Anxiety has a formula, and I wish someone had taught it to me years ago.

Most things in therapy aren't simple, but this one is.

Yesterday, I was talking to my therapist about anxiety. This is nothing new; I’ve been talking to therapists about anxiety since I was fifteen, the age at which I finally sought treatment for the Worries (as I called them) that had plagued me since before puberty.

In the decade and a half since, I’ve had five therapists across five different specialties. I have been treated for OCD, GAD (Generalized Anxiety Disorder), PTSD, anorexia, bulimia, and ADHD (the last of which I did not ultimately have—turns out I’m messy and disorganized and bad at being alive, but not clinically so). I have tried CBT, CPT, ERP, mindfulness, Transcendental Meditation, propranolol, clonazepam, buspirone, Abilify, and every SSRI under the sun. I even once did ketamine therapy.

All of this is to say: I am well and truly therapized. I could not be more therapized if I tried. A Blue Cross Blue Shield mental health deductible absolutely hates to see me coming.

I am especially therapized in one particular field. It is the emotion that runs beneath all of my diagnoses. It is a word so overused today as to be almost meaningless. It is the great plague of my generation:

Anxiety.

I know anxiety. I know her intimately. At times, I feel like there is nothing new I could possibly learn about her.

Which is why it was such a shock when, yesterday, fifteen years into my therapeutic journey, I heard something about anxiety that it feels like I should have been told on day one.

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Here’s what happened:

My therapist (let’s call her Helen) and I were talking about motherhood. It’s a subject I’ve never touched on in therapy before—not out of avoidance, but because it has always felt so far down the road for me. I am not pregnant, nor am I planning to be for quite some time. (Sorry, Mom.)

But for some reason, yesterday, I felt compelled to bring it up. Maybe it was because my husband Pontus and I have been married for almost two years now. Maybe it was because my Instagram has filled up with maternity post after maternity post from girls I went to high school with. I don’t know. Whatever the case, it came up in our conversation—but not for me to say how excited I was about the idea of having a child. It was, naturally, to talk about my Worries.

“What scares you about motherhood?” Helen asked.

“Everything,” I said. “Literally, everything.”

“But what specifically? Can you give me some examples?”

Even though I’d never considered talking about motherhood with Helen until thirty seconds before that moment, the list of fears came to me easily, instinctively, like she’d asked me for my phone number. Like they’d been here all along, just waiting to be said aloud.

“Well, first of all,” I said, holding up a finger, “I am terrified of my body changing. Like, terrified. I have done so much work in eating disorder recovery to reach a point where I’m no longer at war with my body. Where we exist in peace, if not as friends, then at least as neutral acquaintances who don’t think about each other very often. And I’ve done it. I have. But it took years of work to reach this point. I’m terrified of what a substantial change might do to that tenuous peace.

“Second,” I went on, holding up another finger. “What the hell is going to happen to my brain when it’s flooded with pregnancy hormones? The one time I took hormonal birth control pills, back in high school, I went absolutely nuts. My OCD went into overdrive. I couldn’t stop crying. I blew up a happy relationship I was in just because my emotions went haywire. Is that going to happen again when I get pregnant? Is it going to be worse?

“Third, what about Postpartum Depression? I mean, I’m already a fairly mentally ill person. I have a lot of trouble regulating my own emotions. Is that going to make me more susceptible to PPD?

“And what about my POCD? God! My POCD! Sure, it’s well-managed now, but won’t it spike when I have a baby? That would be hell.”

[If you don’t know what POCD is, go ahead and click on this link—you’ll understand why having a spike in POCD while mothering a newborn would be hell.]

At this point, I was crying. Thick, fat tears ran down my face, and snot drizzled from my nose. I was surprised by my own reaction. Crying isn’t an unusual activity for me, but I hadn’t expected it to happen while I was talking about this subject. I hadn’t known how intense my anxiety around motherhood was until I started talking about it.

“And lastly,” I said, holding up a fifth and final finger and shaking my hand at the Telehealth camera. “What if I have a baby, and Pontus dies?”

Helen stared at me for several moments. “Oh,” she said finally. “Is that all?”

“It happens,” I said defensively. “My grandma was 23 when she first became a widow. Her husband, my mom’s biological dad, was a Naval pilot. He died in a training exercise when my mom was six months old.”

“I see.” Helen nodded seriously. “You’re right. I completely forgot that widowhood is genetic.”

This surprised a laugh out of me. Helen laughed, too, and as I wiped the tears and snot off my face, she went on.

