I'm not sure about this. I've had a head injury in the past that resulted in (thankfully temporary) in anxiety issues. There were spells of anxiety where I sort of had a reason to be anxious (e.g. deadlines), but I simultaneously had a rational awareness during the bout of anxiety that my stress levels (so nervous can't work) were completely incompatible with the consequences of missing said deadline (of which there would be basically no consequences; not even in terms of coworkers' view of me or my skills).

Granted I wasn't close to clinically insane I think, but the point is that the brain is complex and ostensibly there seems to be multiple levels of consciousness and activity going on in the human brain. One can reason something in the abstract, yet emotionally feel completely at odds with their reason.

Same thing I thought here. I'd say "to act against reason is to act irrationally." If we only did things we thought we understood, life would be slow and boring.