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.

• 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.

There is, in fact, an incredible freedom in having nothing left to lose.

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.

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

We were at another funeral party. I wasn’t sure who had died this time, but it was a suicide, and upsetting because it was completely out of season. No on killed themselves in summertime. It was rude.

Madness is not what it seems. Time stops. All my life I've been obsessed with time, its motion and velocity, the way it works you over, the way it rushes you onward, a pebble turning in a brook. I've always been obsessed with where I'd go, and what I'd do, and how I would live. I've always harbored a desperate hope that I would make something of myself. Not then. Time stopped seeming so much like the thing that would transform me into something worthwhile and began to be inseparable from death. I spent my time merely waiting.