From the moment the titular character appears on screen in Trey Edward Shults’ Krisha, a current of unhinged anxiety is released. As menacing strings prickle over the soundtrack, the opening shot zooms in on Krisha’s face as she stares transfixed into the camera, her lips tight, chin quivering and eyebrows raised in a vulnerable, yet almost antagonistic manner. It’s an image that quickly establishes the blunt emotionalism of Krisha, a film that grips the audience at the throat and keeps squeezing tighter and tighter.

The drama, which won the Grand Jury Prize and Audience Award at last year’s SXSW, is largely inspired by Shults’ own family history and features many of his non-actor relatives. It follows Krisha (played by Shults’ aunt, actress Krisha Fairchild, in a phenomenal, charged performance) as she reunites with her estranged family for Thanksgiving after being away for 10 years. Where exactly Krisha was and what she was doing is only alluded to in conversations between her and her family members. “I have tried to become a better human being,” she explains. “I have stayed away while I was healing myself.”

Eventually it’s inferred Krisha has suffered from drug addiction and alcoholism, and as evinced by her continual, secretive trips to the bathroom to unlock a box holding various pill bottles, is still battling it. When Krisha first arrives at her sister Robyn’s (played by Shults’ mother, Robyn Fairchild) home in Texas, she’s greeted by warm welcomes from the family, yet a stiff apprehension permeates the home. The tension spikes once Trey (played by Shults), Krisha’s son, arrives and avoids greeting her until giving in with a rushed hug and fake smile. We learn that while Krisha was away, Trey moved in with his aunt Robyn and uncle, both still hesitant about allowing Krisha back into their family.

Krisha is a film about addiction, repressed anger and a family attempting to recover from the unhealed pain of the past. But you won’t find exposition or soapy melodrama here; instead it’s Shults’ frantic visual style and sound design that create a disorienting atmosphere of relentless anxiety and unease. Mirroring Krisha’s psychological state, the film opens at an even, if nervous, pacing, then picks up to a turbulent boil as the tension itches to erupt at any moment, rising and falling with the pulsing, shivering percussion on the soundtrack.

In one unforgettable sequence, Krisha prepares the turkey after popping a handful of pills, which one could assume are for a mysterious injury that’s left her missing a good chunk of a finger – the focus on her bandaged finger further puts the audience on edge and questions Krisha’s stability. While in the kitchen, the dialogue drones to a echoey muffle as other sounds take precedent. The clang of pots and pans, rowdy yells from the boys watching football, and vibrations of cell phone amplify to startling degrees alongside piano notes and screeching strings. The camera jerks and thrashes back and fourth between Krisha and the source of the irritating noises like a chaotic ballet raging in her drug-induced, nerve-wracked mind. This happens again similarly in a later single-shot where the camera pivots around the kitchen, capturing the normal activity around her as she descents deeper into panic.

This visual and aural unease wades into and out of the film, fading as more placid, sober (pun, perhaps, intended) moments show Krisha chatting with family members. But as soon as her nervousness returns, Krisha flees real-life discomforts for the temporary relief of substances. When Robyn brings their elderly mother home for dinner, immediate worry sets over Krisha’s face as she tries to remind her mother who she is. And off Krisha goes, back up the stairs, into the bathroom, door locked, water bottle in hand, swallowing more pills. By sliding back and fourth between these calm, yet upsetting intimate moments, and ones of pure, rattled anxiety, the film never allows the audience to get comfortable or feel safe. This isn’t a traditional family holiday drama where dysfunctional relatives resolve their differences, but a film that feels more like a fevered nightmare, like the stitching together of bad memories you’d rather forget.

Though undeniably a heart-wrenching experience to watch, Krisha is most notable for dealing with the many types of suffering that can come from a broken family. It uncovers the painful messy scabs of addiction and trauma, without vilifying or victimizing its subjects. In Krisha, an emotional slingshot of a film, Shults assures himself a true talent to watch with a debut you won’t easily shake.