In my case, dysfunction in my cognitive abilities shows itself in a propensity to compulsive, monomaniacal obsession with a point of view. I can't get outside of myself.
When I am in one of these moments of despair, I am not cognizant of any other possible way of regarding my present situation, except as what most forcibly presents itself. In the case, of the despair, it won't go away and I can't shift my point of view to subject the despair to analysis to gain a different and possibly deeper understanding. The psychic pain is acute and no more amenable to analysis than a broken leg.
It sometimes happens that I am aware that my thought processes are aberrant, but more often than not, I am not. With awareness of compromised mental faculties, there is at least the possibility of going for a walk, or calling a friend, or something else that will get me out of myself.