“Is Frank Miller okay?” “He does not look well.” “If I wasn’t told it was him, I wouldn’t recognize him.” “Miller has been looking horrible lately. Makes me think he is sick with some sort of terminal illness. In 7 years he's gone from healthy to really sickly, almost emaciated.” “I'll pray for him.”

These are just a handful of Reddit posts and comments from 2014 and 2015, when the declining health of Miller—the legendary comic book creator of The Dark Knight Returns, 300, and Sin City —became both alarming and undeniable. Fans speculated that he had cancer or some other disorder that made the writer, artist, and filmmaker, then in his late 50s, look suddenly ancient. Most were sure he was dying.

Miller actually was dying, as he reveals in a new documentary, Frank Miller: American Genius, which confirms that his debilitating illness wasn’t anything that his fans guessed. He was an addict, ravaged by years of alcohol abuse. In an exclusive new interview, Miller explains that he used to drink to unlock his inhibitions, fueling the morbid creativity that made him such a powerhouse storyteller. His stark imagery, innovative use of silhouette and shadow, and willingness to plumb the darker recesses of the inhuman heart made him a superstar of the comics world. But as his alcoholism intensified, his body withered, and Miller’s own story took a grim turn.

He was aided in his recovery by Silenn Thomas, his longtime producing partner and the director of American Genius, whom he credits with helping to pull him out of a freefall that surely would have killed him otherwise. Their movie, which chronicles Miller’s mental and physical struggles as well as his storytelling triumphs, will have a one-night-only theatrical release on June 10 at more than 90 Cinemark Theatres around the country, featuring a live-streamed introduction from him and Rosario Dawson, who starred in the 2005 movie version of Sin City and its 2014 sequel, A Dame to Kill For, both of which Miller co-directed with filmmaker Robert Rodriguez.

Now 67, Miller has improved significantly from the days when his fans wrung their hands about his appearance. He is no longer a rock-star-esque comic book artist with flowing black hair, but his wit and his pen both remain sharp. He and Thomas spoke bluntly about how close Miller came to the end, and what the future holds—now that he has one again.

Vanity Fair: Let’s begin with how you two came to know each other.

Frank Miller: We met working on a movie. Because movies are her life's blood.

Silenn Thomas: As comics are your life's blood.

Miller: Absolutely. She was a producer on 300. And essentially I've been begging to keep her involved in my life ever since.

Thomas: I’m from Paris, and went to UCLA Film School, which was the only dream I had. I got hired by Luc Besson [on the 1999 historical drama The Messenger: The Story of Joan of Arc]. At the time, the head of Sony was Mark Canton, and he gave me an opportunity to be a producer and an executive at the same time. Mark and Warner Bros. gave me a slate of movies, and one of them was 300. I was the only one in the studio office that really knew that it was about the Battle of Thermopylae. All the others knew Frank Miller from Batman and from Sin City. Frank was like, ‘You guys are doing something that I can tell is respectful to the material.’ Since then, Frank was always wanting to work with me.

Miller: Well, for one thing, she's really, really smart. She's also really, really tough. And I know that in a work situation, I need to have a partner who is willing to tell me I'm wrong and is willing to argue. And this woman can argue until the mountains rush into the sea.

In the documentary, I noticed that you often became very close with people who were extremely hard on you. Your mentor was Batman and Green Lantern artist Neal Adams, who explicitly told you, "You're not good enough, kid. You're not going to make it in this business." And Marvel legend Stan Lee told you that you weren't ready for Marvel.

Miller: Yeah, that was me submitting work that I'd done when I think I was all of 15. He sent me a very gracious letter saying, "Your stuff isn't quite up to our standards yet."

It's rare just for someone to welcome that kind of criticism. To hear your hero say, "You're not quite there, and you may never get there" would be crushing for most people.

Miller: It could be. And that's exactly why [Adams] would say it, because he didn't think people who aren’t tough enough should stick around. Neal Adams would tell me my work was no good, it absolutely stunk, and I didn't have a chance, and should go back to Vermont and pump gas. I would just say, "So what should I do?" And he'd throw a big sheet of tracing paper over what I did: "Recompose it for me—and fix the anatomy." Then he'd tell me, "Go get some little toy cars so you can learn how to draw the damn cars right."

That's good advice. Actionable advice.

Miller: He was endlessly generous. If he saw that you're worth the time, he would do anything. You became part of his family.

Do you think that willingness to confront flaws and fix them—as opposed to people who only reject or deflect criticism—is an important part of who you are and why you became successful?

