person may believe they are above the rules and have impaired judgment about their vulnerability.
They could abuse substances if they believe that these substances cannot cause them harm or that they are protected by an outside force. They might also be more financially reckless.
How is grandiosity managed?
Grandiosity in bipolar disorder is typically addressed as part of managing manic or hypomanic episodes. While treatment needs vary from person to person, a combination of medication, therapy, and lifestyle support is often used to help regulate mood and reduce symptoms.
⚠️ This section is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before making treatment decisions.
Medications
Certain medications are commonly used to help stabilize mood and manage symptoms like grandiosity:
- Mood stabilizers (such as lithium) are often used long-term to reduce the frequency and intensity of manic episodes.
- Antipsychotics may help manage elevated mood and distorted thinking by affecting dopamine pathways in the brain.
- Antidepressants might be prescribed to address depressive symptoms, but are usually combined with a mood stabilizer to reduce the risk of triggering mania.
Each medication comes with its own potential side effects, and treatment plans should be tailored by a healthcare professional.
Psychotherapy
Therapy can complement medication by helping individuals better understand and manage their symptoms. Common approaches include:
- Cognitive Behavioral Therapy (CBT): Helps individuals recognize unhelpful thoughts (cognitive distortions) and behaviors, identify triggers, and develop coping strategies for managing stress and mood shifts.
- Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on stabilizing daily routines—like sleep, meals, and activity levels—to support mood regulation.
- Family-Focused Therapy: Involves loved ones in treatment to improve communication, recognize early warning signs, and strengthen support systems.
Therapy may also help address any distress or confusion a person feels after experiencing grandiose episodes.
Lifestyle
Making some healthier lifestyle changes may also prove to be effective at helping to treat grandiosity and the other symptoms of bipolar disorder. These can include:
- Avoiding alcohol and recreational drugs – since a big concern during manic and hypomanic episodes is the negative consequences of risk-taking behavior, quitting drinking and drugs completely could limit the temptation to use these substances during an episode.
- Build supportive relationships – it can be beneficial to be surrounded by people with a positive influence. Friends and family can support and help watch for warning signs of mood shifts.
- Creating a healthy routine – having a routine for sleeping, eating, and physical exercise can help to balance moods.
- Keeping a mood chart – keeping a record of daily moods, sleep, activities, and feelings can be useful for identifying triggers for when a manic or hypomanic episode may be coming on. This can also be useful for seeing how effective the treatment is and for identifying when treatment needs to be adjusted.
How To Be Supportive
There are many ways in which you can support someone who is experiencing a manic episode:
Build trust
Having an open and honest conversation with the person experiencing mania or hypomania and discussing how it affects them.
You can ask them questions about what they have experienced and engage well in what they are saying to feel heard. This can also help to improve their understanding of what things are like for them.
Ask how you can help
It is likely that the person who experiences manic or hypomanic episodes already has an idea of what they do to help themselves, as well as knowing what does not help.
If they are unsure of how to help themselves, then you can offer to help by exploring their options.
Offer to help with self-management
People who experience manic or hypomanic episodes may find it useful to develop a self-management plan to help them manage their symptoms better.
You could help them to complete this plan by identifying any triggers or warning signs you may have noticed that the individual may not have. You can make suggestions, but remember that the final decision is down to the individual.
The self-management plan can also be useful to review together when the individual experiences another episode.
Don’t make assumptions
It is normal for people with bipolar disorder to have good and bad moods without it necessarily being a manic episode. The person may find it frustrating if they are questioned, or you start worrying about them whenever they are having a good day.
Instead, it may help to look for consistent signs and patterns that they are approaching an episode, and discuss what this episode presents.
Be gentle in your approach
If the person’s behavior is becoming worrying, it is important to gently let them know you are worried about them without criticizing or accusing them.
Staying calm and non-confrontational may make them more likely to discuss what they are experiencing.
You can gently explain that you have noticed changes in their behavior and why it concerns you. Sometimes, people may not notice they are experiencing a manic or hypomanic episode until it is brought up to them by someone who knows the behavior is different from their typical behavior.
Discuss challenging behavior
It can be a challenge to be around someone who is experiencing a manic or hypomanic episode, especially if they are displaying grandiose signs such as being selfish or quick to anger.
The individual may not realize that their behavior is causing tension, so it is ok to set boundaries in a non-confrontational, calm manner.
For instance, you could explain that you will end the conversation with them if they are rude or that you will not participate in their grand ideas if you feel these will have negative consequences.
Offer reassurance
When the manic or hypomanic episode is over, the person may feel ashamed or embarrassed about their behavior. They may feel like they want to isolate themselves from their loved ones if they do not like how they act in front of them.
They may really benefit from you reassuring them that you still care and understand that their behavior is a part of their condition.
Help them find the support they need
People may find it difficult to find the right care and support for themselves. If they agree, you can help them research treatment options, attend appointments with them, or help them find suitable coping strategies.
Plan for a crisis
In extreme cases, manic or hypomanic episodes can become so intense that the individual may need to be hospitalized. To account for this, it can be useful to devise a crisis plan with the individual.
This can include information about who to contact, what to do, and when an acceptable time to consider hospital treatment is.
Do you need mental health help?
USA
Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/
1-800-273-8255
UK
Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email jo@samaritans.org .
Available 24 hours a day, 365 days a year (this number is FREE to call):
116-123
Rethink Mental Illness: rethink.org
0300 5000 927
Further Information
Self Help Resources for Bipolar Disorder or Manic Depression
Severus, E., & Bauer, M. (2013). Diagnosing bipolar disorders in DSM-5.
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