Mental Health and Video Games
How Video Games Portray and Even Help Those Struggling With Their Mental Health
I’ve been an avid gamer for as long as I can remember. My earliest memory with video games is around age 5 or 6, sitting cross-legged next to my father on the living room floor of my childhood home. He had just bought Metal Gear Solid 2: Sons of Liberty for our Playstation 2 and I sat wide-eyed as my dad stealthily navigated his way through a tanker filled with enemies. Looking back, this may have not been the best game for a 5 or 6-year-old child to watch from start to finish but it remains one of my most beloved childhood memories and I warrant that game in particular for fostering my love for video games.
As I’ve grown older, my love for video games has flourished. I, like the estimated 2.7 billion gamers worldwide projected by 2021, love video games for many reasons. Of those many reasons lies the positive effects that playing video games has on my mental health. I have struggled with mental illness since my late teens and have received a series of diagnoses over the years. I am living with bipolar disorder and ADHD and managing my moods, finding motivation, and rising above my crippling depression is an everyday struggle. There are many days where I feel like I’ll never fully recover, sending me into a downward spiral that can feel nearly impossible to climb my way out of.
I Feel Like I’ll Never Get Better
When the Fight Against Depression Seems Like a Losing Battle
As constant as my struggle with my mental health has been over the course of my life, my love for video games has remained just as consistent. When I find myself especially depressed or anxious, video games have always offered a unique form of escape that makes it a bit easier for me to go on.
Sometimes video games offer a distraction, focusing my attention on accomplishing a goal or completing a challenging task and other times the good that a video game does for my mental health is even deeper than that. Every once in a while a game comes along that does everything right, speaking to the struggle of those with mental health issues in a way that is beautiful, supportive, and above all else, informative.
Today, I wanted to take some time to explore the portrayal of mental health in video games as well as the ways this particular form of art can provide aid to those struggling with mental illness. All too often, I see news articles accusing video games of inciting violence and further deteriorating the presence of mental health conditions. Instead, I’d like to touch upon something that is talked about far less: how video games help.
Video Games That Get Mental Illness Right
Let me start by saying that I am in no way suggesting that the gaming industry does everything right in regards to how mental illness is portrayed in popular games. There is still much work to be done and a slew of developers have yet to find the sweet spot when it comes to an accurate, informative, and destigmatizing portrayal of mental illness in their games.
Still, there are a number of video games out there that take on the topic of mental illness in a way that is enlightening and even helpful for those who are struggling. Here are a few video games that have something interesting to say about mental health.
*Important Note*: Please keep in mind that in an effort to explain what each of these games gets right surrounding mental health, I will need to include some spoilers. If you want to skip this section of the article so that you can experience these games spoiler-free for yourself, I’d encourage you to skip to the last section of the article.
Video games are a medium that can be effective in conveying more serious themes and storytelling when developers go the distance to do so. Celeste, a game by Canadian developers Matt Thorson and Noel Berry, encompasses the very real effects of mental illness in a way that isn’t seen nearly often enough in the industry.
The platformer, released in 2018, revolves around a girl named Madeline. There is only one goal in Celeste: assist Madeline in climbing to the top of Celeste Mountain in search of, well, something. It is made apparent in the game’s opening text that Madeline suffers from a combination of low self-esteem and anxiety.
As the game progresses, players will be introduced to another version of Madeline, cleverly named Badeline, who is a clear representation of her own mental illness. Badeline constantly berates Madeline for continuing on her journey, tinkering with the design of each of the game’s levels in an attempt to dissuade Madeline from continuing on her trek.
As players reach the end of the game, Madeline finally confronts Badeline. This moment, in particular, conveys a message that anyone struggling with mental illness will find empowering. As Madeline faces off with Badeline, she realizes that Badeline is far from a reflection of herself. Instead, Badeline encompasses all of the problems that Madeline must let go of in order to truly experience inner peace.
In a moment of true beauty, Madeline embraces Badeline, and the rest of the journey is completed with the two working together to overcome obstacles. Rather than letting her mental illness continue to define her or attempting to purge it from her life completely, Madeline embraces her flaws without giving them power to rule over her.
In this, we find what Celeste truly gets right about mental health: it addresses the reality of living with depression. In reality, depression doesn’t simply disappear after a period of self-improvement. Rather, depression is something that those struggling with have to continuously rise above. The key to happiness in life for those of us with depression is to accept it for what it is and do our best to overcome it just as Madeline does in Celeste.
While a variety of popular video games portray mental illness as something to be feared, paired with violence and villainy, games like Night in the Woods seek to offer a different approach entirely. This 2017 indie platformer centers around Mae, a 20-year-old cat who has recently dropped out of college only to return to her hometown.
Upon reconnecting with her friends from childhood, Mae begins suffering from a series of disturbing dreams. These dreams act as the starting point for Mae to investigate a mystery in her hometown. Upon first glance, Night in the Woods seems like a mystery game centered around a group of friends. In actuality, the game is all about learning to cope with mental illness.