Thomas: I think Frank is, if anything, one of the hardest workers I've ever seen. He will tackle a problem. He will dive into whatever character he decides to explore, work out every story. He’s always pushing everybody to greatness.

Miller: And to bring as much joy to it as possible.

Thomas: But I would say it's really visceral. It's in your veins. Outside of being joyous, sometimes you wrestle just to get to the joyous. It's hard work.

Miller: Oh, my inner monsters are right there for the world to see. There's no doubt about it.

Is staring down your own flaws something you set out to do with this documentary as well? It certainly shows the highlights of your life and career, but it goes to the sadder places too, the more troubling places.

Miller: She proposed the project to me, and I said to her, "Only if you make it." It was important that only she would make it, because I didn't want her to have any restrictions. I told her any question is fair game. And I've done my best to honor that.

Thomas: That's true. When he said that, it meant that he trusted that I would go deep. That the documentary would not be hiding things. After Sin City: A Dame to Kill For, Frank's health was taking a turn. He can discuss his own demons. But there were things that just didn't seem correct. Having known him, and going to such heights with the success of 300, it was very distressing to see. So we called his family to come help, and they did. He was able to have his own chance at redemption, reconstruction, however you want to call it…

Recovery, right?

Thomas: Recovery is the perfect word.

Miller: Survival.

Thomas: That's when our relationship changed. I moved my life to New York at his request, and there were a lot of people—fans, and executives, people who cared—who basically were like, "This is important. You should talk to Frank and there has to be a documentary."

Is that because people thought he was dying?

Thomas: I think people were concerned that, and I detest to say this, but … that he was not going to be around.

Frank, what's it like hearing that people thought you were near the end?

Miller: At this point now, I'm used to it. I know I was real close to the end. My mother once said of my father that he was capable of working so hard that he would work until there was nothing left to him whatsoever, until he was an empty vessel. I inherited that side of him, and added onto it a couple of catastrophic habits that could've aced the whole process.

What was happening in your life that led you to become an alcoholic?

Miller: Oh boy. Well, first, I do have to mention genetics. There's certainly many in my family's history, on both my mother's and father's side. But I also have to point out that—as somebody who digs deep to make his stories—for a very long time, the alcohol was a way to disinhibit and to delve into my own psyche and pull forth all kinds of monsters and wonderlands and angels and devils. When that was going on, it felt like everything was great. Everything was working. I was winning every award my field had to offer. I was getting all these movie offers and so on. What I didn't realize was that it was that I was skating faster and faster on thinner and thinner ice. When it breaks—it breaks. So by my reckoning, it was not a slide. It was a crash. The bottom did drop out.

What was rock bottom?

Miller: If I could remember, it wouldn't be rock bottom.

But it was around 2014, 2015, is that what you would say?

Thomas: 2015, yeah.

Miller: I was at rock bottom when Silenn led the charge to save my life.

Thomas: Something definitely was not okay. The good news is that his family responded, and they came and got him the proper care.

So Silenn was not only documenting your life, but saving it. She had a bigger hand in helping pull you up than she’s letting on?

Miller: Yes.

Thomas: That's kind of him. But I wouldn't have been able to do it alone.

Frank, were the troubles you faced something that built gradually over time? You mentioned alcohol helped your creative process. Was that always a part of it?

Miller: There were many years early in my career where I didn't drink at all. I mean, I could barely afford food. Alcohol is expensive! I'm not a psychologist, but my own self-exploration leads me to think that the attention I got in the world of comics contributed. Going to far away places and being the most famous thing in a fishbowl was definitely very heavy. It made for situations that certainly made it much, much easier to indulge in what was already inside me.

You're a rock star in the comics world. In your early years, you even looked like a rock star with your long black hair.

Miller: [Laughs.] It all fell out.

But you were living that kind of lifestyle, traveling the world. Thousands of adoring fans who want your autograph at these conventions.

Miller: It was a confluence of events, because the comic book industry rebounded back to life. I'd be making an appearance with Alan Moore [creator of Watchmen and V for Vendetta], and it would be like the Beatles met the Rolling Stones.

Thomas: It definitely changed comics for the rest of time. Frank needs a little bit of protection. He will stay with everybody until he's beyond tired. Or he will let certain people in that do not have his best interest at heart.

Do you have a hard time saying no, Frank?

Miller: Sometimes it's really easy, but it depends on who's asking.

Was there more to your addiction than alcohol? Did you feel you had to use other drugs or other stimulants on top of it?

Miller: Not really, no. I find addicts tend to hone in on the one thing they like, and that becomes their dark mistress.

Fans noticed a physical change in you. You got very skinny, seemed to age a lot in a few years. Did you recognize this happening at the time? Or were you not aware?

