It was a warm spring day in London when I lost myself entirely and my mind and body became possessed by a stranger. It was the transformation of a minute, a shuddering loss of innocence, a single comment and the way I saw the world changed for ever.

It was just after my 14th birthday, in May 1992. We were all sitting in a circle at the end of PE class at my school in west London and I was next to Lizzie Bowden, whose identity in our year was that she was the skinniest, mine was that I was the American. I stretched my legs out in front of me, liking the way they looked coming out of my loose PE skirt, rangy and scrappy, I thought. Next to Lizzie’s bony limbs, though, mine looked like matronly trunks. I’d never thought about Lizzie’s skinniness before, but when I asked, “Is it hard to buy clothes when you’re so small?” I felt a small ache. Imagine being so special that they don’t even make clothes in your size.

“Yeah,” she said. “I wish I was normal like you.”

A black tunnel yawned open inside me and I tumbled down it. “Normal.” Not “slim”, not “thin” — “normal”. I looked down: when had my thighs become so much bigger than my knees, not going straight down like they should but ballooning outwards like drumsticks? The Snickers bar I’d had at lunch sat in my stomach like a bruise. And speaking of my stomach, was the waistband of my PE skirt … pinching? My mother had often told me I could eat anything and stay slim. My mother, I now realized, had lied.

Doctors call it the “precipitant”, or trigger: the moment that sets off the anorexia. Mine was being told I looked “normal”. But really, anything would have triggered me, because the anorexia was a bomb inside me, just waiting for the right moment, the single flame, the trigger. And after the trigger: the fall. For some, it creeps up slowly as a cat, but my fall was instantaneous and vertiginous. I cut out whole food groups, then meals. I constructed a world built on my own rules, and I’d never obeyed any more faithfully in my life. Within a month I went from being a cheerful 14-year-old who told my parents everything and would sing songs from MGM musicals while rollerblading in the garden, to being a furious, unreachable adolescent who, every night in front of the mirror in my mother’s bathroom, would stand naked, staring and glaring.

Initially I focused on my tummy, because that was the part of the body I knew denoted fatness. I soon learned there were many more. I did jaw exercises to tighten any possible double chin. I joined a bums ’n’ tums class at my local gym and was the youngest attendee by at least three decades. Being a woman seemed like an unceasing battle against one’s body, and I thought I was gaming the system by starting early, erasing those bums and tums and chins and other unacceptable female parts. But I couldn’t escape my own thoughts: am I taking in calories when I chew on my lips? Or walking past a supermarket? I crossed the road in front of Sainsbury’s just to make sure and I decided lips were OK but lip balm definitely not, so my mouth became raw and scabby. How had I never realized before that the only goal in life was to be thin?

In August I ruined our family holiday to the South of France, my mother crying in her hotel room while I did sit-ups in mine. In photos from then I am not yet skeletal, but the skin is pinching around my face, outlining where my jaw meets my cheekbone; when I smiled, my eyes stayed hollow, sockets in a skull.

When I went back to school after the summer holidays, I had lost more than a third of my body weight. I was so tired, all the time, but also constantly doing star jumps in my bedroom, so much so that I made our house shake down to its foundations, literalizing the metaphor of what I was doing to my family. The sit-ups were even more of a problem. My spine protruded from my back like the fin of a fish, and when it rubbed against the floor, the flesh around it broke and bled. None of this stopped me.

At school I went from being friends with everyone to being friends with no one. My hair fell out in clumps, though I didn’t notice until a woman stopped me on the street and asked if I had cancer. While my scalp became increasingly naked, my arms, stomach and back grew a soft downy pelt. I collected recipes from newspaper supplements and read them in bed like pornography, wide-eyed and turned on. At night, once everyone was asleep, by the light of the fridge I would binge on smells, holding to my nose tubs of ice cream and packets of cheese, inhaling lasciviously. I did that every night for weeks, until my brain decided I was deriving too much pleasure from it and the black serpent inside whispered that there were calories in the food particles I was inhaling, and then I never did it again.

Whatever joy I’d once felt had drained away, going from Oz’s colors to Kansas’s black and white. “Where’s my little girl who used to run through the house singing songs?” my mother asked tearfully. “She’s gone,” I snarled back. I hated seeing my parents upset, fighting with them at every mealtime. It made me feel guilty but helpless. Didn’t they understand I had no choice? I was addicted to starvation, and I could think of nothing but my fix.

