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 on Tuesday in Manhattan. She was 52.

The writer David Samuels, a friend since childhood, said the cause was metastatic breast cancer, which in her case had resulted from the BRCA genetic mutation. Ms. 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 Ms. 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, her drug use, her extensive sex life and more.