I've had psychosis, especially paranoid delusions, since I was a little girl. I never realize that I'm having delusions when they are happening, though (at least I never did in the past.) When I have hallucinations I'm pretty aware of it. But, the delusions totally suck me in.

But, the delusions eventually go away. They just kind of stop.
The worst one I ever had I actually completely forgot about it until I triggered the memory by being in my old neighborhood. It was like a slap in the face kind of memory. But when I remembered it was also like an epiphany that it was a major delusion. It was very eye opening.
Also, I never realize how manic or depressed I am or how big of an impact it's having on my life until after it's over. Only when I look back at havoc do I see how bad I was.