Freeman at age 13.

From the ages of 14 to 17 I lived on various psychiatric wards, all close enough to my home in London that my parents could shuttle my schoolwork to hospital but not so close that I could actually attend lessons, which I wasn’t allowed to do anyway.

My first admission was to Hospital One in September 1992, aged 14, where my concerns were soon limited to wondering which nurse would be on duty that day and had I been good enough to be allowed to use a normal toilet — not the commode in my room that was checked and emptied by a nurse twice a day to ensure I wasn’t being sick or using laxatives. I very quickly became comfortable with that. All responsibilities taken away from me, any control I’d started to have over my life was relinquished. Nothing was up to me and nothing was my fault. Having to eat was, of course, extremely suboptimal, but, deep in my root, hospital felt like a release.

After ten weeks I’d gained enough weight to be discharged but in my head I was sicker than before. People talk about the viruses that people pick up during their stays in hospital; I had picked up a superbug, Anorexia Turbocharged. Whereas before my approach had been clumsily instinctive and blindly ignorant, I emerged from Hospital One in December 1992 knowing exactly what I was doing and determined to keep on doing it. The exercising returned, worse than before, and I was more wildly obsessive about calories than ever. I knew how to cheat the scales when I went for my weekly weigh-ins, slipping paperweights into my underwear and gulping down a gallon of water beforehand. The hospital’s dietician told me that I had to eat a certain number of calories and I used that as an excuse to buy only microwave meals, which had the exact calorie information on the back. The anorexia was clamped onto my brain more tightly than ever.

My hair fell out in clumps, though I didn’t notice until a woman stopped me on the street and asked if I had cancer.

The following July I was released from my third stay in Hospital One and when the school year started I joined a “crammer” school, attended by kids who needed to retake exams or had been thrown out of their former school, where I could do my GCSEs in one year and therefore make up for the year I’d been away. That was the plan, anyway. But in late October 1993, when I was 15, I collapsed on the street near my home in west London and soon I was having these semi-faints once every other week or so. My GP, Dr. Kaye — increasingly worried about my wasting heart muscle — told my mother to prepare herself for the very real possibility that I might die. Soon he yanked me out of school and checked me in to Hospital Two, a private general hospital, where my blood pressure and heart could be constantly monitored. I spent two weeks there before being checked into an eating disorders ward at an NHS hospital in London in December 1993. And that was when I really learned how dark life could be.

Hospital Three squatted on a chaotic street in an unlovely part of southeast London, and to enter it you had to dash across several lanes of traffic. It was no calmer inside, the bus screeches and car horns swapped for shouting patients and overstretched staff. A nurse named Emma explained I’d be in “the dorm” with the other girls, a long, rectangular room in which they’d managed to cram about 12 beds. Each had a curtain around it, but you were only allowed to draw it when you were getting changed, to prevent any surreptitious exercising, cutting or vomiting. In the middle of the room was a long table, where we patients ate our three meals and three snacks a day.

Everyone wanted to be the thinnest and the craziest. On that first afternoon I sat down at the table to eat my snack, but by the time I’d finished my half portion of biscuits, the other girls had barely started. They ground their biscuits into crumbs and were either eating the crumbs individually, speck by speck, or chucking them on the floor, or chewing them up and then spitting them into tissues up their sleeves. Everyone seemed to be in competition as to who could eat the slowest. The main instigators of this were three patients named Caroline, Tara and Nora, and everyone followed their lead in hiding food: up their sleeves, in their pockets, under the table, kicking it under someone else’s chair so they’d then get the blame. Butter was smeared under the table, mayonnaise flicked onto walls, biscuits and bread crumbled onto the floor. This was the room we slept in. It was disgusting and absolute pandemonium and none of the nurses could control it, and some made it worse.

There was one nurse, whom I’ll call Tessa, who never spoke, only bellowed, and if someone wouldn’t eat, she would wrap one muscular arm around their upper half so they couldn’t move their arms and then push the food in. It was, genuinely, torture. She was such a throwback and a cliché it was hard to believe she was real at times — Nurse Ratched crossed with Miss Trunchbull. But she was.

