When you grow impulsive and make less than optimal choices, are you aware that it is happening?

I have been a person who prides himself about being self-aware. I try hard to understand my hidden motives. I try hard not to fool myself about the potential problems that may result from a course of action. I use that knowledge to avoid mistakes and maximize the beneficial impact of my choices.

Since I have started to get sick (with bipolar disorder), I started making poor decisions, even though I knew they were bad decisions. I had a much harder time controlling my impulses than I ever had before in my life. It was the weirdest thing. I would watch myself deliberately driving into train wreck after train wreck, screaming at myself not to do it, and yet seemingly unable to stop.

My therapist says it’s because of the problems in my brain, but it is hard for me to accept that. It makes me think that I have some hidden self-destructive motive that makes me choose hedonism over delayed gratification.

I am aware that I am making stupid choices, and yet I still do it. When people claim that they didn’t know what they were doing because they were drunk or had otherwise incapacitated decision-making, I find it hard to believe. You are not who I am asking.

If you make bad decisions knowing the impact of those decisions, can you give an example? Can you describe what is it like? What do you think is going on inside your brain? Do you think you are crazy?