Each of the game’s characters is grappling with their own mental health issues. Mae, our protagonist, experiences both anxiety and depression. In heightened states of distress, we see Mae even experience dissociative states. Angus and Bea both find themselves struggling with family relationships and past experiences of abuse. Though never confirmed in the game, it is heavily implied that Gregg, another of Mae’s friends, has bipolar disorder.
The exact mental health issues that the characters are struggling with are left to some ambiguity in the game and this is, as explained by the developers, a conscious choice. Scott Benson, the game’s illustrator and animator, explained in a Kotaku interview that this was a choice made in order to let the game progress more naturally. As he explained, the game’s developers wanted the game to be focused around the people that experience mental health issues rather than the issues themselves.
Regardless of ambiguity, Night in the Woods portrays the struggle with mental health issues beautifully through the conversations of the game’s characters. While many of these conversations involve the friends showing compassion to each other’s feelings and insecurities, there are other times where the characters respond more immaturely or judgementally. As the game’s developers explain, this can cause feelings of frustration for players of the game and that appears to be intentional. Still, there’s a purpose. As programmer Alec Holowka puts it:
“There are certain situations where Mae kind of fucks up, and I’ve seen some reactions from players who identify with that and some that are really frustrated, like ‘I wouldn’t do that!’ But I think that’s part of the experience sometimes of mental health, that you don’t necessarily feel like you can make the best decisions all the time. That there’s some aspect of you that’s going to make a bad decision, and you’re kind of struggling with that.”
As to what the developers of Night in the Woods want players to get out of their game? In short, Scott Benson sums it up best: they want players to have faith that there are always solutions to problems, no matter how hopeless a situation may seem.
“The idea is that there are some things that are really bad out there and there’s a lot of black holes that are innately devoid of meaning that you have to work to fulfill, but you don’t have to give up because of that,” Benson said. “There is hope. And sometimes that just means focusing on the day to day.”
While many of the games that best represent mental illness are indie titles, there seems to be a very real lack of AAA titles that get it right. That all changes with Hellblade: Senua’s Sacrifice, a title from developer Ninja Theory who self-describes the game as an “independent AAA game”.
The reason that Hellblade: Senua’s Sacrifice gets so much right about the depiction of mental illness is that Ninja Theory truly went the distance to offer an accurate portrayal. Upon setting out to create the title, Ninja Theory approached Wellcome Trust, a healthcare company in the United Kingdom, who gave them a grant. Ninja Theory’s goal was to offer an accurate depiction of psychosis and they set out to gather all of the facts to do so.
When creating the title, Ninja Theory worked closely with Paul Fletcher, a professor of health neuroscience from Cambridge University, as a consultant. Ninja Theory also took the time to speak with psychosis patients in order to gather the information they needed to offer the best representation of what it’s like to experience it and live with it. Though Ninja Theory originally intended for the development of the game to be an 18-month project, it soon turned out to be a three-year project. The result? A game that has a lot to say about mental health.
Hellblade: Senua’s Sacrifice is focused around Senua, a heroine embarking on a journey to redeem the soul of her lover, Dillon, after he is tragically sacrificed by Vikings who raided her village. In order to do so, she must journey into Hellheim and take on the underworld’s goddess, Hela. Throughout her journey, Senua is plagued with visions and voices. Conveyed through a series of flashbacks and conversations with what is possibly an imaginary companion, players experience the world through Senua’s eyes. As the player, you’re never quite sure whether the visions Senua experiences are real but the effects are still there.
Rather than being a “two-dimensional shell of mental illness” as Fletcher puts it, Hellblade: Senua’s Sacrifice puts players in the role of someone suffering from psychosis. In this way, the game succeeds in creating empathy for those that experience it. Despite the fact that the game won a slew of awards, the real impact of the game itself is the real area of interest here. Ninja Theory was contacted by hundreds upon hundreds of players who either lived with mental illness themselves or knew people living with it. All praised the developer for creating a realistic portrayal of the illness that they had yet to ever experience in another title.
All too often in video games, mental illness is portrayed as a concept that furthers a focus on horror and violence. While Neverending Nightmares may play like a horror game for those who have never experienced depression, those that have will undoubtedly draw parallels between the game and their own lives.
The game, developed by Infinitap Games, is focused around a character named Thomas. Neverending Nightmares is centered in a dark world that works to make the player feel helpless. Thomas even has trouble running for more than a few paces before being overcome by asthma. In the game, we find ourselves encapsulated in a cycle of Thomas’s nightmares where themes such as self-harm are evident.
It should be noted that Neverending Nightmares is far from an easy game to play and this is because of more than just the fact that it can be frustrating. The game is filled with disturbing imagery centered around topics such as suicide and self-harm. While this makes it a difficult game for many to finish, there is something special about it. The game is a raw, visceral depiction of mental illness in a world where the way we talk about depression is so often censored and the impact it has so watered down.
