Lessons at 40

This past July and August, I worked on my tan. As I sit here typing my nose is even a little sunburned, something I would never have allowed in the darkly strict sunscreen years of my thirties. But a cool thing happened last autumn; I turned forty. I promise this post is ultimately uplifting and even offers a few words of humbly-delivered advice. But in order to get there a certain amount of backstory is necessary.

My thirties were tough, I can’t pretend otherwise. I was a veritable mess of nervous energy on a good day, often immobilized by anxiety on a bad; poised at the entry point of serious motherhood as I rolled into that decade, my girls were both toddlers and in addition to a daily load of housework and meal preparation, I held down a full-time job teaching English at a local high school. To make matters all the more hazardous to my mental health, my husband was a full-blown functional alcoholic, a terrifying fact neither of us would acknowledge for at least another few years.

And then at age thirty-two, I visited a dermatologist for the first time at the urging of a friend who insisted everyone should get a periodic skin exam, during which a small, dark brown mole on my leg was removed. It turned out this mole’s pathology was “severely atypical” and I was introduced for the first time in my freckled, Irish-pale, sun-worshiping life to the idea of potential skin cancer.  

Immediate tailspin. Thirty seconds after the nurse read aloud the pathology report over the phone and despite the fact that an atypical mole is not cancer, I concluded I had six months to live. I began preparing myself for the advent of certain death; I imagined a thousand different scenarios in which my young children would be forced to face life without me. Milestones I would miss.

Who would walk them to the front entrance on the first day of kindergarten? Who would hang the Christmas stockings and read Max and Ruby stories and make noodles the way they liked? Their dad?

Their dad kept a steady job (hence the “functional” part of functional alcoholic) but clandestinely drank cheap vodka, neat, in the basement after work, booze he hid with studied precision in various locations around our house and garage – such as the water heater, the toilet tank, the gas grill on the back deck. Alcoholism had sunk its claws deep; the poor man was a wreck but he hadn’t yet reached what alcoholics (and their struggling family members) often refer to as “rock bottom.”

My anxiety escalated. I became a hypochondriac of immense proportions, for a time calling to request appointments at the dermatologist’s office with nearly the regularity of a visit to a favorite drive-thru coffee bar. I inspected my skin, hairline to toenails, about five times a day (or fifty, depending on my stress level). I Googled “melanoma” and read for a few focused and horrific minutes, then promptly slunk to a corner of my living room, sank to a crouch, and hugged my knees while rocking and sobbing.

I knew I was as good as dead. If it wasn’t skin cancer it would be lung cancer. In my twenties I’d smoked like a chimney – or a girl with a serious desire to rebel in a stupidly inappropriate but sickly satisfying way against her shitty upbringing.

This idea lodged itself late on a Saturday night; I called to request a chest x-ray as soon as the appointment desk opened on Monday morning. All hypochondriacs fear the weekend because unless you want to brave the ED to stammer out your latest medical crisis, you must wait for Monday morning to make an appointment. And we all know what waiting means; the word “tenterhooks” comes to mind.

My doctor, a kind, elderly man whom I often secretly pretended was my dad, the sort of father I self-righteously felt life should have provided for me, suggested cognitive behavioral therapy, or CBT. He also said perhaps antidepressants would be a smart choice. He explained that hypochondria is a state of perpetual misconception in which the mind morphs ordinary aches and pains into hideous cancers and unpronounceable diseases.

I heard what he said, nodding at regular intervals; not only did I respect him, I considered myself an intelligent, well-read person. But I didn’t make any appointments to begin therapy. I continued to sink within a despairing pit of my own construction; a seemingly bottomless, ragged-edged hole in which the light of day appeared as a murky, acid-green speck of light, as unreachable as the moon. But, weirdly, I didn’t believe I was depressed. I was anxious, a completely different state of mind.

Anxiety was like a potent cocktail I drank without intending it, without wanting it, something that swirled hotly through my blood in the fashion of alcohol, deadening sense and logic while sharpening awareness, but in creepy ways. For several awful months, I felt like sunlight was the wrong color, a vaguely threatening shade, something in a nightmare from which I couldn’t awake. Sunlight, which I used to absorb like a sponge, had now become the enemy, the causer of skin cancer and paranoia.

I learned later this dream-like sensation is called “derealization” and is a harmless, garden-variety side effect of anxiety. But tell someone who is suffering from derealization that it’s harmless and she’ll laugh in your face. It feels like hell. It skews your perception and causes everyday moments to seem off-kilter in a way you can’t quite put your finger on; you know something is wrong, but have been stripped of the ability to explain. And though you can’t just “snap out” of it, as well-meaning people will insist you should, it does eventually go away.

