Struggling to Distinguish Between Psychosis and Intrusive Thoughts

For me the feeling that follows after intrusive thoughts stemming from OCD is (depending on obsessions) either annoyance its come up or panic cause something isnt right. I do not have the hallucinations you spoke of but deal with delusions and the occasional voice talking to me. Intrusive thoughts can help spark delusions but when it happens its more of a seed filled with paranoia that starts growing. And the I voices hear outside of my head feels like someone is speaking to me rather OCD can come from inside with an impulse of sorts. Theres overlap sometimes so its not uncommon to hear intrusive thoughts being spoken to you in a hallucination. I am still figuring this out for myself. Understanding how OCD worked alone versus alongside psychosis helped but there isnt much research on the latter so I had to take from my own experiences. It might be helpful to graph or write about symptoms and explain how you feel in the moment when it happens and if there are any changes. It could be a good opener to bring to a doctor and in the mean time let you get more aware of symptoms. What youre going through sounds really hard and I hope you are able to get clarification soon.

I think sometimes the difference can be so subtle that you can only tell by talking to a professional. A psychiatrist won't expect you to know what's causing the symptoms, that's usually their job to find out, not yours. A lot of symptoms for the things you mentioned can overlap so it might be hard to tell without someone to help guide you.