Something seems to be wrong. You may be describing symptoms of a mental illness.
Your symptoms have compromised your life and thus far you’ve simply been living with them. You’ve probably grown accustomed to them. You likely don’t recognize how incapacitating they really are. People are surprisingly good at adapting to even the worst set of circumstances.
To answer your specific questions, yes, it is possible that your symptoms could develop into full-blown psychosis. As you have described, there are times when they severely limit what you can do. You need a “safety net” to prevent the progression of a possible mental illness. That’s where treatment could help.
Regarding your second question, there may come a time when your “mediocre… checks and balances” will not be enough. Therapy and/or medication could prevent a negative outcome. Your symptoms may never worsen, but you don’t want to take that chance. Being proactive is the best approach to preventing mental illness.
I would strongly encourage you to consult a mental health professional. They can determine what’s wrong and develop a plan for treatment. You mentioned the possibility of being hospitalized. Typically, people are only hospitalized when they threaten to kill someone or to commit suicide. If that’s not the case for you, then hospitalization would be unlikely. Treatment could help you immensely. You should take advantage of what treatment could do to improve your life. Please take care.
Dr. Kristina Randle