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When you feel down in the dumps, what do you do? Seek comfort in your family? Pop a pill? Take a vacation? Lars von Trier has his own way of dealing with the blues: He makes some of the most flipped-out cinema in the history of the art form.

The Danish provocateur (Breaking the Waves, Dogville, The Idiots) has stated for the record that Antichrist was conceived and produced in the wake of a deep depression. Given that the film looks as though it could have been art directed by Hieronymus Bosch, there’s little reason to question the veracity of his claim. His sanity? Now, that’s another thing.

It all starts off accessibly enough. He (Willem Dafoe) and She (Charlotte Gainsbourg) are shot in silvery black and white as they shower and then make love in slow motion. We listen to Handel’s Rinaldo and watch as a toddler a room or two away climbs down from his crib, unlatches the child gate and makes his way to a window blown open by a dazzling snowstorm outside. Seconds later, the child starts a slow (motion) descent to the pavement, and his parents commence a slow descent into madness. Or hell. At the very least, the most ill-advised attempt at couples therapy ever.

You see, He is a psychotherapist, and She is suicidal. Even Dafoe knows it’s not a good idea to treat someone so close to you, but he rationalizes that he understands his wife better than another shrink possibly could. Big mistake. He takes her off meds and away to their isolated cabin in the Pacific Northwest woods to work through her guilt and anguish. Even bigger mistake. Has this dude never seen a horror film?

Not that von Trier’s latest fits neatly in that category. It’s either a whole new sort of horror film or a whole new sort of film altogether. At any rate, increasingly horrifying, disturbing, mystifying events unfold. In his attic, for example, Dafoe discovers hidden remnants of his wife’s abandoned thesis on “gynocide,” the extermination of suspected witches during the Middle Ages.

He comes across bizarre illustrations of women being tortured. Unfortunately for him, the director has included these as a foreshadowing device.

No, the couple’s time in the woods does not heal psychic wounds or bring them closer. Gainsbourg doesn’t respond at all well to treatment. On the contrary, she directs her overwhelming grief and existential rage toward her unsuspecting husband, and the result is unlike anything you’ve seen on screen. The film’s third act makes Saw look like a beach-party picture. The faint of heart would do well to steer clear.

Every viewer will find his or her own meaning in the movie. Von Trier has called it “a testament of atheism.” And, given that it contains a scene in which a fox croaks the pronouncement, “Chaos reigns,” that’s probably as fair a starting point as any. Antichrist is at once mesmerizing, gorgeously shot, staggeringly well acted, filled with startling, unforgettable images and boldly original. You leave convinced it’s the work of an artist who possesses singular gifts even if, when he made it, he may not have had all his marbles.