If there is something to be learned from the words people pick for their passwords and proxies, then Lena Dunham’s choice of aliases – pseudonyms that, as a public person, she has used over the years to conceal her identity when checking into rehab or ordering room service – give us a tiny glimpse into the writer and director’s self-image. Among her staples, “Lauri Reynolds” (after her mum, Laurie, with whom she is strikingly close); “Rose O’Neill” (after the American millionaire illustrator, who lost her fortune to burnout and hangers-on); and my favourite, “Renata Halpern”, an alias Dunham shares with readers of her delicious new memoir, Famesick, without explaining the name’s origin.

“Has anyone else clocked the Renata Halpern reference?” I ask Dunham, who is in her apartment in New York, talking fast via video call while waiting for an egg-and-cheese bagel to be run up from the deli. On the brink of 40, she is in her dark-haired era – very Jane Russell in Gentlemen Prefer Blondes – which, this morning, is set against a bright orange shirt and the pale, glowy skin she describes as the single happy side-effect of hypermobile Ehlers-Danlos syndrome, a genetic condition of the connective tissue with which Dunham was diagnosed in 2019. Later this month, she’ll return to London, where she has lived for the last five years with her husband, Luis Felber, and where she enjoys greater anonymity than in her native New York – although, she says, not enough to dispense with the aliases. (“Just when you think no one cares, someone does something creepy, so you have to watch out.”)

Renata Halpern: the alter ego of Savannah Wingo, luridly traumatised minor character in The Prince of Tides, Pat Conroy’s timeless potboiler of the mid-1980s, made into a movie starring Barbra Streisand and Nick Nolte which has always attracted a certain kind of smirking obsessive (hi!). Dunham screams. “No one’s ever caught it! The amount of mail I’ve received to Renata Halpern … thank you. Now I’m going to have to change my fake names.”

Here we are, then, nine years after the sixth and final season of Girls. If Dunham gravitates towards the names of hurt or traumatised women, it is advisedly so; for the last 20 years, her life has been a lot. Famesick covers it all without flinching: the early exposure that coincided with social media’s wildest west period; the creative and personal pressures of running a hit TV show that would’ve buckled a grizzled veteran three decades her senior; the health dramas, including a multi-year struggle to get doctors to take her endometriosis seriously; the subsequent addiction to prescription drugs; the dysfunctional and damaging sex and relationships; the challenge of dating musician Jack Antonoff; the challenge of managing actor Adam Driver; the fallout with her close friend and business partner Jenni Konner; the work; the loneliness when the success – irony klaxon! – of a show typifying the lives of a group of millennial women threw her completely out of sync with her peers.

In Famesick, Dunham places PTSD, loss, trauma, fuck-up and body horror at the centre of the story, and describes herself variously as oversensitive, people-pleasing and always lying in bed. And yet, reading and talking to her, one is keenly aware that, alongside this version of Dunham, is the other one: the absolute powerhouse of a woman, steely eyed, tunnel visioned, who pushed through punishing volumes of work at the highest of levels, year after year after year.

It is, of course, this version of Dunham – the gimlet-eyed artist, ambitious to get the thing right – who wrote the book. Famesick is frank, unsparing, in parts horrifying and more honest about the experience of fame than anything I’ve read. As one would expect, it is also very funny. Here’s Dunham in hospital shortly before her hysterectomy, when she has been pumped full of drugs more commonly used to trigger labour: “It wasn’t lost on me,” she writes, “that this was the closest I’d ever come to birth – but beside me was not my husband, ready to greet our bundle of joy, but only Mary, a nurse from Staten Island who wondered aloud why I was so often nude on television.” (After the operation, her uterus, she discovers, was “worse than anyone had imagined. It was the Chinatown Chanel purse of nightmares, full of both subtle and glaring flaws.”)

On accusations of nepotism, she writes: “Nobody watching HBO had ever heard of my parents, unless they had trawled some of the quieter corners of the Museum of Modern Art and really studied the wall tags.” And this, which made me laugh out loud: “When I met my husband, he told me about his trauma, and I told him two things I saw as facts: I was sick, and people did not like me.”

