Falling in love happens so suddenly that it seems, all at once, that you have always been in love.

For me, the first sign of oncoming madness is that I'm unable to write.

Madness strips you of memory and leaves you scrabbling around on the floor of your brain for the snatches and snippets of what happened, what was said, and when.

And so I am feeling numb. It's a curious feeling, and I get it all the time. My attention to the world around me disappears, and something starts to hum inside my head. Far off, voices try to bump up against me, but I repel them. My ears fill up with water and I focus on the humming in my head.

I threw up again that night, half-afraid that my eyeballs would explode. But it was, by far, more important that I get rid of dinner. Of course, by then, throwing up was the only way I knew how to deal with fear. That paradox would begin to run my life: to know that what you are doing is hurting you, maybe killing you, and to be afraid of that fact--but to cling to the idea that this will save you, it will, in the end, make things okay.

My brain sometimes departs from the agreed-upon reality, and my private reality is a very lonely place. But in the end, I'm not sure I wish I'd never gone there.

• This seems impossible to me. It seems biologically impossible to stay the same size, although I must. It seems one must always be either bigger or smaller than they were at some arbitrary point in time to which all things are compared. The panties that are possibly tighter than they were. When? You can't say when. But you are absolutely positive no question that it's true.