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.

You wake up one morning and there it is, sitting in an old plaid bathrobe in your kitchen, unpleasant and unshaved. You look at it, heart sinking. Madness is a rotten guest.

Never, never underestimate the power of desire. If you want to live badly enough, you can live. The great question, at least for me, was: How do I decide I want to live?

The idea began to sink in, more than it ever had, that I might be crazy, in the traditional sense of the word. That I might be, forever and ever amen, a Crazy Person. That's what we'd suspected all along, what I'd been working so hard to disprove, what might be true. I preferred, by far, being dead.

• 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.

My bones are brittle, my heart weak and erratic, my esophagus and stomach riddled with ulcers, my reproductive system shot, my immune system useless... I'm not going to have a happy ending.

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.