I feel like I can’t do anything.

I (20f) said this to my boyfriend this morning. It’s the second day in a row I’ve called off work because I can’t sleep to save my life. I wake up probably every two hours, have bad dreams, I suffer with sleep paralysis. Then I wake up with so much anxiety I’m nauseous, then vomit, then lay back in bed and cry because my brain is immediately so loud.

I’ve been on buspirone 15mg 3x a day for a few months. Been on buspirone itself for 3 years with gradual increases. It’s now fully not working. I’ve been managing decently with work but now it’s just debilitating and I genuinely feel like I just can’t do anything but be anxious. That’s all I ever am these days. I work childcare and I love it, but it takes so much out of me. I was good at it, less overwhelmed when my meds were working, but now I can’t even take care of myself so how do I take care of 9 three year olds by myself for 11 hours a day? Just the other day I had to leave the classroom when my coworker conveniently walked in at just the right time because I was about to burst into tears and have an anxiety attack. The kids were fine, they were coloring, there was no reason for me to feel overwhelmed in that moment but I was.

Anyway, I have two main questions:

1. I need a doctor’s note for work but I’m not physically sick. Do I just go to urgent care, tell them what’s going on and ask for a doctor’s note? Can’t see my PCP, no availability soon enough.
2. Speaking of PCP, should I continue seeing my PCP for anxiety? I can’t stress enough that it’s debilitating. It’s been a long time coming with my medicine not working and panic attacks increasing. Will I be better off with a psychiatrist?

Thanks for any answers. I’ve had a lifetime of anxiety and I’m tired.