Andie MacDowell’s career as a successful model, who went on to become a successful actor, almost ended before it began. It was 1979, in the middle of the Studio 54 era, when she moved to New York. She was 21 years old, had just been signed by the Elite model agency and appeared to have the world at her feet. But she soon wanted to go back to her home town. “There was a lot of cocaine around,” she says. “I had a small experience at the very beginning and hated it. I hated it! It was only, like, a month. I really didn’t like the way it felt. It didn’t make me feel good and I couldn’t sleep. I actually went into my agency and said I wanted to go home, and they said: ‘You need new friends. You’re around the wrong people.’”

Who was she hanging out with? “I don’t even remember, honestly,” she says. “I wasn’t around famous people at that point. It was not what I intended to do.” John Casablancas, the founder of Elite, flew with her to Paris, “and this young man showed up at the agency who didn’t drink, smoke or do drugs, and it was like, I had a boyfriend.”

The young man was Olivier Chandon de Brailles, the heir to Moët & Chandon. “I don’t know if they prearranged the whole thing, but it sure did work out well for me. I started working non-stop and my whole life opened up. I was about to go home for a few seconds there.” She pauses. “I’ve never told anybody that story so please don’t make it sound like I was a big druggy because I really wasn’t.”

I meet MacDowell at her house, a secluded Spanish-style property that is modest by Hollywood Hills standards and homely, with a “Hello” doormat. A tiny rescue dog called Ava Gardner is sunning herself on the terrace. Next door is a building site, which MacDowell apologises for. A house is being built, she says, for her daughters, Margaret, 24, and Rainey Qualley, 29, who have followed her into the movie business.

Margaret is the breakout star of Quentin Tarantino’s Once Upon a Time in Hollywood, playing one of Charles Manson’s followers. The day before I meet her mother, she has been nominated for an Emmy for her supporting role in the TV show Fosse/Verdon. MacDowell was in her car when she heard the news. “I was having a hard time driving, I was so excited,” she says. “I’m trying to figure out where I’m going, but I’m crying; I was really having to focus.”

MacDowell with Bill Murray in Groundhog Day. Photograph: Moviestore/Rex/Shutterstock

It is almost 30 years since MacDowell received her first big industry nod for her acting – a Golden Globe nomination for Steven Soderbergh’s acclaimed indie film Sex, Lies and Videotape. There were more nominations for the romcoms Green Card (in 1991) and Four Weddings and a Funeral (in 1995), and she had success, too, with the 1993 comedy Groundhog Day. Now 61, MacDowell has continued to work consistently, while spending much of the past 20 years bringing up her daughters and their older brother, Justin, in North Carolina, after divorcing their father, Paul Qualley, in 1999.

She grew up in Gaffney, South Carolina, not too far from where she raised her own kids, and her deep resistance to drugs and alcohol can be attributed to her upbringing. Her mother was an alcoholic and the role of carer fell to MacDowell, the youngest of four siblings. She and her mother, “had a great relationship and I always felt loved,” she says. “There was this old-fashioned can opener attached to the wall and she’d be in the kitchen drinking and I’d clean the oil off the can opener and talk to her and ask: ‘Why do you drink?’”

When she was 10, she would get up in the middle of the night to check that her mother’s cigarettes were stubbed out properly. “There were burn marks all over the floor and on the couch; it’s amazing we didn’t burn down,” she says. That’s a lot of responsibility for a child, I say. “I think I’ve felt responsible all my life. But I’m good at it. I’ve been in training for a long time.”

At 16, she was working in McDonald’s alongside her mother, a former music teacher, and watched her get fired for turning up drunk. At 17, she involved doctors to try to help her mother overcome her alcoholism, which failed when one of them gave her mother Valium. “That was a bad decision because then I couldn’t communicate with her. And I communicated really well with her. We could have committed her; we just didn’t have the guts. The doctor told us she would die in five years. The strange thing is, she did.”

MacDowell was living in Paris when her mother died of a heart attack, and clings to a letter she received from her. “She said she had quit drinking and that she was so proud of me,” she says. “That was the last year of her life and I didn’t really get to be around it, which was super sad. I think about going back to Gaffney. I’d like to go back and try to find out from other people what that year that I didn’t get to experience was like.”

MacDowell with Hugh Grant in Four Weddings and a Funeral. Photograph: Polygram/Working Title/Kobal/Rex/Shutterstock

She is a big advocate of therapy, which helps, although she is not having any currently. “I feel like everything is going really well for me right now,” she says. “The last therapist I had – I felt like I’d done so much therapy – I was like: ‘She’s already diagnosing me and we’ve only had two conversations.’ You have to listen a little longer before you start telling me what’s wrong!”

