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I’ve written video-game reviews from time to time, but this is the first one for which I’m giving a trigger warning: discussion of severe mental health issues.

Hellblade: Senua’s Sacrifice is an unusual video game in that the lead character is psychotic. I’m not using the term in its popular (and incorrect) sense of meaning “psychopath.” Senua is clinically psychotic: she hears voices in her head, experiences illusions, is compelled to match patterns visually, and occupies what is (probably) a world of her own. I say “probably” because the game does not bother to distinguish between the “real” and the “fantasy” of Senua’s world.

Within the game, Senua is a Pictish warrior woman. She’s experienced horrific tragedy and abuse. She’s on a quest in the wilderness to come to terms with what she’s witnessed. On the way, she fights demons, solves puzzles, and reviews her past. More than I won’t say, because the peeling away of Senua’s world view and her past is part of the game.

The game is not exploitative, either of Senua as a female character, nor of mental illness. The creators of Senua, Ninja Theory, consulted with mental health professionals and interviewed people with psychosis. According to the extra video that comes with the game, in viewing the almost-finished game both the professionals and the patients confirmed that the game matched their experiences.

The game is relatively short, as modern high-quality video games go. It took me about 12 hours to complete it; experienced video game reviewers reported finishing it in six to ten hours. The graphics are excellent, especially the remarkable motion capture of Senua (played by Melina Juergens). I was moved by Senua’s facial expressions as she pleads directly into the “camera”, her eyes piercing yours.

Senua is the only human figure rendered in the game. The remaining human characters are inserted as video overlays. It’s an unusual effect that reinforces the idea that they’re all people she’s seeing in her memory.

Before you rush out an get Senua (it’s available for PS4 and Windows), be aware that this is a video game, not just a travelogue through a troubled mind. The gameplay reflects Senua’s mental state: No help is given in how to play the game; if you want to know what the controller buttons do, you have to check the options screen. There are no maps or display overlays. There are no direct instructions for combat; however, the voices in Senua’s head will often give you strategy tips.

The game can be punishing, especially for a clumsy video gamer such as myself. You are bluntly told near the beginning of the game that there are only so many times Senua can die in combat or fail at certain platforming puzzles. After that point, the darkness consumes her, which means the game save data is deleted and you must play the game from the beginning again. You aren’t told how many times you can fail; I failed about 20 times and managed to get to the end.

I’ve written a long game review for a game that’s among the shortest I’ve played because I think Hellblade: Senua’s Sacrifice is worth it. The goal of the designers was to expose and destigmatize psychosis. I think they succeeded.