In an interview with The New York Times earlier this month, Ms. Williamson — a celebrity in the self-help world who gained a large following in part through her association with Oprah Winfrey — said that she had never told anyone not to see a doctor, and that she understood clinical depression was real and sometimes necessitated medication.

“I have no judgment — nor do I believe I have ever expressed any — of anyone taking antidepressants,” she added in a text message after the interview. “I’m happy for anyone who is finding the help they need for any ailment whatsoever. My problem is not with antidepressants per se, which clearly have and do help many people. My problem is only with their overprescription, and the practices of pharmaceutical companies when drugs are marketed in predatory ways.”

Before granting the interview, Ms. Williamson asked me to read her book “Tears to Triumph.” Its premise is that trying to avoid or suppress emotional pain is often destructive , and that such pain can be a “spiritual journey.” In the book, she describes depression and anxiety as results of a society “that repudiates love” and urges readers to heal themselves by surrendering their suffering to God and rising “above the thought system that creates it.”

She also says she has twice received diagnoses of clinical depression, and writes:

However deep my suffering, I didn’t want to be anesthetized as I went through it. Like an expectant mother who wants to give birth naturally, rejecting drugs during labor because she wants to experience “natural childbirth,” I wanted to be fully available to the depths of my pain. Why? Because I knew it had something to teach me. I knew that somehow, in some way, my suffering would lead to a blazing new dawn in my life — but only if I was willing to endure the deep, dark night preceding it.

Ms. Williamson spoke with The Times for almost an hour. These are edited excerpts from the conversation.

On clinical depression: ‘It’s not always a scam at all’

In your book, you criticize the drawing of a distinction between “sadness” and “depression.”

My point is, there is a spectrum of normal human despair. Things happen in life. People get sad. That does not, of itself, indicate the presence of a mental illness. People go through personal loss. That’s not a mental illness. People go through a breakup. That’s not a mental illness. My point is that over the last few decades, there has been a medicalization of normal human despair.