Allison - it is very common in all medical students to fear failure. Fearing success is more of an ADD/PTSD thing.
Chunking - do your learning in chunks. In the next 30 minutes, all you have to learn is how beta-receptors work in smooth muscle. Then take a 10 minute break after you learn that chunk. Jog in place, run up and down the stairs ro 10 minutes. Next chunk, what happens with beta-agonists and beta-antagonists at each organ. After your 20 minutes of studying that, break for 10 minutes. Stretch, do a quick yoga break. Next chunk, etc.
By only having to learn a 20-30 minute chunk, you eliminate having to think about everything in the entire book, or year of medical school. Studying in chunks also helps decrease brain fatigue.
Troubled sleep needs to be addressed. Better sleep hygiene - no computer near bed-time as the underlying blue-light emitted from computer screens tells the brain it is time to wake up. No caffeined 12 hours before you'd like to sleep as caffeine has a 12 hour half-life. No hot showers/baths immediately before bedtime unless you want to lay in bed awake for an hour or two. The core temperature of the body goes down when it's sleepy time. Alcohol may make you sleepy in the short term, but will tend to make you wake up prematurely. Herbal tea, like Sleepytime with chamomille and valerian can help. Benedryl is non-addictive, but you need to have at least 6 hours to sleep or you'll feel hungover. Sleeping pills can be addictive, but some other meds work well for PTSD patients like Prazosin or clonidine. Those meds make people have less startle response and help make you sleepy. But as alpha blockers, they can't be skipped injudiciously as blood pressure can shoot up in some patients. Some of the older antidepressants - tricyclics - induce sleep as a side effect. In small doses, trazedone, amitriptyline induce sleep, but they tend to have longer hang-time. (ie You need at least 8 hours to devote to sleep.)
All the best to those in the midst of their education!
