Psychosis or Anxiety?

22M. At 17, I had a severe panic attack in a high school class that triggered intense derealization. Since then, I’ve experienced a persistent loop: the derealization triggers panic, and the panic intensifies the derealization. This cycle continued through university and still significantly affects my life today.

One of my biggest fears throughout this has been psychosis. Over the years, I’ve noticed occasional minor auditory hallucinations like muffled voices or thinking I hear my mom say something. These usually occur during high anxiety or panic states and tend to come and go.

I’ve tried several medications in the past (including sertraline and Ativan), which have helped to some extent, but the core issue has remained. I'm now trying sertraline again after a long medication-free stretch. Since restarting it, I’ve noticed a spike in derealization-related panic and more frequent auditory misperceptions. I’ve also developed a strong hypervigilance to sounds and an overwhelming fear that I might be having a psychotic episode.

My question is: Are these minor auditory experiences an early sign of psychosis, or are they more likely symptoms of a chronic, severe anxiety disorder?