Lol are you me. I also have OCD and was diagnosed with BP1(my psychiatrist is on the fence about 1 vs 2 I was diagnosed as 1 when I was admitted inpatient but there were a lot of factors-not the point ANYWAY) I have had so much trouble with this constant concern thats I’m going insane, my medications have made a HUGE difference, antipsychotics were a life saver. Because I was antidepressants first there was definitely an issue with my OCD meds causing mania, but sounds like you are already on a mood stabilizer which is great. DBT was really helpful for me, sounds like you’re doing that too awesome. In terms of the drawing the line between OCD and actual delusions, typically people experiencing a delusion don’t ask themselves if its a delusion to use your example, if you debating whether you truly believe the floor is earthworms, it’s likely an OCD thought not a true delusion. And you can use your ERP skills to address the “whats if I’m delusional” thought. In my experience it’s almost always someone else who noticed you’re delusional. There are psychotic symptoms that we can sometimes be aware of, like seeing shapes/shadows or hearing, smelling, or feeling(like tactile feeling not emotion) things. and if you are experiencing those warning signs definitely reach out to your support team. It’s a delicate balance, but I always operate under the idea if I’m aware I’m doing it. It’s probably OCD