Hypervig, over watchful over things actually there / scenarios with basis in reality.
Paranoia, preoccupied with things that are not actual / things with very little basis in reality, or being possible for current settings.
... And the quality of those emotions, ime. As in grounding will kick hypervig to the curb, paranoia, not so much, got to address that it actually is paranoia and different skillset. I usually do better when having to turn paranoia on its ear and to something I am familiar with and that is more hypervig lair ((ookay, you are in enough rice pudding you are dead tomorrow? Can you walk me through precisely how? vs. if it were actual, would need to know where to duck to, f*ck the bullshit.
People around me I trust have usually been able to tell both apart just well. Also because when hypervig on steroids, I make sense, essentially / am able to walk them through things very fast. When paranoid, I miss out huge chunks / have less facts and orientation in them, more suppositions.))