Yeah I'm not going to do that because let's be real it'll throw red flags everywhere and mess up my professional life.
You should make an appointment with a psychiatrist and a counselor. You don't need to take a leave, but you definitely need to find help. You just admitted to being an alcoholic (or at least having alcoholic tendencies)... which is already a big step... because to get help takes acceptance that you have a problem....
But let's be real: Not a single person on here can tell you it will all be okay afterwards. It appears that, whether it was medicine, or something else, you'd really be in a bad spot regardless as long as the stakes are as high as they are in medical school and residency. For me, when the challenge of med school was confronting me, I worked harder to make myself adapt to be stronger than it. For that, I believe I am coming out an even stronger person than I was when I first started.
The challenge of medical school makes me stronger and makes me a better person. Why? Because I didn't allow myself to sink, because I have a genuine passion for the material, the connection, and I thrive on competition.
It appears for you to be the opposite - You have allowed yourself to spiral due to the "Backstabbing" the "Competition", the "politics" and are looking at everyone in medicine as if they "suck". It appears to me as if you've lost your passion or don't know what to do.
Most people in their 4th year are EXCITED about residency because they're pursuing a specific specialty they're genuinely passionate about. Do you have that? Are you not passionate? If not, then you need to seriously reconsider what you're doing because it WILL NOT GET EASIER WITH THIS ATTITUDE. You're not gonna walk into residency jaded and wake up 3 months later after having a horrible attitude and suddenly it will be okay.
You need to break the downward spiral you seem to be in. There's 1,000,000,000 things someone can tell you to do to get out of a depressive cycle - but let's be real, it just takes time and energy. You have to start waking up every day with goals on your to-do list for things that will make you happy. Whether that's simply sitting down and having coffee with your fiancé, going on a walk in the evenings, going to the gym together, you can't assume residency will be better than medical school. It's going to be way worse. You're essentially going to be a smelly resident living and breathing out of a hospital.
If you don't have a genuine passion for this, you will be miserable. But, you can counteract that by having enough outside of medicine to offer you sanity and keep you tethered to reality.
For what it's worth, I wish you the best and hope you are able to find what you're passionate about to break this downward cycle.
Worse case scenario you take a chill very rural residency somewhere with lower stress than the hustle and bustle of some ultra-competitive academic residency somewhere.
