Overcoming Anxiety, One Adventure at a Time

How a confusing personal battle inspired a fun solution for helping people treat anxiety.

Worry Quest is a concept for an anxiety treatment app that translates therapy and self-care techniques into fun adventure games. Check out the prototype video on Vimeo. The following is my story behind the idea & process.


A young Matthew, facepalming

For a good portion of my life, I was a really anxious kid but didn’t think anything of it. I had a hard time looking people in the eye, was painfully bad at dating, and put sometimes unreasonable amounts of pressure on myself to be perfect. Often, my anxiety would manifest itself in obsessive thinking, headaches, and breakdowns. I thought that was just who I was — a sweaty-palmed kid in an ever-spinning world.

These feelings intensified when I moved away from my home state of Michigan. I started a new job in Toronto. I hardly knew anyone there, and I was still insecure with who I was and what I wanted to do with my life. Self-doubt crept in. My social anxiety became severe. Making new friends seemed an impossible task. I found a community in a music scene, and it was full of weirdos like me. However, I found that my anxiety persisted. I had breakdowns so bad I was unable to work.

In Canada, mental health care is essentially a basic right provided to all citizens. After a bit of searching, I was able to get to a therapist for free under the national health care. During my therapy sessions, I practiced Cognitive Behavioral Therapy, which helped me contextualize and understand my anxious thoughts. I became a student of my own brain. I studied countless books. I tried to make sense of all the nonsense that my mind was feeding to me.

Variety of mental health books I’ve read

Grad School Jitters

Three years into my professional career, I felt I needed a change of direction. Sitting behind a desk all day was wearing me down, and I wanted to step away from the computer to pursue a more human-centered design approach. Even before graduating from Michigan State, I knew I wanted to pursue graduate education, so I figured it was time to take the jump. I applied and got into multiple schools I was excited about.

Yet, after I committed to MICA, I felt my self-doubt creep back in. It was going to be a big move. I was about to remove myself from a comfortable life in favor of a debt-ridden, uncertain future. Deep down, I knew I was making the right decision, but the ruminations drove me crazy. I wasn’t feeling like myself and wasn’t interested in hanging out with my friends, despite the fact that I was soon leaving them for a new place. As the year progressed, my negative thoughts worsened.

When I got to Baltimore, my anxiety reached its peak. I had severe panic attacks and was unable to leave the house. I distinctly remember going to a walk-in group-therapy session on the verge of tears. All of the health-conscious techniques I tried to make me feel better were not working. To my dismay, it was very difficult to find a therapist covered under my insurance, and student counseling was filled up. I remember sitting in my bathtub with a list of therapists and my phone, making one call after another: wait list, wait list, no new patients, leave a message. I bussed to far-away, unfamiliar areas of the city and waited in long lines for walk-in clinics, only to be told that it would cost me $800 for a session. Eventually, I was able to find something covered under my insurance, albeit about a 20-minute drive from my house. Trying to find someone to help me with my anxiety was anxiety-inducing. I can’t imagine what it would have been like if I had not had insurance.

Early thesis ideas

Imagine an entire year dedicated to eating, sleeping, and breathing in the service of a singular creative enterprise. This is what it feels like to work on the immersive — and sometimes elusive — MFA thesis project. At the end of the first year in the GDMFA program at MICA, students are required to choose a topic that will serve as the subject of this one-year, independent, intensive experience that represents a culmination of skill and perspective developed before and during graduate school — a graphic-design magnum opus. I chose to address the gaps in mental health care experienced by young adults.

I came to MICA because I wanted to make things that have positive impacts on people’s lives. Having lived with anxiety for so long and having known so many others who have dealt with similar issues, I wanted to encourage dialogue about mental health in a creative, memorable way that people would be able to relate to their own lives. And I wanted it to be humorous and fun; many products and services in this area are either prohibitively pricey or overly clinical. From all of this, Worry Quest was born.


Zine made from interviews. Check it out here.

