Varies from person to person. With time many learn to recognise their episodes and develop insight. However consultation with a psychiatrist is a must.

Hi there, A detailed medical and psychiatric history is always needed for every case.Also a detailed mental status examination is necessary. A large number of patients start understanding about what kind of symptoms they have gone through when they were ill.Most of the time, symptoms don’t become overnight. So when they undergo the relapse of the symptoms, they can understand that some thing is wrong now with them. A person is either Euthymic or in mania, both don’t coexist. Euthymic can understand about illnesses but with the psychopathology and impairment of judgment and insight, a maniac is not likely to understand about the psychopathology.