The unnamed narrator of Ottessa Moshfegh's new novel takes pills. Lots of them: "My Ambien, my Rozerem, my Ativan, my Xanax, my trazodone, my lithium," she says, like reciting a rosary. "Seroquel, Lunesta. Valium."

The pill-popping is concerning. But it's not Moshfegh's biggest concern in "My Year of Rest and Relaxation," a darkly comic novel that makes something new out of familiar themes of disenchantment. Her biggest concern is existence. The narrator is a young, attractive woman who lives in Manhattan off an inheritance from her parents. But she chafes at conspicuous consumption and shallow friendships, feeling detached from an inner life.

Moshfegh doesn't mean this to be a critique of only well-off Manhattanites. She means to ask: You feel it, too, don't you, sometimes? Don't you ever just want to check out and nap? For, say, months? The narrator pursues her good long rest with the help of a stack of bad movies — Whoopi Goldberg is her spirit animal of brainless banality — and a massive clutch of prescriptions from Dr. Tuttle, a wildly unscrupulous psychologist. "It's like I'm in hell," the narrator laments. "Hell? I can give you something for that," Tuttle replies.

Moshfegh is building a fine career out of such bleak, at times repellent characters. Her 2015 novel, "Eileen," was an NBCC and Man Booker finalist and PEN/Hemingway winner for debut fiction, thanks to its noirish portrait of an isolated young woman hitting an emotional breaking point. If you like Patricia Highsmith, you'll love Moshfegh. If you like reading about vomit and other digestive disruptions, you'll love her even more.

Moshfegh's strategy is similar here — the narrator quits her job at a tony art gallery in gross-out fashion. But under the novel's veneer of absurdity and provocation is a nuanced study of emotional helplessness. The narrator's parents are rarely far from her thinking, although she denies she's grieving. She mocks her appearances-obsessed friend, who eulogizes her own mother with a speech that "sounded like she'd read it in a Hallmark card." But the narrator knows her life is no less mediated.

Submitting to Big Pharma is the best if-you-can't-beat-'em-join-'em tactic she can imagine. Moshfegh plays up the humor and strangeness of the concept, partly to ensure we don't think of the novel as a pat addiction narrative. (Dr. Tuttle is a rich mine of non sequiturs for this purpose: "Do you have a family history of nonbinary paradigms?" she asks.)

My Year of Rest and Relaxation, by Ottessa Moshfegh

But the novel is also set during 2000 and 2001, with the twin towers looming much like the narrator's late parents. A little "hibernation" might do us some good, Moshfegh suggests. We might see the world more clearly. But, alas, the world will still be with us.

Mark Athitakis is a writer in Phoenix.

My Year of Rest and Relaxation
By: Ottessa Moshfegh.
Publisher: Penguin Press, 289 pages, $26.
Event: 7 p.m. July 17, Common Good Books, 38 S. Snelling Av., St. Paul.