Process

Worry Quest™ is a prototype for a smartphone app that translates proven anxiety therapy and self-care techniques into fun adventure games. It aims to provide a personalized, inexpensive, enjoyable way to fill gaps in mental health care experienced by young adults. I have involved the public in every step of the research process. I interviewed my friends about anxiety in their own lives.

I learned what anxiety meant to them, how anxiety manifested itself in their own lives, and how they coped with it. They also identified dream products and services that they wished existed in order to help them with their issues. I had asked, “In an ideal world, what sort of thing would you imagine to help your anxiety?” Their responses were tremendously candid and inspiring.

Anxiety Demons

Representations of anxiety in comic art (sources: heymonster, Claire Jarvis, Lunarbaboon)

Comics artists consistently depict anxiety as a monster. The monster of anxiety appears as a faceless, grey, blobby, floaty thing that lingers above someone’s head and meddles with their day-to-day living. I applied this symbolic approach for a new purpose. I wondered how people would respond if they could externalize their anxiety as monsters. I developed a “draw your demon” activity that allowed participants to externalize and visually confront their demons. I tested this activity with my peers in class, and they found it to be really helpful.

Drawings of Anxiety Monsters

I incorporated this “draw your demon” activity into Cognitive Behavioral Therapy, which is “a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns. [Oxford]” Laying the activities out this way revealed to me that coping with anxiety is like a hero’s quest: with all its ups and downs, triumphs and tribulations.

Cards = CBT + Anxiety Monster drawing activity

The hero’s quest provided a structure for an adventure-game smartphone app. An anti-anxiety app for young adults made sense: 85% of young adults (18–29) own a smartphone [Pew], the cost of an app is cheaper and easier to find than therapy, and the phone is a readily available source of information and games. However, when I looked at mental-health apps, I found that they were one-dimensional, had great ideas that were poorly designed, or were formally clinical in their approach. In contrast, I wanted to fill that void by designing something fun, creative, personal, and approachable. I wanted my product to incorporate ideas from various types of therapy to serve various types of people. I didn’t want a one-size-fits-all approach, and I didn’t want it to feel too clinical. Of course, it wouldn’t replace therapy. It would, rather, act as a supplemental tool for self-discovery.

Making it personal

To enable the user to personalize their experience with my app, I had to conduct extensive research about what resonates the most with the app’s audience. Feeding off of the success of my previous “draw your demon” activity, I developed public participatory design prompts to gather research. I created two giant posters that invited people to contribute.

Some people didn’t take these prompts seriously and drew obscene things (genitalia and racist stuff). That’s always a risk with public projects. However, I was pleased to find that the majority of folks were generous and honest.

Prompts in the wild

Drawing Demons

Draw your demon!
Think of something that makes you feel anxious, whether that be a specific situation from the past or something in daily life. What would that feeling look like as a scary monster? Draw it, name it and leave a brief description of why you drew it that way below your drawing.

The variety of responses for this activity allowed me to organize young adult anxiety into seven categories. I was also able to generate visual assets for my app — rooted in real research — such as icons and monster parts representing peoples’ fears. Within the app, the seven categories allow users to tag their demons for future reference. The seven categories also act as filters that provide users with relevant monster parts for when they assemble their own demons. Beyond that, these labels will help users filter through others’ demons in the public Worry Quest “Demon Gallery.”

Left: research drawing. Right: Anxiety tags and Demon Builder.

Actualizing the Adventures

How do you deal with stress, worry, or anxiety?
We all cope in our own way, whether that be exercise, therapy, meditation or having a drink with a friend. What do you do that works best for you? Please write it or draw it in the space below, using anything you’d like, or the pen provided. Rate how effective it is from a scale of 1 (not very) to 10 (very!) & describe why.
Responses to coping prompt

Activity #2, in tandem with my previous research, helped me figure out the spectrum of ways people cope with their anxiety. Because everyone prefers to cope with their anxiety in different ways, I didn’t want to give users just one option. Providing more than one option would allow for a wide range of personae to be covered, as well as enable folks to try new methods. For simplicity’s sake, I categorized preferred coping mechanisms into three main journeys:

Pleasing the User

At its core, Worry Quest is an app about emotions. Naturally, this would require content and aesthetic considerations that add up to an all-around seamless, pleasurable experience. Therein lied a big challenge: how can I use my knowledge about user-centered design, coupled with user research, to make anxiety therapy rewarding and fun?

