I haven’t found it difficult yet, but we haven’t driven far. I really just have to concentrate and think far in advance on what I have to do.
Local driving rules are slightly different than home. It is just little things like when making a left turn onto a road (like a right turn by North American standards), you have to wait for oncoming traffic that is turning right and crossing a lane of traffic.
Also, one thing that has really gotten me more than a few times is that the turn signal level is on the right side of the wheel. I keep turning on the wipers instead of the turn signal.
Thankfully everything here is totally laid back. Cruising along at 40 KM/h in our rented Toyota Estima is not seen as slow.