There’s no question that sometimes paranoia manifests not as baseless delusion of persecution (e.g., the CIA is tracking me), but as fear of behaving in public in a way that might freak out others and maybe result in arrest and forced hospitalization. Since some people suffering from SZ can’t gauge social reaction, and perhaps have had some legitimately bad experiences, they don’t trust themselves to behave in public in a way that is safe for them, which is why so many withdraw socially.
This absolutely how I felt about my wife just before she abandoned our home and went into hiding 5 weeks ago. I bumped into someone yesterday who has been in contact with her, and she was saying “she is fine, don’t worry”. I was trying to explain that she is ignorant of the illness and that she understands nothing about it. My wife had insight and was asking for crisis care shortly before she left. She made a radical change of plans with little thought of the consequences. All these people look at me like I have the problem. I was on the phone to my father-in-law for a couple of hours today and he just said “these people are all ignoring that she is doing irrational thinking”. It is completely true. She has just under three weeks left on her visa. She has build up so many things here that she is about to throw away, yet everyone around her, that are clueless about her illness think “no, she just left you, everything is cool”. It drives you bonkers.