Anxiety was metastasizing inside me, rather than the cancers I feared. I became increasingly isolated and suspicious, afraid to bring my toddlers shopping because what if someone snatched one of them from the grocery cart while I rifled through bananas or compared melons? Sleep became a stranger and when I did drift into a fretful snooze, I was plagued by the feeling that someone, most likely a grungy serial killer with a length of nylon rope, would be hovering at the foot of the bed when I opened my eyes.

I became a checker. Not the friendly, department-store kind, but a ritualistic, obsessive-compulsive type. If I wasn’t frantically combing my skin for pigmented lesions (Isn’t that a great fucking way to describe your moles? Thanks a lot, dermatology) I was checking my kids in their beds, checking my door locks, checking my husband’s breath for the subtle, telltale reek of booze; to this day the scent of vodka turns my stomach.

Here’s the good news: I’m forty and comfortable in my own skin. I’ve left anxiety behind. I’m no longer bound to the rack of irrational fears and I cannot tell you how damn good that feels.

Here’s how I got there. I like lists; it’s the grammar teacher in me, so I’ll use one to explain. But first and foremost, and to sum up the gist of this entire list, I TOOK ACTION.

I took action and stopped allowing anxiety to render me immobile and afraid. I refused to continue being a prisoner to my thoughts.

  1. Therapy

With my doctor’s help, I found a local therapist. This was three years after the severely atypical mole incident. I met with her every week for six weeks, then twice a month for another two months. I was motivated to do this because it was either talk to someone or try antidepressants, and I was reluctant to take medication for something I didn’t believe applied to me (anxiety versus depression, I mean).

For me, therapy was the better route. My therapist’s advice was invaluable. I’ll call her Krista. I poured out my very heart to her, withholding nothing. By then, I was so desperate to feel better I didn’t care if she thought I was a total whacked-out freak or beyond help. I told her about my checking behavior, my irrational fears (fears which seemed incredibly real and plausible to me), my alcoholic husband, my troubling childhood.

I talked and talked and talked. She listened and listened and listened. And finally, once I’d all but slumped forward over my knees from emotional exhaustion, she replied.

2. Applying What I Learned

Krista taught me that compulsive behavior is learned and can be stopped. She helped me set limits on how often I could “check” my skin. For instance, I could only check my skin twice a day, once in the morning and once in the evening. (This can be applied to anything you might be regularly checking). She explained that compulsion leads to compulsion – so, in other words, the less you check, the less you’ll want to check.

It sounds crazy, I know. I didn’t believe her at first. But then it worked. I slowly began to lose the desire to check my skin. And then, to my absolute relief, the irrational desire to check things began to dissolve as well.

I felt in control for the first time in many years. And, ironically enough, Krista insisted one of my major stumbling blocks was the fact that I was attempting to “control” things no person is able to truly control, therefore driving myself to the brink of insanity. An alcoholic husband. Potential illness or disease. The future.

Once the truth began to sink in, I realized I’d been living in a hell of my own making. The speeding anxiety train, flying along the track and sending up sparks, was an illusion. All along, I’d possessed the power to get off that goddamn train.

3. Al-Anon

This is a group for those who are affected by someone else’s drinking, a group I joined in my later thirties. Al-Anon has thousands of chapters around the world and I can guarantee there is a group meeting routinely somewhere near you. Check online or in a phonebook; they often meet in church basements.

People in Al-Anon are the most no-nonsense and accepting group I have ever met. Their basic tenets involve self-care and recognizing that you can choose positive thought patterns instead of negatives. That you can find joy in even the most difficult situations.

Al-Anon is incredibly, profoundly empowering. I learned that my husband’s drinking was not my fault and that I can’t control anything but my own actions – truths almost identical to what Krista had said. Everything else is out of my hands and that’s OK.

It’s not that you should step aside and become a bystander in your own life; it’s recognizing that you are capable of reacting appropriately no matter what the situation, that you have that choice. Anxiety strips you of the ability to make choices; or, at least, that’s how you feel. Once you realize that you are in charge, you begin to feel better. And better and better.

These basic realizations struck me like volleyball-sized hail despite how obvious they may be to other people. I adopted the habit of making a list each night, reflecting on at least three things I was grateful for, no matter how shitty I felt that day. I began to focus on things I’d neglected, things that made me feel good and whole, like bringing my girls to the nature center, taking a daily walk along the bike path, and writing. Oh man, it felt good to be writing again. Writing had thrown me a life preserver many times in the past and it was during this dark time – my thirties – that I produced the bulk of my current novels. Weird. Life is so weird. And hard. But it’s so damn beautiful and precious, too; the ultimate paradox.

4. Self-Care

Al-Anon and Krista agreed on many things, such as the following – caring for yourself is just as important as caring for anyone else in your life. A little self-care goes a long way. For example, before doing anything else in the morning, get up and spend a few minutes actively caring for yourself.

This can be as simple as starting a pot of coffee (or tea or fruit smoothie or whatever you enjoy drinking in the a.m.) before preparing the kids’ school lunches. This can be taking a second to step outside and inhale the dawn air. Observe the sunrise. Stretch your arms above your head and then out to either side. Smile and breathe deeply. Think about what interesting things you are going to do today. Reread your list of gratitude from the night before.

