My mental and physical health health are effecting my job

This year has been extremely hard. I have really severe OCD and GAD and I’ve been going through a lot of med changes and with that comes really really bad side effects and transition periods. Right now I’m having crazy physical anxiety like heart palpitations, dizziness etc. I work from home so it makes it a bit easier but some days have been really really hard for me. I can’t take time off as I have my mortgage and just bought a new car. Any advice on what I should do? Take shorter days but work more? I’m booked out about a month so cutting back hours would be really hard. Anyone else go through this? Looking for some advice on people who make have chronic illnesses etc. Thank you.