You have asked many good questions, all of which are difficult to answer because I have limited information about your situation. Generally speaking, it is possible to have symptoms of a variety of psychological disorders simultaneously. I cannot say with certainty if you have any of the disorders that you described. I would need to interview you in person to determine which disorders you may or may not have.
Paranoia is generally not associated with anxiety disorders; however, it would depend on how you are defining paranoia. Paranoia is associated with two main personality disorders, paranoid personality disorder and schizotypal personality disorder.
Delusions of grandeur refer to the belief that one is extraordinarily powerful and influential. It is not based on reality. Self-esteem is related to confidence level. If you struggle with the ability to determine the difference between what is reality and what isn’t, then professional assistance would be recommended.
Having serious psychological symptoms can impair one’s ability to work and to function on a daily basis. It would be advisable to have a psychological evaluation to determine your mental health status. The symptoms you have described are troubling. They seem to be interfering with your life and causing you distress. They should be eliminated as soon as possible.
You have tried medication with limited success. I would suggest that you continue searching for the right medication. I know that process can be frustrating but finding the right medication can significantly decrease your symptoms.
You should also try counseling. A therapist can help you to stay grounded in reality and teach you strategies for dealing with your problematic symptoms. Never be accepting of psychological symptoms. Many treatments exist that can significantly decrease or eliminate them from your life. I wish you the best. Please take care
Dr. Kristina Randle