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We assume you are using "mad" in the sense of insane. The answer is sometimes, especially if the problem has arisen in adulthood. Others realize it through observing the ways that better-integrated people function. In many cases, however, people are simply aware of not fitting in. When one is subject to the problems all the time, they can come to seem normal. To use an extreme example: if you believe you have to line your hat with tinfoil to keep aliens from stealing your thoughts, then people who don't take that precaution are obviously insane.

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15y ago
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Q: Do mad people know they're insane?
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