Actress Sarah Paulson has steadily built an enviable resume over the last two decades. From her Emmy-winning performance as Marcia Clark in the miniseries “The People v. O.J. Simpson: American Crime Story” and parts in acclaimed movies such as “12 Years a Slave” to her recent Tony Award-winning role in the Broadway play “Appropriate,” the thespian transitions between stage and screen with ease, in turn becoming a familiar and welcome face not just to New York City theatergoers but to culture vultures everywhere.

Primarily a supporting actress up to this point when it comes to film, Ms. Paulson leads the new psychological horror movie “Hold Your Breath,” available on Hulu. Set in the Oklahoma panhandle around the time of the Dust Bowl, the picture centers on a mother and her two daughters as they attempt to weather severe storms, deal with drifters, and face their own demons. As Margaret, Ms. Paulson shoulders the film’s intensity gracefully and incisively throughout, even during its strained yet appropriately grim finale.

When we first meet her, Margaret is having nightmares but maintains a relatively composed demeanor during the day. Her husband has departed recently to find work in the east, as their wheat fields have grown fallow and parched. Dust is ever present in the air, catching the light within their home despite her continual efforts to keep it out. Her two daughters, Rose and Ollie, fear she might have another breakdown induced by sleep deprivation, as occurred after their sister Ada died of scarlet fever; Margaret worries that the two will also fall ill and die.

The trio do venture out when the atmosphere isn’t too dust-filled and blustery, wearing handkerchiefs as masks. The girls’ aunt Esther also lives out in the middle of nowhere, in a household with children but no father as well. Sometimes, too, they go to the local church, where Margaret often embroiders with other local women. Despite these excursions, their social isolation is acute and when they hear about a murderous drifter in the area, and then actually meet a traveling faith healer, Margaret’s mental state grows increasingly unstable.

This setup bodes steady fear and fright, and the film’s anxious editing delivers on both fronts. Haunting imagery, such as a barren landscape populated by kids in goggles and a dead horse, creates an eerie atmosphere, with the color red especially vibrant amongst a color palette dominated by whites, browns, and grays. Speaking of the latter, the girls read a ghost story about a “Grey Man,” a presence that can be inhaled and compel the inhaler to do “terrible things.” As a metaphor for psychosis and infection, the ghostly figure works, though its obviousness as a stand-in for the constant dust is, well, a bit too on-the-nose for this viewer.

Quite possibly the most frightening aspect of the narrative is the dust, which covers every interior surface. The audio aura, too, evokes the threat of suffocation through sounds of hacking coughs and gritty winds, with the soundtrack creaking and crackling. For germaphobes and OCD cleaners, the movie will represent not just a nightmare but a real phobia. Indeed, when Margaret scolds Esther with the line, “You might try sweeping,” one can almost picture these factions silently nodding their heads. Mentions of masks, quarantines, and diseases also bring to mind the recent global pandemic.

As the mysterious stranger, Ebon Moss-Bachrach (of “The Bear”) effectively counterbalances belief and altruism with cunning. Broadway star Annaleigh Ashford is both creepy and heartbreaking as Esther, a woman who’s nearly given up on being a good mother. The character of Ollie is deaf in the picture, and Alona Jane Robbins, a deaf actress, plays Margaret’s youngest, most defenseless daughter compellingly. Rounding out the central cast, up-and-coming actress Amiah Miller astounds as teenage daughter Rose, with the force of her intelligence and compassion increasing as the film progresses and its mother-clashing-with-daughter theme pivots into plot.

Harrowing for nearly its entire, succinct runtime, the movie toys with ideas of extreme weather and the supernatural, yet co-directors Karrie Crouse and Will Joines’s real interest lies in the twin terrors of motherhood and guilt. Margaret’s increasing anxiety dovetails with bouts of sleepwalking, which leads her to become alienated from her own family as well as further disturbing scenes. Ms. Paulson does “worrying” well, but even more than that she demonstrates how Margaret is a proud, steely, able woman who can survive even the strongest storm and protect her girls. Yet the specters of poverty and grief remain, working to block out all hope.