Freeman at 14, in the hospital

Tara, Nora and Caroline were bullies too. Tara was 27, but so thin and wasted that she looked about 87. She loved to know how much other people weighed and regularly sneaked peeks at the charts in the nurses’ office, gloating over who weighed more than her. Nora was 26 and a few years later, when the Spice Girls became big, I thought for a brief moment that she was in the group because she looked so much like Posh Spice. It was easy for me to imagine what she had been like at school, because that’s exactly how she was in the dorm: the mean girl who reveled in her cool status and made sure others felt excluded. Do you know what makes you cool on an eating disorders ward? I’ll let you in on that secret: it’s if you’ve been fed intravenously. It doesn’t matter if you’ve had 17 admissions and you’re crippled with osteoporosis. If you haven’t had the tube, then you’re just a day tripper, and Nora made sure I knew it. For years I regretted resisting the tube in Hospital One. The one time in my life I’d had a chance to be cool and I’d botched it. Typical me.

Caroline, 31, was a devout Christian, but no one lied more than her. She took hiding food to a kind of art form, slipping whole slices of pie up her sleeves, though her preferred technique was to flick her food towards other people’s plates and then watch as the nurses made them eat it, smiling to herself like a cat.

Everyone wanted to be the thinnest and the craziest.

I didn’t have a strong enough sense of self to resist being influenced or bullied by these girls. So within days I too was taking two hours to eat two biscuits and dissecting my meals as if they were scientific samples to be examined. I would slosh my soup all over my bowl and spread my food all around my plate to leave behind as many dregs as possible. I pressed the grease out of my chips, squeezed the butter out of my toast, smeared the ice cream around the bowl. I gratefully sank into the quicksand of craziness, fastening an easy identity out of illness.

This was now my fifth hospital admission and I assumed this would be my life for ever: starving at home, being stuffed up in hospital. Over and over again, and I couldn’t imagine how anything would ever change. In January 1994 the eating disorder ward in Hospital Three was transferred to Hospital Four and there I was assigned a therapist, JF, who was the first doctor I’d met who understood exactly how the black snake in my mind worked. It felt like finally finding true love after years of bad dates and I saw her twice a week for the next four years. The next change came — improbably — from within me. By August 1994 I was on my third admission to Hospital Four. Caroline was back in too, and on one particular morning she was hysterical, screaming, kicking, punching — the nurses, the table, herself — because there was more butter on her toast than on anyone else’s. It had been Caroline’s 32nd birthday the day before and a thought appeared in my head — as unexpected and unbidden as the panic two and a half years earlier after I’d been told I looked “normal” in PE. The thought was this: “I will not be having temper tantrums over toast when I’m 32 years old. This will not be my life.” It felt, just for a moment, like popping up for air after being suspended in dark water for so long. I’d had a glimpse and something started to shift.

Other things were changing too. JF had been adamant that I continue with my studies from hospital and my school somehow got special dispensation from the examination boards to let me take my GCSEs on the ward, supervised by a teacher. I was delighted by this setup, entirely because whenever I took an exam I got to miss a snack. Thoughts about how I did barely crossed my brain, as I was far more concerned with whether at lunch I’d get a corner piece of the apple pie (extra pastry! Nightmare!) than the vagaries of my biology GCSE. But when I called the school to get my results, I stopped thinking about the apple pie. School, for the first time in two years, suddenly mattered to me again.

Before, Hospital Four had normalized chronic anorexia for me; now it acted more like a warning: “Look at these thirty, forty and fiftysomethings whom you live alongside in here,” the hospital whispered to me. “Look at them crying over mashed potatoes, hiding bags of vomit under their beds, sneaking in star jumps in the shower. Look at them, because unless you finally do something, this will be you.” The part of my brain that controlled self-preservation had long ago gone dark, but suddenly it started to glow, an old machine cranked back into life.

After another crammer course to get my A-levels, I managed, despite myself, to get into university. I arrived in October 1996 and was definitely still ill, soothing myself by hiding in my room and eating bags of vegetables, the bitter snap of raw broccoli between my teeth reassuring my anorexic self that I was still furtive, solitary and weird. But I made kind friends and learned that it was absurd to worry about what people were thinking of me, because they were too busy worrying about what other people thought of them. I was rigid with control and ate the same food every day. But my life, somehow, was moving forward.

