I'm a fan if Sarah Silverman. I do see her boldness, and spirit of "going for it" in this performance. However, I am disappointed to say that the movie doesn't go anywhere, or do anything. There isn't really a "story" in the sense of a narrative, with a beginning, middle, and end - even an artsy, unconventional, or avant-garde beginning, middle, and end.
This movie just lays there, static. It's really just a tiny snapshot of a sad and profoundly dysfunctional life, albeit an impactful and striking snapshot. While the dysfunction was portrayed accurately and with some skill, we need more.
It's like showing us a photo of a close-up of some water, and saying "Behold - the mighty Mississippi!" One would need to show more to convey riverness. Or, to expand the corny analogy theme further (sorry), it's like a one-note waltz. That might be a GREAT note! But to be a waltz, you need three notes.