When you believe that you are not worthwhile in and of yourself, in the back of your mind you also begin to believe that life is not worthwhile in and of itself. It is only worthwhile insofar as it relates to your crusade. It is a kamikaze mission.

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.

And so I went through the looking glass, stepped into the netherworld, where up is down and food is greed, where convex mirrors cover the walls, where death is honor and flesh is weak. It is ever so easy to go. Harder to find your way back.

Soon madness has worn you down. It’s easier to do what it says than argue. In this way, it takes over your mind. You no longer know where it ends and you begin. You believe anything it says. You do what it tells you, no matter how extreme or absurd. If it says you’re worthless, you agree. You plead for it to stop. You promise to behave. You are on your knees before it, and it laughs.

When you're teaching creative nonfiction, it helps to have written about your life in a very open way, because you can say, 'Look, how much are you willing to risk emotionally to write? How careful can you be with the other people you're writing about?

After a lifetime of silence, it is difficult then to speak.

I know how this feels: the tightening of the chest, the panic, the what-have-I-done-wait-I-was-kidding. Eating disorders linger so long undetected, eroding the body in silence, and then they strike. The secret is out. You're dying.