Anxiety and work stress in a new doctor

Hi,

I am a first year doctor. I initially studied in Australia but moved back to my country (I won’t specify where but in Asia) I have been working for 4-5 months, went on a one week leave. After that 1 week I went back to work and everything went downhill. After a few bad nights of sleep, I dreaded going to work, I started to have panic attacks at night, and run on 2-3 hour sleep whilst doing 30 hour days. Eventually I applied for time off as non paid leave as I was not functioning well and getting panic attacks every 5-10 minutes. I get worried about assessment forms that have to be filled in and I am just very worried about things in general. There are assessment forms that seniors fill in to assess performance as well as anonymous forms for co workers. My psych has diagnosed me with adjustment disorder with anxiety and insomnia and acute stress disorder.

Somehow in that time I have developed a fear of the hospitals, and my ability and confidence is also diminished. Through this I have been well supported by family and my partner (who unfortunately is away at the moment for school related matters). It was so bad that I was seeing a psychologist and psychiatrist at the moment, the medications have helped, but therapy such as visualisation and positive thinking is still difficult. As an intern, a first year doctor, I know that many doctors also feel exhaustion and burn out, and I think mine was a pretty severe case as it led to frequent panic attacks and fear of work that was very ptsd like that I had to take an LOA from work.

I have even entertained the idea of quitting but I know that deep on my heart I cannot quit and I know I will regret it if I quit. However the initial reasons of why I wanted to do medicine seems to have gotten lost. As a first year doctor there are also tons of assessments and I am scared I am unable to pass or live up to expectations. Although I know it is futile to think about that as well.

I realistically know I need to take one step at a time, however currently I am on non paid leave however I do feel this emptiness and these sense of loss. I also know for my mental health and the well being of my patients, I did have to take no paid leave. Somewhere along the way I crossed the line from being a normal amount of stress and functionality to the other extreme and I am scared I cannot go back as I fundamentally understand that my job involves stress.

I am grateful for the support I have and perhaps it helps me not maybe reach a bad turning point but it does not help my feelings of inadequacy and failure. I just wanted general advice on how to not let work affect me so much, how to be less negative on my outlook and not stress so much about my work performance and evaluations and how to able to really focus on life outside and the good things I already have and in turn just focus on one day at a time.