Let’s start with that last one: in the early 2010s, after the first season of Girls aired, she found herself the target of obsessive online criticism. As she writes in the book, strangers online reached out repeatedly to tell her about, “my bad body, irritating voice, clearly horrific politics, inability to walk in heels, poor sense of style, and the fact that anyone – literally anyone – was more deserving of all of this than I was”. A young woman with talent, opportunity, power and exposure, who didn’t look as if she habitually starved herself, Dunham was extremely triggering to a large number of constituencies, from angry basement-dwellers to the legions of men who hate women, to anyone older than her who hadn’t had the writing career they felt they deserved. What I find remarkable, after that first flush of fame, is that Dunham didn’t stop looking at the online commentary or sharing intimate thoughts and feelings. Instead, she remained perversely, hopelessly open. Why on earth put yourself in harm’s way like that?

“I don’t know,” she says. “If you have an addictive personality, which clearly I do, any hit of the dopamine of positivity [is welcome] and there’s also a hit of adrenaline that comes from the negative. And then, because you see something negative, you want to see something positive to erase it, and you end up in this cycle. It’s easy when you’re young to feel the internet’s a game you want to win. I remember breaking up with a guy in my early 20s and him writing an email that was really mean. And my father said, ‘Well, why don’t you just ignore him? You’ve broken up, you don’t have to do anything else.’ And I was like, ‘Because I don’t want him to have the last word.’ And then you meet up with the person and they act sweet so you kiss them, then they act mean again. And that’s the relationship you’re in with the internet.”

It is interesting to compare Dunham’s experience with that of young women in the public eye today. No one is as young as she was – just 23 when she sold Girls, and 25 when it first aired. The nearest comparison would be 30-year-old Rachel Sennott, who at 28 sold, then later wrote and starred in, HBO’s hit show, I Love LA (Sennott’s pitch: “Entourage for internet girls”), now heading into its second season. Sennott has acknowledged her love of Girls and debt to Dunham, some of which occupies definite cautionary-tale territory. For young women in the public eye, now, says Dunham, “I am one of the many examples they have of what [can happen] and there’s a sense of people learning how much vulnerability is useful and how much is not. And I did not have any of that. I didn’t have any sense about even just simple things like posing, or style, or how to show your body, or how to show your face.”

She and her fellow Girls stars were like “lambs to the slaughter.” This was driven home to Dunham recently while talking to a 26-year-old about obsessive compulsive disorder. “I said, ‘What are the things that come up for you?’ I was thinking about the stuff that comes up for me, my big OCD thoughts, which are the classics, like, ‘Am I a pervert? Am I evil?’ Ideas about purity. And he said, ‘I have very extreme cancellation anxiety.’ And I was like, oh, I heard the word ‘cancelled’ in real time when someone said to me ‘you’re cancelled’ and I was like, what does that mean? Like a TV show?”

She has been cancelled too many times to count – she addresses them all in the book, big, small and enduringly weird. (As she writes, “‘I saw Lena Dunham serve her dog salmon on a china plate’ should not have been a headline, but it was.”) In New York, rumours about her rose to the level of legend. “One of my best friends, Alissa, was once in a bookstore in Brooklyn and she overheard someone saying, ‘Lena Dunham’s been throwing these really exclusive sex parties, and they’re happening once a month and it’s really hard to get an invitation.’ And she was like, it must be really hard to get an invitation because she’s literally always in her bed watching The Bachelor.”

The fact that for years now she’s been free of social media apps on her phone – Dunham writes posts which someone else uploads – is, she says, “aside from sobriety and moving more slowly and understanding my health better, a huge part of how my life can be calm and joyful”. In recent years, she has only caved in, once. “I made the mistake of going to [the apps on] my husband’s phone – I wanted to see what people said about our wedding picture.” My hand flies involuntarily to my mouth. In 2021, Dunham married Felber, with whom she’d been set up by a friend, and for the ceremony in London, wore a beautiful satin gown designed by the British designer Christopher Kane.

“I was so excited,” she says, her voice falling. “I felt like it was so joyful and I wanted someone to say how cute my husband is, whatever. And I looked for five minutes and – it was five minutes I deeply regretted.”

