(Warning: this article contains strong language and hard-hitting concepts - and is not suitable for younger children. Teens only please!)

I have anorexia nervosa. In doctor-speak, that means I have a “nervous absence of appetite.” I would go further and say that I have a nervous fear and disgust toward eating food.

We all have a critical voice that comments on what we do. When I sit down to eat a meal, the critical voice inside my head goes crazy. It shouts at me: What are you doing? Do you want to get fat? It tries to scare me: You’re choking. Maybe that food is poisoned. And it calls me names: You bitch! You stupid loser bitch! My critical voice is never pleased with me, but most of the time, it only really goes crazy when I eat.

The funny thing about this is that because I have anorexia nervosa, my critical voice has had lots of company.

My first psychiatrist lost his patience and threatened me. “You won’t have a final school year with all your friends,” he yelled. “You’ll spend six months in a hospital with a tube up your nose!” And you deserve it, you loser! yelled my critical voice.

When my heart grew thin and weak, I went to a heart doctor, a cardiologist, and the cardiologist yelled at me too. “Stop being stupid!” he told me. And my critical voice said, Yeah, you stupid bitch!

Nobody can see the yelling that takes place on the inside. All they can see is how calm I am when they join the yelling. They see me smile, and they think I’m arrogant and rude. It isn’t that. I’m just comfortable being yelled at.

But over the years, the shame from all that yelling has added up. Shame: that’s a “painful feeling of humiliation.” Getting yelled at day and night inside my own head is painful and humiliating, even when nobody else joins in. That load of shame used to feel so heavy, I could hardly get up in the morning.

There’s one good thing about being an anorexic, though. It isn’t the reason I became an anorexic, but it’s one of the reasons I didn’t want help for so long. We anorexics can’t bear to eat, even if we want to. But in our society, people who don’t eat are winners.

Imagine what it’s like for someone like me, trudging through the day getting yelled at and insulted. And then, out of the blue, somebody says, “Girl, I wish I could fit those jeans! What’s your secret? How do you do it?”

That was always the nicest part of my day.

Did I want to be skinny? No. I didn’t stop eating to trim down, I stopped eating to shut up the voice. But once people started coming up and begging me to help them diet, did I want to stay skinny? Hell yes!

That’s the problem with getting help for anorexia. Lots of anorexics can’t understand what treatment is supposed to do to help us. The one thing we know treatment will do is make us gain weight—and that will take away the nicest part of our day.

But here’s the thing: anorexia nervosa isn’t a lifestyle, even though it feels like one. It’s torture. It’s very slow, painful death. Your hair falls out, your teeth rot, your bones turn brittle, and your skin turns patchy. Then you die. Really! Anorexia kills.

The way to live a happy life isn’t to trudge along with a burden of shame, hoping that every now and then someone will pay you a compliment. It’s to turn around and take a good hard look at that shame. Where did it come from? Why are you giving it a ride?

My shame came from something that happened when I was 13 years old. I sneaked out to a party, and a stranger raped me in a bathroom. When I tried to fight back, he yelled at me. He was the first one to call me a bitch.

I didn’t want anybody to know what happened. I blamed myself for being stupid. (Stupid bitch!) I felt completely humiliated, and that’s how I started to carry that secret burden of shame.

But it isn’t my shame. It’s his shame. He’s the stupid bastard who felt so weak, insecure, and out of control that he had to hit and hurt a little girl. I know that now. I don’t carry his shame anymore, and I don’t need those compliments to get me through my day.

So now I eat. It’s still hard sometimes, but I work with my doctors, and I fix myself well-balanced meals. And when my critical voice says, I think that peach has been poisoned, I say, Voice, you are one paranoid, crazy bastard! Let’s work on that together, shall we?

Elena Vanishing, A Memoir written by Elena Dunkle and Clare B Dunkle (Published by Chronicle Books) is available at the Guardian bookshop. Also see Elena Dunkle’s website.

If you are worried about anorexia then you can get help and advice from B-eat - the UK’s leading charity supporting anyone affected by eating disorders or difficulties with food, weight and shape. There’s also good advice on the Young Minds website here.