This makes sense. (Preamble about where I'm coming from: I can only recall one visual hallucination (true hallucination, not, say, hypnopompic) that was quite unsettling. Minor vague peripherals somtimes when very depressed. Oh. And olfactory hallucinations [same scent, definitely not there] from time to time.) So anyway(!) Though I do not experience to the degree you speak of, delusions, yeah, like paranoia --knowing it just can't be reality, but nonetheless undissueded. I had a time of being absolutely convinced that the apartment complex had a bunch of surveillance-cams. I'll skip the details, but it really impeded me. TG I didn't think the were inside(!) Reality check 1: cheap*** apt. complex. As if they would spend the $ and put them at the stupid places I had "figured out" they were! Reality check 2: BF. But I still wouldn't go by where I thought they were, and couldn't stop thinking about them. So, yeah, it was clearly a delusion. But it took awhile to realize it (a week or so). Thanks to reality checks, I knew it wasn't real, but still "knew" it was(!) On the weirdest visual, it was a cat. We didn't HAVE a cat! So, aware that it must have been a hallucination, but damn, I saw it!

Which leads me to wonder. Perhaps how long it goes on contributes to lack of awareness?? Like, my thought process when deeply depressed for a very long time is... I'll "say" that I concede that perhaps it is "off" a bit from what others say (ie. reality check), but not only do I deeply believe my twisted thinking, I really don't know how veeery far off base I am. Like you say, Anika, realizing it after the fact. The delusion of the spy cams went on for awhile before I was sure it wasn't real. The hallucination of the cat could be verified right away. Maybe part of the awareness comes from the battle between what you know or hear to be real and what you are seeing or believing??

I hate that saying too.