Famesick cuts off before the detail of Dunham’s marriage to Felber. Instead, there are two, central love stories in the book: one with Antonoff, the indie rock star and producer whom Dunham dated and lived with for five years until they broke up in 2017, and a platonic one with Konner, her ex-producing partner and a woman 15 years her senior, who was assigned to Dunham by HBO as a mentor when she first started working on Girls. Konner was married with two children when she met the young Dunham and the next 10 years were an absolute corker of toxic female friendship: jealousy, manipulation, sulking, clinginess and, eventually, the death of the relationship – as well as some lovely, sunny periods of mutual admiration and support.

Dunham’s youth and inexperience made her vulnerable, in those early years at HBO, to the influence of older people, not all of whom had her best interests at heart. She wasn’t a child star, but might as well have been; a wunderkind who, after graduating, hustled the low budget to write, direct and star in the autobiographical movie Tiny Furniture, which after winning best narrative feature at South by Southwest in 2010, brought her to HBO’s attention.

It was an extraordinary position to be in at 23: given the keys first to the pilot, then to the season, then to a six-season arc of the hit show she would not only write, but also direct and star in. At the time of signing, Dunham was still living at home in the family’s Tribeca loft. When she travelled for meetings in LA, she had a stuffed toy in her suitcase. She had never had a job, apart from babysitting or other Saturday-type jobs. She had no idea what was coming, and when her dad – someone she characterises drily in the book as, “forever looking a gift horse in the mouth” – tried to warn her things might be about to get weird, she shooed him away. “I was like, ‘You dumb old man, you don’t know how the world works! You check your email once a week!’ And he was right about everything.”

As catalogued in Famesick, the first fallout was major disruption within her close friend group. Before Girls, Dunham’s only plan post-graduation had been to get a job teaching video production at Saint Ann’s, her old high school in Brooklyn, partly for the health insurance and so she could make “weird indie films” on the side. Instead, she became suddenly, outrageously successful. As her fame grew, so her closest female friends withdrew from her. She discovered dinners and weekends away that she wasn’t invited to. When they did invite her to things, nobody asked her a single question about her life, either because her success was so triggering to them or because they assumed her life was perfect. In one, painful scene, they prank-called her. These parts of the book are fascinating, and brave. It’s such a taboo to talk about this stuff, but of course, that’s not a challenge from which Dunham has ever shrunk.

“The jealousy thing; it’s so complicated,” she says. “You never want to be the person who’s saying, ‘People are jealous of me’, because then people are like, ‘Girl, no they’re not.’ So I was self-conscious about it. But I was also interested in the way in which having a very clear professional arc in your 20s, when a lot of your friends aren’t there yet, isn’t just that they’re jealous of you; it’s that their life has a different central narrative. My life was completely built around my job. And everything else came second to that. Whereas a lot of people I was close to, their life was built around their relationships, their social life. People worked so that they could go and hang out, instead of hanging out a little so that they could feel better about always being at work.”

And my God, she worked, endless long days with responsibility for hundreds of cast and crew. Dunham’s leadership style was “coper”, and bravado is a big part of this story, the feeling she had, rightly or wrongly, that any show of weakness and this vast opportunity would be taken away from her.

“One of the great lessons of my life has been, like, companies are not your friend. And companies that are publicly traded are not your friend. I’m no longer interested in breaking my body for a company that gets more in tax write-offs in a year than any of the artists will make in their lifetime.” It wasn’t only her youth that put Dunham in an invidious position. “I know lots of male wunderkinds, and they’re having a different experience,” she says.

How so? “Young men are allowed the grace of learning how to behave, and the expectation isn’t that they’re going to do really brilliant work and then also be kind to everyone and listen to everybody, and remember everybody’s children’s names, you know. I did things on Girls like saying, ‘I don’t think we should go 10 minutes late because people might be hungry.’ And that doesn’t occur to men running sets, because they’re given the freedom to just be creative and have a stormy mood, and go into a room and rethink something and come back out. But as a woman, you have to perform grace all the time, in a way that I’m only just now startling to unbuckle from. But: I also care a lot about having a set where people are happy, and feel free and heard and unafraid. Largely because I don’t want people to feel some of the ways that I felt.”