Freeman was studying for her A-levels while an inpatient in various psychiatric wards.

For the next 20 years I had two full-time jobs: being a functioning anorexic and being a functioning but extremely obsessive adult riddled with OCDs. This was very tiring, not least because I also got a third full-time job, which was working at a newspaper, although at least I got a salary and annual leave with that job. In my twenties I became a fashion journalist and while it was undoubtedly bizarre to be recovering from anorexia while working in fashion, like a diabetic in a sweet factory, I was able to mine the good from fashion and leave the bad because I’d already fully explored the promise that thinness leads to happiness and seen what a mirage that was.

But I was still in no way recovered. Spontaneity was impossible; my meals were monotonous; and friends were kept at arm’s length so they wouldn’t see or, worse, comment on my extremely rigid eating patterns. I really didn’t want to go back into the anorexia but I needed something new to obsess over. Bad boyfriends worked for a while, as they hit that anorexic sweet spot of making me more miserable the closer I got to my goal: the more unavailable and unkind the boy, the more consumed I was with the belief that my happiness depended on him. Heroin addicts — as emotionally unavailable as me — became a speciality of mine. But after several years I could no longer convince myself that I felt anything for these men other than a narcissistic belief that if I got them clean, that would prove how special I was (better than heroin!). So I cut out the addict boyfriend middle-men and instead threw myself directly into a massive pile of drugs. Not heroin, thank God (it turned out even my self-destructive impulses had limits), but cocaine, the stupidest and shallowest drug of all. At first the drugs stopped the internal noise, took me out of myself and proved especially good at helping me to be honest with people about the past 15 years of my life, because it turns out what people say about coke is true: it really does make you talk about yourself a lot. But soon I was out of control. I wasn’t an Irvine Welsh character, but the drugs destroyed my fragile happiness and I was back in the land of self-loathing.

And so in 2009, in my early thirties, I moved to New York. I’m probably the only person in history to move to Manhattan to get away from drugs, but it worked. I wrote and slept regular hours and it was nice not to feel like complete garbage most of the time, so of course that’s when the anorexia came back. Not drastically, but I became more obsessive about food than I’d been in a long time because I still had no idea how to live, hour by hour.

For me, anorexia was a manifestation of anxiety, a lot like an OCD. It was a way of articulating that I was unhappy without having to say it, because that, I thought, would seem hideously ungrateful. And perhaps most of all, it was an expression of my overwhelming fear of growing up and becoming a woman, and what that would mean: primarily, leaving my mother behind, and boys expecting something from me I did not know how to give. As my body started to go through puberty, it seemed alien to me. And so I starved it back to the point where it felt sparse and familiar, not fleshy and dangerous.

Anorexia is not about the food. But it becomes about the food, and the only way out of it is through the food: you have to eat in a healthy way every day, for the rest of your life, and eventually, one day, it won’t feel like you’re eating your own heart every time you do it. I know, because that’s what I did, and that’s what happened. And then, at the final yard, I got the push I needed over the finish line from an unexpected source — I gave birth to twin boys. After three years in New York I had moved back to London, and by my mid-thirties was in a relationship with a man who was a) nice to me and b) not a heroin addict. He didn’t change me: I wanted to change and he was there at the right time, and so I changed while I was with him. And then I got pregnant.

Some women tip back into anorexia after the baby is born, and I can understand that: your body has obviously changed and your life is terrifyingly out of control. But for me it did the opposite. I had the boys at 37 and then a daughter at 41, so I was a long way from the illness at its most heated, and being an anorexic mother was not an option for me, because that’s not who I wanted to be. It was as simple as that.

It seems such a silly, Hallmark movie end to this story: “sick for decades and then having kids made her all better!!!” Children are not a cure for eating disorders, and mine didn’t cure me. It was time. I had outgrown that scratchy, self-made jumper of self-defeating self-destruction and I no longer believed that holding on to splinters of anorexia made me special. I truly wanted out, but I needed something to yank me out of it other than the needs of my own body and life, because I never cared about them. My children did the yanking. I had at last found something I cared about enough.

Hadley Freeman is a writer for The Sunday Times