Her latest role, in the comedy-horror Ready or Not, is fun; she plays the glamorous matriarch of a rich, ridiculous family who embark on a deadly game of hide and seek to “initiate” their son’s new wife into the firm.

“I didn’t really know what I was getting into,” she shrugs. Yet, with generally positive reviews and a supposedly handsome box-office return, it looks set to become one of the year’s unexpected success stories in the horror genre. It is directed by Matt Bettinelli-Olpin and Tyler Gillett. She says she liked the fact that “they were young guys and they’re weird; their energy was different from anything I’ve ever experienced.

“I thought it was really smart and original, but scary and gory as well,” she says. “There’s some classic horror movie stuff, but then all these great lines.”

MacDowell adopted a big fake glossy ponytail to make her character, Becky Le Domas, “look a bit crazier and more powerful”. It is reminiscent of the eccentric Aunt Ivy she played in the latest series of the bizarre British sitcom Cuckoo, earlier this year.

While the roles she has played most recently are entertaining – and show off her sense of humour – they do not showcase the full range of her talent. By comparison, her depiction of a grieving widow in 2017’s Love After Love was so raw that critics compared it to her Sex, Lies and Videotape breakthrough. “I’m so glad you watched it,” she replies. “Not as many people have seen it as I would have liked.”

She is baffled by this. “Is it my fault it’s not a huge hit? I still did great work, you know. You’re probably seeing better work in that than in Four Weddings. But it’s not a hit, so … therein is the problem, because everyone is looking for a hit. If you don’t have hits, you don’t resonate as well within the business. Interestingly, very few people have blockbusters. But once you’ve had blockbusters, you’re expected to have blockbusters.”

When Love After Love was released, MacDowell described herself as “starving” for the role. “There was just a lack of interesting characters,” she says. “You’ve heard every woman say it, because it’s the truth. We’re a very youth-oriented culture. In most movies, the leads are in their 30s and a great leading role for a mature woman is hard to come by. I have felt lulls. Since I was 40, I have felt particular lulls! I’ve been struggling since I was 40.”

That was the year people started asking her how it felt to have reached an age where she would never work again. “Everyone said everything was going to change at 40 – and it was true,” she says. “I did some shitty movies that I’ve never even seen!” She cites Town & Country (2001), one of the biggest box office flops in Hollywood history, as an example.

How did she cope with no longer having her pick of roles? “I kept trying to be positive. I didn’t want to be a whiner because I knew that men were in control and I didn’t want it to be harder than it already was. I knew if you spoke out and whined, they hated you. So I just tried to project this positive attitude. Even in the back of my mind, I’m still trying to please them, because they’re in control.”

The month before we met, she heard a male actor (“I’m not going to say who”) say: “People go to movies to see men, not women.” Did she challenge him? “It didn’t feel like I was going to change him,” she sighs. “There are a lot of people [in Hollywood] that still push that way of thinking. That is what they think. They’re going to continue to think it. They’re going to continue to push it. Even if a story is about a woman, they’ll cast the male lead first because they believe people do not care about seeing women. Even women, they’ll say that women and men go to the movies to see men.

MacDowell as the eccentric Aunt Ivy in the British sitcom Cuckoo. Photograph: BBC/Rough Cut

“It sucks the air out of you. It hurts, not just for me, but for every woman, that this is our position still.” She is heartened by the Time’s Up movement, and the attitudes she sees in women her daughters’ age. “The younger generation are not like my generation. We were well trained to be ‘less than’. We had a certain acceptance of our position that the younger generation is not going to tolerate; the wherewithal to teach them they deserve better and they’re not gonna settle for less. I know my kids won’t.”

I ask if she had any reservations about her daughters getting into the movie business, knowing from her own experience what lay ahead. “It’s funny; everyone says that like there’s some fear of being in this business, but it’s actually a really good business. I just didn’t want them to do it as children. Rainey was asking me at 14. I was like: ‘At 18, if you want to, you can.’

“Life can be crazy in any profession. When there’s a lot of money, there’s more opportunity to be crazy, but that’s not my lifestyle and it’s not their lifestyle either. We’re really kind of boring people. We barely want to go out ... I’m a home body and I do yoga and I hike, that’s kind of it. No drugs and rock and roll!”

She moved to California to be near her daughters in 2017, and says she had no idea how much she would enjoy it. For all the struggles women in Hollywood have when they pass 40, she is clearly realistic and healthy, appropriately optimistic. “Everyone has their own journey,” she says. “Maybe something fabulous is going to happen for me at 70.”

• Ready or Not is in UK cinemas from 25 September