Do these things. Don’t just think about doing them, really do them. This is all part of taking action and empowering yourself to feel better and safe and mentally whole.

Anxiety is all smoke and mirrors. It goes and stays away when you take action by caring for yourself and look outward rather than fixating on negative thoughts. Doing instead of thinking. Moving instead of remaining stationary. Outward focus instead of inward.

5. Simple Appreciation

In the past, when I read online articles about how to “overcome” anxiety, I never seemed to find concrete tips. So, here are a few that worked wonders for me.

Say out loud (seriously out loud, no exceptions), “I give myself permission to live in the moment.” Say, “I don’t know the future and that is all right.” Also say, “I give myself permission to live my life.”

We are happiest and most content when we live in the moment. When I start to feel my thoughts whirling away toward the future – really, where most all worry exists – I stop, inhale, and then start examining what’s literally right in front of my eyes. I used to make frequent, quiet, spoken observations as if learning a new language – “The sky is violet just now, the air is still, clouds are massing on the horizon, I can hear sparrows and chickadees and my neighbor’s lawn mower.”

One thing I stopped doing was Googling diseases and reading about conditions. Stop doing that. Full stop.

When I still taught English, before I became a full-time writer, one of my favorite plays to teach was Thornton Wilder’s Our Town. God, I love that play.

Its basic theme is achingly simple and incomparably lovely – even the least important day of your life is still important. Something to be cherished. Valued. A day to spend living. LIVING. Looking outward and upward and whispering aloud, “I choose joy.”

Whisper this to yourself about a hundred times a day. Seriously. I did. I do. Understand that trying to predict all possible negative outcomes solves nothing. Understand that you are equipped to face life as it comes and that’s all any human can be expected to do. Give yourself permission to let go. Say out loud, “I let go.”

6. Reading

I found incredible solace in memoirs during the height of my anxiety. My top five recommendations are Wild by Cheryl Strayed; The Liars’ Club by Mary Karr; Confessions of a Prairie Bitch by Alison Arngrim; Men We Reaped by Jesmyn Ward; and Smoke Gets in Your Eyes by Caitlin Doughty. I also reread Cold Mountain by Charles Frazier probably twenty times in the past decade, underlining passages that moved me, new ones with each subsequent reading. Read! And read. (Just don’t read Internet articles about diseases and conditions).

This upcoming September I’ll be forty-one. I have two book series in print and am currently working on two new standalone manuscripts. I am suntanned.

Later this evening I am going to eat chicken tacos with plenty of salsa, refried beans with plenty of melted cheese, and a piece of caramel cake my youngest daughter baked yesterday. I still worry about things. I’m human.

But I don’t slip into that despairing cavern anymore, the deep hole in which I spent so much of my thirties. And it’s because I realize now that I have the choice NOT TO; that cavern no longer has power over me.

Do I regret the things I missed while in the stranglehold of anxiety? Of course. But there’s no real point in regret; it holds you back from moving forward. I am happy in a way I’ve never been and I am still sometimes stunned by this fact.

Maybe, as I once read long ago, the “autumn” of a person’s life is the most wondrous of all. I look outward instead of inward. I appreciate. I’m grateful. I read and write and jog and bike and journal and watch TV and plant sunflowers and grow tomatoes and take fun road trips. I let the sun touch my face. I take care of myself. I choose joy. I’m saying that out loud right now.

“I choose joy.”

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Abbie Williams

Abbie Williams avidly loves language, nineteenth-century history, and women's studies, all of which inspire her many novels. When she isn't writing, teaching, or taking care of her busy family, you can find her hanging out lakeside in her native Minnesota, probably listening to bluegrass music.


  1. I see so much of my own story in your, Abbie. Thank you for sharing. Your experience helps me understand some of the loved ones in my life better. And I can relate to the anxiety produced by the “big secret” of alcoholism lurking under the surface of life. You write beautifully.

    1. Angela, thank you for your reply! It took me a long time to break from the isolation, and even shame, being anxious. Now that I feel better, I want to help others by sharing. Life is hard, especially if you’re close to an alcoholic, but it’s so beautiful, too. It just took me a while to see the beauty past the anxiety. I hope you’re in the middle of a great weekend!

  2. Such a beautiful article. I love the way you have listed how you TOOK ACTION. I think the key to life is taking action to change the things we dont like about life. Simple appreciation really stands out for me especially when am tempted to complain about everything that is not right around me. Thank you for sharing.

    1. Hi Emma,

      Thank you for replying. I agree that taking action is part of the key to a contented life. It’s easy to complain (I am a big-time complainer if I don’t watch myself) but it makes me a whole lot happier if I can just move on and ahead. I hope you are in the middle of a good day!

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