What is especially powerful about Neverending Nightmares is the fact that the game is drawn largely upon the inspiration of its creator, Matt Gilgenbach, and his own experiences with depression. As Gilgenbach described in an interview with GameChurch, creating the game was therapeutic and helped him work through his own experiences with depression:
It has definitely been therapeutic for me, because I feel like I am able to sort of open up my head and let some of the negative, horrible thoughts out. Making them tangible causes them to lose their mystique and power–their grasp over me. So it does feel really great to expressing my feelings and help those who are suffering from depression.
The main point of the game according to Gilgenbach? Fostering a connection with players on an emotional level. For those who also experience depression, like myself, Neverending Nightmares can feel like a glimpse into our own minds where we find some reflection of ourselves. While it is far from a pretty picture, Neverending Nightmares is a game that gets mental illness right all because it makes us feel like, despite all of the darkness surrounding us, we aren’t alone. As Gilgenbach says:
I do hope that Neverending Nightmares allows other people to connect with me on an emotional level. While it is not autobiographical, I don’t live in 1906 and carry a candle around, the emotions and even some of the imagery are very true to my experience. So I hope that I can connect with people and my experience will resonate with them and help them through their struggles or at least help them better understand mental illness.
How Video Games Help Those Struggling With Mental Health Issues
Now that I have shared a few of my favorite games portraying mental illness, it’s time to talk about how exactly video games help those who experience mental illness. In a world where video games so often get a bad rap, I think a balance is badly needed. There are, in many ways, benefits for those who experience mental illness when it comes to playing video games.
According to the report 2019 Essential Facts About the Computer and Video Game Industry, an estimated 164 million adults in the United States play video games. Of these, 63 percent of gamers play with others. When playing video games with others (either locally or online), we foster a connection.
According to both the experience of those experiencing mental illness and a slew of scientific reports, social isolation in people with mental health issues is not only common but significantly impactful on community participation, wellbeing, and recovery. We tend to isolate ourselves and breaking through that barrier and fostering a connection with others can feel nearly impossible.
Video games offer a way for us to break that barrier. Through engaging in online play, we foster a connection with others, sharing common interests and having fun. Considering how many of us choose to play video games with others, it seems it can’t be argued that video games offer a valuable chance for those of us who struggle with the urge to self-isolate to enjoy the human connection that is so impactful to our recovery process.
It is commonly believed that video games play a central role in stress management. There are a slew of games out there that work to offer a relaxing, enjoyable experience that can be largely impactful in not only reducing stress but anxiety.
Take games like Stardew Valley or Animal Crossing, for example. In especially stressful times, each of these games has offered me a way to plug in and wind down. Stardew Valley is a largely popular farming simulator game that creates no direct threats to how a player chooses to play the game. Your goal in Stardew Valley is simple: grow your farm, make friends, and enjoy adventures. You can play the game however your heart desires and, unlike many games, there is no consequence for how you choose to spend your time. This creates a relaxing environment that can have profound impacts on feelings of wellbeing.
Animal Crossing is another game that is an amazing way to relax and destress. With the most recent title in the series, Animal Crossing: New Horizons, having just released on March 20th, there has truly been no better time to get lost in the world that Animal Crossing sets you in. I, like many around the globe, have been stuck in the house for days upon days during these uncertain times. Although I have been able to keep a reasonably strict schedule in regards to my at-home work responsibilities, Animal Crossing has been invaluable for taking my mind off of the current state of our world. When I find myself starting to get anxious after looking at the countless breaking news notifications to bombard my phone throughout the day, I withdraw to the world of Animal Crossing where I can focus my attention on interacting with my friendly island neighbors and growing my island to my heart’s content.
Destigmatizing Mental Illness
Finally, video games are increasingly becoming beneficial to those with mental illness in one profoundly impactful way: destigmatization. In recent times, the way that the media portrays mental health conditions such as depression and anxiety has undergone a dramatic shift (as is evidenced in the popular titles I’ve highlighted here).
As Dr Matthew Barr, from the University of Glasgow puts it, there is great potential for video games to impact the way we view mental health on a large scale:
“That’s where the potential lies: in the experiential and interactive nature of games,” says Barr. “You can learn a lot by being forced to experience the (game-based) world from the perspective of another person — to be in their shoes.”
In a world where so many of us have felt like we were all alone in our battle against mental illness, it seems that new doors are opening even in the most unexpected of places. When I was young, watching my father play games like Metal Gear Solid 2: Sons of Liberty, I had no idea how mental illness would impact my life.
As I grew up and continued to love and play video games, I found myself yearning for games that spoke to me on a deeper level, games that were centered around characters who were just like me. Now, in 2020, I’m more optimistic than ever that I will continue to embark on new adventures and experiences with characters that I can relate to. That, in itself, makes all of this a little bit easier.