I believe it has been a combination. I switched psychiatrists. I've never been given medication for my severe anxiety, but this doctor prescribed me buspirone. It doesn't take away all of the anxiety, but it lets me keep my head above water. The 2nd thing, I had to be honest with myself and realize I was holding back from doing more because I was afraid it would make me worse (exerting more energy than what I have). I let go of the fear, and thought about how I will be helping my family if I become more active. I can't always control how I feel, but I can control my actions. When I can, I force myself to be more active around the house. This improves my self esteem and it (most times) actually helps me have more energy as opposed to staying in bed all day and letting all my energy drain away