NEW YORK (NYT NEWS SERVICE ).- Elizabeth Wurtzel, whose startling 1994 memoir, “Prozac Nation: Young and Depressed in America,” won praise for opening a dialogue about clinical depression and helped introduce an unsparing style of confessional writing that remains influential, died Tuesday in New York City. She was 52.

Writer David Samuels, a friend since childhood, said the cause was metastatic breast cancer, a disease that resulted from the BRCA genetic mutation. Wurtzel had a double mastectomy in 2015. After her diagnosis, she became an advocate for BRCA testing — something she had not had — and wrote about her cancer experience in The New York Times.

“I could have had a mastectomy with reconstruction and skipped the part where I got cancer,” she wrote. “I feel like the biggest idiot for not doing so.”

Writing about her final illness was a natural choice for Wurtzel, who had for a quarter-century scrutinized her life in relentless detail, becoming a hero to some, especially to many women of her generation and younger, but also drawing scorn. “Prozac Nation,” her first book, published when she was 27, was unvarnished in its accounts of her student days at Harvard University, her drug use, her extensive sex life and more.

It divided critics.

“Wurtzel’s nation is a nation of one,” Karen Schoemer wrote in a dismissive review in Newsweek. “She makes only tenuous attempts to draw parallels between herself and her generation, and she randomly blames her parents, her therapists, her friends, the divorce rate, drugs and the times for her problems.”

But Michiko Kakutani, reviewing the book in The New York Times, found more to like. She acknowledged that its self-pitying passages “make the reader want to shake the author, and remind her that there are far worse fates than growing up during the ’70s in New York and going to Harvard.”

“But,” she added, “Ms. Wurtzel herself is hyperaware of the narcissistic nature of her problems, and her willingness to expose herself — narcissism and all — ultimately wins the reader over.”

The book became a cultural reference point and part of a new wave of confessional writing.

“Lizzie’s literary genius rests not just in her acres of quotable one-liners,” Samuels said by email, “but in her invention of what was really a new form, which has more or less replaced literary fiction — the memoir by a young person no one has ever heard of before. It was a form that Lizzie fashioned in her own image, because she always needed to be both the character and the author.”

In a 2013 article in The New Yorker drawing parallels between “Prozac Nation” and the HBO series “Girls,” then in its second season, Meghan Daum expressed the admiration and frustration the book inspired in some women.

“We resented her for being such a famous and hot little mess,” she wrote, “yet we couldn’t help but begrudgingly admire her ability to parlay her neuroses into financial rewards and a place in the literary scene.”

Wurtzel followed her own lead with her subsequent writing, especially “More, Now, Again: A Memoir of Addiction,” published in 2002. That book detailed her abuse of cocaine and of Ritalin, which she would grind up and snort. As she put it in a 2013 essay for New York magazine, “I made a career out of my emotions.”

Elizabeth Lee Wurtzel was born July 31, 1967, in Manhattan. Her mother, Lynne Ellen Winters, was married to Donald Wurtzel, and until recently Elizabeth Wurtzel had assumed that he was her father. In a 2018 essay in New York, she wrote of learning that she was actually the product of an affair between her mother and photographer Bob Adelman, who died in 2016.

She had written voluminously about her difficult relationship with Donald Wurtzel, who divorced her mother when she was young; in the essay, she reassessed that angst.

“Thousands of words on the wrong problem,” she wrote. “I have perfected a two-handed backhand to clobber the lob that is coming at me that is: the wrong problem. I have aced the wrong problem.”

She grew up on the Upper East Side and began writing “Prozac Nation” in 1986, while she was a student at Harvard.

“It was originally a book about Harvard; it wasn’t even about depression,” she told the news website Vice in 1994. “But everything in it was about being depressed, so that changed it.”

While earning her bachelor’s degree she wrote for The Harvard Crimson and started an internship at The Dallas Morning News, but she lost that job amid accusations of plagiarism. After graduating she was able to get jobs with New York magazine and The New Yorker, writing about rock music, often in a way that invited derision. When Tina Brown took over as editor of The New Yorker in 1992, Wurtzel was one of her first cuts.

Although Wurtzel’s tone in “Prozac Nation” was often described as self-absorbed, she had a different explanation.

“The way I am,” she told The Fort Worth Star-Telegram in 2002, “is that I put everything I have into whatever I’m doing or thinking about at the moment. So it’s not right when people say I’m self-absorbed. I think I’m just absorbed.”

Her first book after “Prozac Nation” was “Bitch: In Praise of Difficult Women,” published in 1998. Its original cover photograph showed Wurtzel topless and extending her middle finger.

“While ‘Bitch’ is full of enormous contradictions, bizarre digressions and illogical outbursts, it is also one of the more honest, insightful and witty books on the subject of women to have come along in a while,” Karen Lehrman wrote in a review in The Times. “Unfortunately, the title and cover preview the book’s central confusion — what exactly about a difficult woman is worthy of praise — as well as Wurtzel’s own insecurities as a writer and grown-up.”

The book did not do as well as it might have, because by the time it came out Wurtzel was struggling with the drug addictions she later detailed in “More, Now, Again.” In that book, she bluntly described how she would feed her addiction by whatever means necessary.

“Any pill will do,” she wrote. “I don’t care about the effect anymore, up or down, so long as I’m never just straight. I steal pills from people’s medicine chests. Everyone has had a root canal or wisdom tooth extraction.”

Wurtzel cleaned up enough to be admitted, in the mid-2000s, to Yale Law School. Her past gave her unusual insights in some of her classes, especially criminal law.

“We talked so much about drug policy in that class,” she told The Times in 2007, the year before she graduated, “and I was struck by how little knowledge these people were working with.”

For a time she worked for the law firm Boies Schiller Flexner, though she left in 2012, saying she wanted to devote more time to writing.

“I choose pleasure over what is practical,” she wrote in 2013. “I may be the only person who ever went to law school on a lark.”

In 2015 Wurtzel married James Freed Jr., who survives her, as does her mother.

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In 1995, in an afterword to a new edition of “Prozac Nation,” Wurtzel sought to draw a broader lesson from her landmark book.

“If ‘Prozac Nation’ has any particular purpose,” she wrote, “it would be to come out and say that clinical depression is a real problem, that it ruins lives, that it ends lives, that it very nearly ended my life; that it afflicts many, many people, many very bright and worthy and thoughtful and caring people, people who could probably save the world or at the very least do it some real good, people who are too mired in despair to even begin to unleash the lifespring of potential that they likely have down deep inside.”

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