I tell her that, given she was his boss, I found her account of how Adam Driver behaved towards her on set and in rehearsal completely unacceptable. Driver played Dunham’s character Hannah’s on-off boyfriend, Adam Sackler, for all six seasons of Girls, during which time he was spectacularly rude to her, according to the book. He once hurled a chair at the wall next to her. He punched a hole in his trailer wall. He screamed in her face. She smiles. “At the time, I didn’t have the skill to … it never entered my mind to say, ‘I am your boss, you can’t speak to me this way.’ And, at that point in my 20s, I still thought that’s what great male geniuses do: eviscerate you. Which is weird, because I was raised by a male genius who would never do that.”

She says, “I have lots of amazing men in my life. Judd [Apatow] is a great hero of mine; Tim Bevan at Working Title is a huge part of my life and so is cinematographer Sam Levy. I just worked with Mark Ruffalo, the most thoughtful, sensitive, politically engaged, beautiful person. There’s plenty of them walking around. But there were years when I thought: Can’t I just make things that only have women in them?”

There is another strand to the jealousy story that’s even harder to write about, but Dunham goes there – and that is parental resentment. A great hero of the book is Dunham’s affable dad, Carroll, an artist, who brings her coffee every morning when she’s feeling sad, accompanies her to doctors’ appointments and is an all-round mensch. Her mother, Laurie Simmons, also an artist, is a more complicated figure whom Dunham refers to as her “original frenemy” and whose number she has saved in her phone under “Laurie Simmons” not “Mom”.

Of Simmons, she writes: “Art had always been her religion, the one thing I knew I could not touch, change, inform, or be more essential than. And now I was the story.” When things got tough between them during those early days of Dunham’s fame, “we never discussed it,” she writes. “To name this would be to cop to an ugly emotion, directed at an even uglier target – her own child.” And yet, at the same time, the family remains almost suffocatingly close. Long after Dunham moved out and bought her own apartment, she would spend several nights a week at her parents’ house. “Every time my boyfriend would go on tour, every time I would have a hard day, I just reported immediately for duty to the guest room.”

This was partly a question of delayed development brought on by losing all the milestones of youth – those incremental steps towards independence – to her brutal work schedule. It was also a response to the fact that, surrounded as Dunham was by people either hating her or sucking up to her to try to get their screenplays made, her parents were the only people who saw her as she was and would tell her the truth. “I’m sure people will have a lot of different perceptions about the relationships in the book, but I tried to do the most loving, not-takedown version of everyone because it was important to me that my own culpability in dynamics be explored.”

Well, I say, as a lesbian – a formulation with which I like to start fully 50% of my sentences – based on Dunham’s account of her, we have all dated Jenni Konner, a textbook bloody nightmare of a woman: love-bombing and withholding one minute, and sulking the next; charismatic; keeping Dunham on eggshells until she gets her own way; resentful; occasionally amazing; making pointed comments about Dunham’s weight; leaning on Dunham to get HBO to pay the two women the same, even though she didn’t create the show or appear in it. Dunham is obsessed with Konner, desperate for her approval and terrified of her low opinion and it’s a relief when, eventually, the pair go to a therapist to negotiate the end of the friendship. “My female relationships have always been very deep, and very complicated, and very romantic,” says Dunham. No kidding, I say; you really do attach … forcefully. She hoots with laughter. “Forceful is a good way of putting it. You’ll have to talk to my mom about that one.”

A difficulty of memoir is that the writer spends years finding the right words to pick through the minefield of old relationships and then, during publicity, is invited to say it all over again, only less judiciously. Dunham clearly doesn’t really want to go back over the saga of Konner, beyond thin observations of the “recollections may vary” and “mistakes were made” variety. She’s aware of this, too, of course; as someone who has never had an unstudied response to anything in her life, Dunham says to me, “I feel like because I am trying to be so measured in my response to you I am probably driving you mad.” This is correct, but I get it. These things are hard.

To mitigate criticism of her old mentor, Dunham goes in hard on herself, itemising all the ways in which Konner must’ve found her needy and annoying. She does the same when writing about the end of her relationship with Antonoff, flaming herself for being difficult and having too many needs. My opinion about this is that, in both cases, and based on the evidence of the book, Dunham’s neediness was at least in part an anxiety response to the way these people were treating her; in other words, the withholding, the manipulating, the gaslighting: these things will drive a person crazy. Which isn’t to say that Dunham isn’t quite capable of being a nightmare in her own right.

