There's childhood and early onset bipolar, but it transitions in your early adulthood into something a little bit different, and extremely severe. It was at that time that my impulse control just went out the window. Impulse control when you're manic just disappears.

My god! people say. You have so much self-control! And later: My god. You're so, so sick. When people say this, they turn their heads, you've won your little game. You have proven your thesis that no-body-loves-me-every-body-hates-me, guess-I'll-just-eat-worms. You get to sink back into your hospital bed, shrieking with righteous indignation. See? you get to say. I knew you'd give up on me. I knew you'd leave.

Hatred is so much closer to love than indifference.

This is the very boring part of eating disorders, the aftermath. When you eat and hate that you eat. And yet of course you must eat. You don’t really entertain the notion of going back. You, with some startling new level of clarity, realize that going back would be far worse than simply being as you are. This is obvious to anyone without an eating disorder. This is not always obvious to you.

All of us carry around countless bags of dusty old knickknacks dated from childhood: collected resentments, long list of wounds of greater or lesser significance, glorified memories, absolute certainties that later turn out to be wrong. Humans are emotional pack rats. These bags define us.

• Eating disorders are addictions. You become addicted to a number of their effects. The two most basic and important: the pure adrenaline that kicks in when you're starving—you're high as a kite, sleepless, full of a frenetic, unstable energy—and the heightened intensity of experience that eating disorders initially induce. At first, everything tastes and smells intense, tactile experience is intense, your own drive and energy themselves are intense and focused. Your sense of power is very, very intense. You are not aware, however, that you are quickly becoming addicted.

Hospitalizations in general are blurry. The days are the same, precisely the same. Nothing changes. Life melts down to a simple progression of meals. They become a way of life fairly quickly. You may welcome this transition. It may seem inevitable to you. You have been removed from the world. It is all right, in a way, because there is nothing so sure, so safe, as routine.