I have experienced paranoia so bad I was terrified to walk to the mail box twenty feet from the front door once a day. So I do understand. My paranoia is so much better on lithium and with therapy. Something you are doing that is a great sign is that you are challenging your own paranoid thoughts. My therapist is always telling me to do that. Paranoia survives in emotion run amuck and emotional reactivity.
With me, A guy tried to say hi in a coffee shop. I was repeatedly attacked by a male in high school. My paranoia kicks in: This man is going to hurt me and I need to protect myself. He is coming after me. I need to run away.
I can almost hear my therapist saying: really? is this what is really happening? Think it out.
Logically, he was most likely simply trying to be nice. He may have not even wanted to pick me up. He was well within societal bounds to say hi and I am overreacting. Something else she wanted me to do is think Why? Why did I react that way? What is my trigger?
Ok it was my history of abuse. Why else? I am across the street where attacks took place. Etc.
it takes the power from the paranoia and the emotional kick of fear. As you are, Use logic to defuse the intensity. I also use repetitions in my mind to distract me. I recite the alphabet forwards and back. Which is harder than it seems. That grounds me and distracts me from the spiraling paranoia.
I can't say what will happen when you go to your appt. logically no one can, even you. However, no pdoc or therapist no matter how good can help you with what they don't know about.
You are not alone in this struggle.