Flows and Familiarity

I focused on the sensible flow and delivery of content, so that users — in their already fragile state — wouldn’t get tripped up, confused, or frustrated. To accomplish this, I mapped out user journeys that helped me understand snags in the process and get the content critique that was so important to improving the core of my idea.

Low-fidelity user flow diagram

I made sure the Worry Quest interface was welcoming and easy to use. When I looked at the interface of comparable “prompt then type” apps, I found that the ones that stood out kept cognitive load to a minimum. So, instead of having my users repeatedly type their feelings, I provided simple journaling prompts and activities. A quest wouldn’t be a true quest without excitement, so I punctuated the moments in between journaling with games that have familiar dynamics (e.g., Fruit Ninja, Breakout), which serve to bring the user out of their head and into the experience.

Simple & fun

With these strategies, I condensed different therapy processes to their essence without losing their effectiveness, and I crafted a storyline that feels fun and effortless.

Emotional Rewards

I know from my own experience that talking yourself through an anxious period can be challenging. Every bit of encouragement helps. This led me to build positive affirmations and rewards for completing tasks into the Worry Quest prototype. Exciting color, animations, and illustrations reward users for completing self-care.

Color script

Color, as used in the app, emphasizes going from darkness (painful, anxious, unsure) to light (enlightenment, relief, self-awareness). Color also rewards the user for being brave enough to complete different activities along the way. Animations become increasingly active, splashy and energized as users progress farther along their journeys. Friendly animal avatars change their expressions, elevate in rank, and earn cooler costumes as their users continue to take good care of themselves. These combined rewards act to inspire a sense of excitement and empowerment through a gradual, positive progression in the emotional experience of each therapeutic journey.


Feature in the Baltimore Sun. Read it here.

Looking Forward

Luckily, I found the process of working the Worry Quest prototype to be extremely fluid. When I was stuck on one idea, I was able to pivot to another, enabling me to try countless ideas until something clicked. I’m proud of being able to define my own workflow and develop my own research methods while also incorporating proven user experience and therapy techniques. I admit that the continuous journey of trial and error was sometimes frustrating — it’s quite easy to get bogged down in the “right” and “wrong” ways to do product design — but I learned to break through that stagnation by making things, repurposing what I needed, and and getting rid of what I didn’t. If I wasn’t sure about where to head next, I deferred to my variety of super helpful and intelligent consultants, who were able to to push me further.

Drawings from exhibition participants

The most rewarding part of my work with Worry Quest has been, and continues to be, the positive dialogue about mental health I’ve been able to have with the public. Friends, family, strangers, therapists, and classmates have all told me that this is addressing a need and that it’s a novel way to approach mental health care. I’ve had folks come up to me after reading about my project to share an anecdote about how anxiety affects them or their loved ones in daily life. People were overwhelmingly willing to participate in my user-research exercises, and countless participants drew out their anxiety demons in my exhibition — so much so that I ran out of paper twice!

The community’s positivity and willingness to share are the forces that will keep me pushing this project forward. My goal for the immediate future is to pair with a developer to create a working prototype so I can test it with different audiences. Then I can make some refinements and eventually have it available in the app store. Hopefully, Worry Quest will become an accessible, invaluable supplement for mental health care and foster a community of people who are openly talking about mental health, sharing their demons, and helping both themselves and each other.

Exhibition participants drawing their demons

I know from my own experiences that battling anxiety is tough. It requires strength and persistence. The anxious brain can trick you into blurring the lines between reality and fiction, leaving you freaked out and confused. I’ve learned that, in an increasingly anxiety-inducing world for young adults, a tool that makes it easier — and possibly even fun — to fight back against these evil demons is needed more than ever. Why not make folks feel like their own brave heroes in the process?

Matthew is a recent graduate of the MFA in Graphic Design at the Maryland Institute College of Art in Baltimore.