How can I create a sense of psychological horror in a comics story without relying on supernatural elements?

Psychological horror focuses on the characters' internal struggles and perceptions. Explore themes like paranoia, delusion, gaslighting, and repressed trauma. Use unreliable narrators to create doubt and uncertainty. Focus on subtle visual cues and unsettling imagery that suggest a character's deteriorating mental state. The horror stems from the character's own mind, rather than an external threat.