“Emma,” she said, “you just painted the bleakest portrait of motherhood that I’ve ever heard. You listed almost every possible thing that could go wrong. Is that truly what you believe is going to happen?”

“I mean…” I shrugged. “I don’t know. Sort of?”

Helen gave me a certified Look™.

“Okay, no,” I said. “It’s not what I believe will happen. It’s what I’m worried will happen.”

“Right. It’s your anxiety talking. You’re thinking only about the negatives that could come out of motherhood, none of the positives. Not to mention that, even if any of these things were to happen, you’re completely disregarding all the resources you would have to navigate them.”

Here, she paused. “You’ve heard of the formula for anxiety, right?”

I stared at Helen’s kind, pixelated face. Helen stared back, blinking expectantly. I’ve been in therapy for fifteen years; the casualness with which she posed the question made me feel like a child in an Advanced Mathematics course who didn’t know what a plus sign was.

“Uh. I don’t think so, no.”

“Oh!” She smiled. “It’s simple. Get out a pen and paper.”

I did. Once I was ready, Helen instructed me to write down the following:

“Basically,” she explained, “anxiety happens when you feel that the amount of risks you’re facing outweighs the resources available to deal with those risks. Say you’re driving a car, and the gas tank is close to empty. The risk present is that you’ll run out of gas. But if there’s a gas station close by, and you have money to pay at the pump, you already have the resources necessary to deal with that risk. Therefore, the resulting value of your anxiety should be low. But if you’re in the middle of nowhere and your wallet is empty, the value of your anxiety would be substantially higher.”

I nodded as I listened. I have always liked tangible explanations—facts, figures, things I can write down in a notebook. I was good at school; I am less good at life. But this this felt like a merging of the two, and I liked it already.

“The same formula can be applied to all of your worries about motherhood. Let’s take the risk of your body changing and it triggering old fears and habits from your eating disorder. Is that a risk? Sure. But you’re completely discounting all of the work you’ve done since you went into recovery. All of the skills you’ve added to your toolkit for dealing with issues of eating and body image.” She paused. “Let’s list a few. If you have a spike in ED symptoms, what do you usually do?”

“I use noting,” I said, listing one of my favorite skills I learned in treatment. “Instead of buying into the thought, arguing directly with it or letting it dictate my actions, I acknowledge it, let it exist in my mind, and then I redirect my focus to whatever I was doing before. I go on with my day.”

“Right,” said Helen. “So, that would be one of your resources. What are a few others?”

“Pontus. I go to him for support all the time. Or I could call my older sister, or one of my girlfriends.”

“Or you could call me, or your old ED specialist,” Helen added. “So: mindfulness techniques. Family. Friends. Access to mental health care.” She ticked everything off on one hand. “Those are a lot of resources for dealing with that one risk, is it not?”

I nodded slowly.

“I’m not saying that a spike in your ED symptoms won’t happen. I’m not saying that, if it did, it wouldn’t be uncomfortable. But when you consider all the resources available to you to deal with that risk, do you not feel a bit better?”

I considered her question.

And you know what?

I did.

Which was crazy, because I have spent more than half my life in search of things that would make my chronic anxiety decrease. Most of them have been hard-won, coming only after weeks, months, or even years of practice (mindfulness, meditation, therapeutic skills, etc). Some have been chemical, like medication. But this—this was easy. This was tangible. This was a formula I could turn to when things feel overwhelming or insurmountable (which they almost always do).

At its core, this concept is embarrassingly simple: when you’re dwelling on potential risks, don’t discount the resources you have to deal with them. Put differently: when faced with problems, consider also their solutions.

It feels almost humiliating that I, a 30-year-old woman, needed to have this concept spelled out for me. But that’s the thing about having severe anxiety. It is an all-encompassing fear that takes over your entire brain, shutting down basic systems like logic or reason. It breaks down your machinery. The reason someone like me goes to therapy is to learn techniques to help bring that system back online—a process that, for someone without severe anxiety, is probably automatic.

I’m not saying that this formula is a magical, quick-fix cure-all for anxiety. I’ve been in this game too long to believe in those. But it’s one more thing to add to my toolkit. One more technique I can reach for when I’m spiraling out. One more—as Helen would put it—resource to lean upon when things get tough.

And every additional resource makes the final value of that equation feel just a little less scary.

Thank you for reading! If you liked this piece, you can find my full-length novels featuring characters with anxiety disorders below:

• How to Hide in Plain Sight (OCD representation)

• Guy’s Girl (anxiety/eating disorder representation)