non vet here. (ptsd-nos dx with major depression and agoraphobia) I was first diagnosed with schizoaffective disorder because they didn't think I could get ptsd without going to war, and maybe they didn't believe what happened to me either. I left that clinic immediately after that. They almost had me convinced I WAS delusional and paranoid in some psychotic way. But slowly I started realized that most everything I was paranoid about were triggers either directly connected to what happened or loosely connected. I thought I was psychotic because I would do weird things like watch cars and confront people if I thought they were following me. I once freaked out and threw my phone at a black suv and ran down the street thinking they were stalking me. I would scan rooms looking for anyone watching me or following me. I didn't understand why I felt possessed to do those things. But I realized it was because I was scared for my life and the things that happened to me were pretty fucking insane. There was a lot of psychological shit that happened and that's hard to express. There was no reason for me to scan a restaurant for whatever, nothing bad ever happened to me in a restaurant, but I was so afraid all the time and was told horrible things would happen to me if I didn't follow certain rules...... I thought I was psychotic until I realized I was only reacting to something that happened to me. Psychological abuse/brainwashing etc does things that make you seem as if you are psychotic but it's all trained reactions. The more complex the trauma the more complicated the symptoms of the ptsd will be.

But on the flip side I generally do have paranoid traits outside of my ptsd. I struggle to trust anyone really at all. I accuse people of stealing from me a lot, talking trash about me, snooping around in my car, stealing my meds, sometimes stress makes it worse, and I start thinking my loved ones are trying to poison me. I would never have thought in the past I would have asked my mother dead pan if she would poison the coffee. I'm not delusional because I don't truly believe these things, i'll just ask people about it and try to clear up any misunderstanding, so yea I just call them episodes. I just sometimes flip out and tear the house apart looking for some missing object, call up friends asking about them stealing from me etc. etc. But I actually haven't had any really bad paranoid episode in a while........ Obviously none of those things are connected to the ptsd in any way I can see. That's how I tell the difference. sorry if this isn't clear or what you wanted. I took a bunch of ativan.