It’s not often that one feels the obligation to mention a trailer when discussing a serious film (and Alex Ross Perry’s drama of psychological dissolution is nothing if not serious).

But the arch US promo for Queen of Earth looked to be telling us things worth attending. A sonorous, brown voiceover helps bolster suggestions that we're dealing with a high-end 1970s horror film of the slasher school.

In a sense this is true. Shot in luscious Super 16 by Sean Price Williams, featuring promiscuous lens flare and creepy dissolves, the film uses that vocabulary to tell the story of a young woman fighting depression near the sort of lake around which men in hockey masks used to lurk with cleavers.

There’s more. Consider the salad. About halfway through, Virginia (Katherine Waterston) brings her friend Catherine (Elisabeth Moss) a plate of unappetising leaves. While Catherine curls within herself and, over days, gives in to demons, the plate sits untouched by her bedside.

There is surely a joke here about the skinned rabbit – just as much a dish of its time – that rots while Catherine Deneuve goes murderously crazy in Roman Polanski's Repulsion. That really was a horror film. Queen of Earth is both more mundane (such things as this happen all the time) and more peculiar (who tells such a story in this skewed fashion?).

The film begins with Catherine dissolving as she deals with the man who is rejecting her. Her father has recently died and, knocked sideways by both crises, she travels to her friend’s house with recuperation in mind. Relations with Virginia are never entirely comfortable, but that association seems sunny when set beside Catherine’s interactions with Rich (Patrick Fugit), a smug neighbour, and – seen in flashbacks to the previous summer – her ex-boyfriend James (Kentucker Audley).

Moss is incandescently brilliant as a woman who smiles when she should be unnerved and boils with rage at the most inconsequential slights. (“Only I call her ‘Ginny’,” she barks at anybody who dares to refer to her friend by that diminutive.)

Those horror tropes allow Perry, director of the less satisfactory Listen Up Philip, to build tricksy angles – significant sections could be Catherine's delusions – into a film that might otherwise have ended up looking like Ingmar Bergman's Persona. Meanwhile, the two startling lead performances help him fight off the archness that is always at the elbow: Moss and Waterston create something rooted, real and still just a little bit Swedish.

A transfixing oddity.