“That’s really helpful feedback,” says Dunham. “At the time, I thought I’m giving [Antonoff and Konner] all of me. Everything that I have to give is yours and what more can I do?” Looking back, she understands this was a category error. “That’s an essential misunderstanding of what the other person is asking of you.”

She lives in London, now, on the other side not only of those first 10 years of fame, but of the terrible health problems that came with them. Dunham was in almost constant pain during the final seasons of Girls, due to multiple ovarian cysts from endometriosis and the undiagnosed Ehlers-Danlos syndrome. She had many unresolved, exploratory surgeries, culminating in the hysterectomy at the age of 31 that sent her into menopause. She developed a dependency on Klonopin, an anti-anxiety drug, that she puts down to lax prescribing by a doctor and that she overcame after a stint in rehab. In one horrific scene, a doctor gives her an excruciating, manual pelvic exam and bursts a blood-filled cyst. In another, a doctor removes 37 lesions from her bladder, liver, abdominal wall, and spine. He tells her he doesn’t even know how she’s been walking.

These parts of the memoir are astonishing and were the hardest to write, she says, not least because they coincided with her relationship with Antonoff. The pair met in 2012 and after a whirlwind romance, moved in together and things rapidly deteriorated – Antonoff, on tour with his band, Bleachers, was barely around and when he was, wasn’t helpful. “He spent a lot of time telling me about the kind of person I was, and it wasn’t the good kind,” she writes. After her hysterectomy, he sauntered into the hospital two hours late bearing a bunch of “bodega flowers”, mumbling an apology and saying he had texted to see if they could wait for him. From the book: “‘Yeah,’ my father said, looking like he was considering grievous bodily harm for the first time in his life. ‘Surgery is like a train, not a tour bus. You either make it, or you don’t.’”She got better. She split up with Antonoff. After a period of burnout, someone sent her the pilot for a new HBO show called Industry to see if she had any ideas about who could direct it. It was a lightbulb moment; Dunham, in desperate need of a change, offered to direct it, flew to the UK, and the shoot – which involved lots of lovely young actors who reminded her of how she had been before fame fell on her head like a house – felt like a renewal. She met her husband. She made the movie Catherine Called Birdy – a perfect film, in my view – and then the semi-autobiographical TV show, Too Much. She has multiple projects in the works with her production company and its deal with Netflix.

London has been good for her, she says, not least because she thinks British women age differently. “They lean into their eccentricity as they get older. And it’s not just artistic people – it’s a woman who you see walking her dog on the road in the countryside in funny boots. It’s very different in New York, where I feel like I grew up with women who had a lot more agita about ageing. It’s really cool to get older with [the British model] as an influence.”

Being with Dunham has been a steep learning curve for Felber, meanwhile, who is not a creature of Hollywood but of north London. “When I first met my husband, he was just a British boy who had not been engaged in all of the feminist dialogue I had, and when I said something like, ‘You know, there are things about my job that are really hard as a woman’, he said, ‘Well, it’s hard to be a person.’ And I looked at him and said, ‘Never say that to me again. Never. Do not even try it.’ And now he starts everything with, ‘Well, you know, as a woman in Hollywood …’”

Felber has also had to make adjustments around Dunham’s closeness with her parents. “He’s like, ‘You cannot talk to your parents on speaker phone once we’re in bed for the night. Four of us in the bed! You’ve gotta take those calls out in the hall.’”

She is happy, she says, and has been in a great place for well over half a decade. What does that mean?

“It means that when things come up, I’m capable of handling them. I’m capable of expressing my own needs, boundaries, requirements. I get to work regularly yet not in a way that breaks me down. I have amazing, really supportive people around me. It makes me sad sometimes that it required such a big reshuffle. I guess what I wanted to capture in the book was: right life, wrong time,” she pauses. “If Girls had all appeared when I was a fully formed person, at 33, I would’ve understood how to handle that work, that place, those gifts, those people in a different way. But it was, basically, that I got everything I could’ve dreamed of at a time when I had no ability to handle it. And it required a rebuilding, and I’m very happy with where I landed, and very lucky. That’s just life, I guess.”