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A year in advance? You burned out. Take a break from the MCAT and come back once you are refreshed. Allocate around 3-4 months to the test, pick one prep company (I went with Kaplan, 514ed it), and stick to a schedule. Also, address your anxiety in some form. Get started with a psychiatrist, you can't afford to let something that is probably treatable prevent you from reaching your goals.
This is spot on advice!!! Getting into med school is only the tip of the iceberg. Getting through it is even more stress and anxiety provoking, so get help!
Just as the posters above me have stated, you need to address and treat your anxiety issues (focus on becoming the best you possible in mind, body, and spirit/higher power). Although I have not taken the Beast (MCAT), the test that I will have to take in the foreseeable future does not scare me. What is even more frightening is the multitude of exams that are beyond the level of the Beast that awaits in medical school. Not to mention the risk of failing out/debt over your head (at the same time)...at that point you have to give it everything you got to jump over every hurdle that stands before you (even when you are beyond exhausted)...because there will be more hurdles beyond medical school (life).
Your score equates to about a 14 on the old exam. I highly doubt that you are going to get in anywhere. I struggled to get interviews with ~500, excellent GPA/Extracurriculars/LoRs. Follow the above advice...get help for your anxiety, don't burn yourself out, take a prep course, work through your anxiety. Med school is rough, and if you don't address those issues now, you are not going to do well.
It would probably be best to retake the exam. A lot of schools will automatically remove you from their applicant pool with that MCAT score. You don't want to waste an application cycle. Most schools are looking for at least a 500, but I've seen people get a few points below and still get secondaries and interviews. I would definitely look into ways to decrease test anxiety.... you've got a world full of tests coming.