Your understanding of yourself makes other people feel understood themselves—and that’s all very good,” a therapist told Elizabeth Wurtzel ’89 midway into rehab. “But where has it landed you? It’s landed you in a mental hospital.”

The author of Prozac Nation, the autobiography of depression that spoke to a generation, returns now with More, Now, Again, her second memoir before reaching the age of 35. The book chronicles her descent into addiction and slow rise to recovery. In an age of perpetual confession and personal narratives, Wurtzel is gambling on the persistence of her own appeal.

Wurtzel chooses a tiny, candlelit French eatery buried in New York’s West Village for our interview. While at Harvard, she won a Rolling Stone College Journalism Award for her music writing in The Crimson.

Entering, she spots a writer she knows, author and journalist Douglas Cooper, sitting by the window. “Every time I see you, you’re being interviewed,” he grins.

She smiles too, impishly, unraveling her blonde hair from a scarf. “Well, have you written a bunch of books about your problems?”

Cooper later compares Wurtzel to La Traviata or a martyred saint: a figure we love to watch suffer. “Ordinary suffering tends to be kind of dull, whereas the Passion of Liz is pathos raised to the pitch of art porn,” he writes in an e-mail. “Agony on ecstasy. If drag queens are not dressing as Elizabeth Wurtzel 30 years down the road, I’ll be deeply surprised.”

In More, Now, Again, Wurtzel marshals the same unsparing detail and narcissism mingled with self-deprecation that characterized Prozac Nation. Hovering around boldness but dallying with melodrama, she begins by describing how she holed up in Florida to write her second book, Bitch. Wurtzel emerged from the success of Prozac Nation armed with a cocaine habit compounded by a growing Ritalin addiction.

Even when she was snorting up to 38 crushed-up pills a day, Wurtzel says she believed her habit, however disturbing, was essentially harmless.

“I am abusing a drug that’s basically for six-year-olds,” she laments in More, Now, Again when her denial begins to fade. “I could not imagine walking into an N.A. meeting and talking about addiction to Ritalin. Everyone would laugh! It’s just too weird and smarmy, too pathetic. So uncool.”

Wurtzel herself has criticized the way that drug use and addiction, particularly in women, tend to be glamorized in the media. But on the face of it, Wurtzel’s tales of fanatically seeking drugs, getting caught shoplifting, razing the relationships in her life and developing an obsession with porn are hardly alluring.

“I actually have to say that most of my behavior while on drugs was just gross or embarrassing,” she says, mentioning a particularly graphic passage in More, Now, Again, in which an isolated, drug-addled Wurtzel becomes obsessed with tweezing each hair on her legs and eventually takes to plucking at her skin:

“After a while, the whole point is the digging. What else is there under my skin? What will I find inside of there?…My goal becomes finding a bone, getting far enough into my leg to touch ossified ivory mass, to massage my own skeleton with my Tweezerman scalpel. I work on this task for hours. Blood spurts everywhere, the white tile on the bathroom floor is covered with stains, blood drips down my legs, there is blood on my hands, blood on the sundress I wear, and I am too busy trying to find a bone to notice.”

But even that episode, however horrifying, takes on a romantic cast in the telling. As she says in the book, “Just because you feel deeply and indiscriminately does not mean that your feelings are indications of anything other than your flat-out fucked-up life.” Though many take issue with the chosen outlet of her talents, it takes skill to suffer as beautifully and artistically as Wurtzel. Her lack of shame in laying bare the details is only the beginning.

By some happy accident of timing, Wurtzel delivered Prozac Nation, which was entirely about her own experience, into a world that was poised to debate depression openly for the first time in the face of sudden availability of drugs like Prozac.

“Sylvia Plath with the ego of Madonna,” was how the New York Times Book Review described her at that point. Despite its autobiographical cast, Prozac Nation was universalized into a cultural moment, packaged as a symbol and embraced into a canon of disaffected Gen-X plaints. The book has since been adapted into a film starring Christina Ricci and will be released by Miramax in May.