How aware people are of when they are having mental health issues varies quite a bit.
People who are really out of it do not know that they are having issues. For a person who is delusional, their delusions are their reality. There are also plenty of people who have personality disorders that prevent them from realizing that they are not behaving in a typical manner. People with Narcissistic personality disorder aren’t able to grasp that they are narcissistic – they just think everyone else is an idiot.
Other disorders have less of an effect on reasoning. People who have anxiety disorders are usually quite able to tell that they are having a panic attack, people with OCD understand that their compulsions aren’t something other people have.
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