Miller: Okay, this is the scary part. I did not. One of the things about being in your cups, so to speak, is that you become astonishingly unaware of yourself. You're aware of your moods, your emotions, your desires. But your rat-mind is taking over.

Thomas: It was definitely scary, because it was very abrupt. We had to react quite fast because it was really... I think the body catches up to express it externally before it's too late.

Did you fight Silenn and your family when they were trying to alert you to what was happening? Did you accept that kind of criticism the way you did when Neal Adams told you as a young artist, "You need to redraw these images?"

Miller: I was just full of acceptance and I took it all in … Are you kidding? There is no way to be confronted with that without feeling utterly surrounded, utterly negated, imperiled, and threatened on every front. On top of being embarrassed to the point of terror. No, I was not a good audience for that.

Silenn, how did he finally come around to accept help?

Thomas: Two of his brothers were very involved and only wanted the best for him. They understood that they needed to come and help get him the proper care so he could give himself that chance at recovery. They were instrumental in extracting him from what was going on. And then it was a long process. You've now been in recovery and sober for, I think, over eight years. And that's magical to witness.

Miller: It took your commitment and others—which I had, by the way, done nothing to deserve. You protected me from influences and then gave me the most precious thing an addict needs, which is time.

Thomas: But you do deserve it. There was one person I won't name, but she was very concerned and she did say to me, "You have a child. You should go back to L.A. He wants to die." I knew in my gut that that was not true. He told you that there's joy in the process of wrestling with stories and characters, and that's the Frank I knew—that I know. So when someone said that to me, I was like, "No, he deserves that chance. We need to do everything we can.”

Frank, do you remember when you finally heard the wake-up call? You said you were unaware for a long time how serious your problem was, but was there a moment that someone broke through and you listened?

Miller: You're referring to the moment of clarity. There were so many, across so many years. The dangerous thing about moments of clarity is that they can go away again. You have to go through soul-deep trials to realize how deeply you have wounded yourself and so many other people, and how deeply you betrayed your own abilities. Everything gets put on the witness stand when you go through something like this. You have to go through it all piece by piece every day. It's a process. And then what I've found, I'm talking about my own personal struggle is it's clarifying what I want to do with my work.

Did getting clean and sober change your artistic abilities? You mentioned that alcohol was helpful for a time to unlock your creativity.

Miller: I only gave you the happy part of it. Of course, it all went right straight to hell. I couldn't draw anything. I couldn't make a story to save my life. I produced next to nothing for a good long time. But what's happened is, during this long and sometimes difficult reconstruction, I've just found that I'm allowing myself to slow down. It's like: stop and smell the roses. Then I'll go right back to my thick brush—slash and dash. But occasionally I'll just slow the motor down and go, “I really want to make this a moment that you pay attention to.”

How do you feel watching the documentary and seeing yourself as a younger man, at the start of everything?

Miller: In a lot of ways, I think that's me right now. I wasn't that way for a long time, but I think I know how to do it a lot better now. My brain's more sophisticated than it used to be, but my intention hasn't really changed since I was a little boy.

What's next for you?

Thomas: The beauty is that you're doing a new book of Sin City.

Miller: Yeah, it's a new Sin City—and it's a western. It's back in the beginnings of the city. It's going to be cool.

What made you decide to explore that era?

Miller: I had been planning on doing a World War II-era Sin City that was going to be called The Homefront. And I may yet do that one. Then I thought, “Why not just pitch it further back to when they had just founded Sin City?” It was like the legendary Dodge City, just a bunch of saloons and prostitutes and people riding through town. So I started playing with that and I ended up drawing a picture of my guy Marv with a mohawk and paint over his face. And that became the beginning of it.

This is the same bruiser character that Mickey Rourke played in the movies?

Thomas: It’s his ancestor.

Miller: Yeah, the idea is it's like Marv from many, many generations back. He was originally a Comanche or a Mohawk or such.

How far along are you?

Miller: I've planned out a bunch of pages, done pencil drawings and fussed around with it. It's kind of my pet project.

What’s behind your interest in the dark side of human nature? You write about fantastical people, but you bring a warmth and humanity to them even as you focus on things like violent crime or the horrors of war.

Miller: I believe that my stories are about the forces of good and evil, and I believe that those two abstractions are at present in all of us. There would be no such thing as good if it wasn’t something you had to make an effort to be. I'm fascinated by the borderline between psychotic behavior and something that is much deeper and more pernicious. That to me is a lifetime artistic journey.

This interview has been edited and condensed for context and clarity.