One of my regular routines is to complete a few rounds of Tetris before I sleep. I suddenly realised one night that I was actually playing the game to clear my head before sleeping. I often suffer from intrusive thinking that usually creeps in at night as my schedule doesn’t allow any other time. But by focusing on making patterns and clearing lines I was giving my brain time to process.
Long story short, I started thinking about Mental Health in gaming a whole lot more. From games that address it directly to the impact that games can have on our mental health. I called in the help of writers and friends to share their experiences. Hopefully there is something here for everyone.
Addressing Mental Health in Video Games
In 2017 I was asked to review a copy of, “Among the Sleep”. This was probably my first exposure to games where mental health was an underlying theme. My opinion of the game aside, I was very supportive of the drive to bring mental health into the spotlight. I then shortly after picked up a copy of Hellblade: Senua’s Sacrifice and the ball kept rolling from there.
Hellblade is a great example of a studio making every effort to address mental health. Working alongside University professors, treatment centers and even the Wellcome trust to make sure that their depiction of psychosis was accurate really resonated with me. It’s clear that more studios are embracing the inclusion of mental health issues in their titles. In many cases, making them the primary focus of a character’s story arc. Who doesn’t love a game where you can help a character grow over time?
The portrayal of mental health has certainly changed for the better over time. Where initially mental health stigmas were enforced, usually in a survival horror settings, we now see more rounded titles. Whether it is indie gems such as Night in the Woods and Celeste, to bigger studio offerings such as Life is Strange. Developers have worked hard to help push the idea, “It’s OK to not be OK”.
So what are some of OUR memories?
So my next port of call was to pester those I know and love. Considering up to 50% of people will suffer a mental health issue in their lifetime. I figured I probably should ask what experiences they had and were willing to share. It’s safe to say I collated a lot of responses, some are quoted and some paraphrased elsewhere.
Honestly, I used to play a lot of MMO’s growing up because it helped me handle my own depression. Allowing me to forget about any issues I was facing while playing. There’s a lot to be said for using games as escapism.
I remember vividly when Mom would come home from long days of school and work. The first thing she would do was bury herself in Dr Mario. I mean, she was super good at it, but it was more than that. She would slam the difficulty slider to maximum and play it until she cleared it. Years later I realized it was a coping mechanism. Helping her feel like she could organize her thoughts and unwind after stressful days. I used to be so frustrated that she monopolized the TV! But looking back, I’m glad she had a place to get all that stress out. She rarely wanted to play against someone else, it was all about her curing those viruses.
What does the Science Say?
OK, this is the paragraph where I mention the thing that a tiny group of non-gaming people want to hear. The WHO recently acknowledged gaming addiction as a mental health disorder. And this tends to be where the focus of video gaming and mental health lies. In fact, a number of studies have recently surfaced that support video games in associations with mental health!
Most recently, the University of Oxford published a study looking at actual game data during the pandemic. Studying games with online components, specifically Animal Crossing: New Horizons and Plants Vs Zombies: Battle for Neighbourville. What was important about this study was it addressed a big problem in collecting data. This study finally used actual player data as opposed to asking people to complete surveys, a first of its kind.
What is quickly starting to show though is that certain games can have a positive impact on mental health. These tend to focus on titles which provide immersive, escapist or social aspects. Often combined with a sense of accomplishment or interaction. The study was also quick to point out games and situations that can still have a negative effect. The key message was that companies need to be less secretive with data. This will give us a more realistic picture of the impact on mental health.
Are the Negative Stereotypes fair?
The problem with most “studies” into the effects of gaming and mental health look at surveyed data of players, which isn’t ever as accurate as actual play data. But as it fits into pre determined narratives, it’s often something the media like to latch onto, particularly in the UK. With regular articles pointing to the violence and aggression of games and their addictive nature. But is this really fair?
Well obviously not, but we like to show both sides of the coin! If we look at the current negativity surrounding games and mental health then, unsurprisingly, it mostly casts a shadow on a small group of titles. If we just look at addiction in video gaming then the majority of more modern titles are ones with a common theme. Loot boxes, the scourge of every gamer, which are thankfully being challenged for what they are, gambling. Other titles beg the question, is it the game the player is addicted to or the escapism it offers? One is a problem for developers, the other a bigger question of society.
This negativity stems from what makes video games so appealing. The release of Dopamine as a reward for completing tasks! Developers build this into titles with short objectives that reward the player often, encouraging them to continue playing and, in the early days, paying into the arcade machine.
The other negative that comes to the floor often is the link between violent games and aggressive tendencies. Well there are certainly some links between certain games and negative moods, but there has never been a significant link to this. Yes, there are people who do bad things and they have a copy of Call of Duty on their shelf, but then they probably also had a box of cornflakes, ergo cornflakes cause mental health issues!
Video Games as a Force for Good
Tales of Symphonia was a very informative and transformative game for my brother and I when we were young. We played it back when we were in grade school, and the tale of perseverance through emphasis of the diversity between the characters really spoke to us. It really helped to form some of the morals and methods we use to live our every day lives. While it’s not a FANTASTIC game for young minds, it does teach you that even if there are differences, the heart is still the heart, and the greater good is something everybody can fight for
Context plays a huge role in determining the affect a game can have on mental health. Whilst there are plenty who will advocate against them, there are those who champion their benefits. Indeed, there is plenty of proof that games that promote social interaction and cooperation actually instill those virtues into the young people they encounter.
Studies in Singapore and Japan have both shown that playing “prosocial” games such as Super Mario Sunshine and Chibi Robo actually induced prosocial tendencies in a relatively short space of time. The opposite was also true though showing that the “tool” isn’t the issue but the application of it.
So what games are “good?”
This is almost as proverbial as “how long is a piece of string?” The real answer is that the type of game depends on the player, their interests and even the type of mental health symptom they are experiencing. For some, the fast paced puzzles of games like Tetris, Puyo Puyo or Columns provide a focus that can help organise thoughts and banish invasive ones for example.
For others, the immersive, story driven narratives of role playing games provides the escapism to another world. With clearly defined quests and objectives, their sense of accomplishment can often bolster a narrative that can be infinetly more impactful simply because the player is taking an active role in shaping the character and their world. Anyone who has played through Futaba’s story in Persona 5 can surely attest to the uplifting feeling that your interactions have in game.
And we can’t talk about games that help work through mental health issues without talking about the calming influence that certain simulation games provide. With so many staples from Animal Crossing to Stardew Valley, Story of Seasons to The Sims, the sense of control in an otherwise chaotic world means that the genre is seeing even more titles bursting onto the scene, like the more recent indie title Littlewood.
The scope of experiences is huge, and ever growing!
With my recent battle with PTSD I was constantly having flashbacks, intrusive thoughts and bouts of anxiety and depression. These were compounded with feelings of self blame, hatred and low self esteem. Suffice to say it was a real recipe for curling in the foetal position on the sofa! For me, Beat Saber was and is the perfect antidote. The fast paced nature, the haptic feedback and the customisation meant I had a sense of control but could also shut the world off completely and focus. Add to that the calorie burning and my sense of achievement skyrocketed!
Usually the “go to” response I receive when I talk about my mental health issues revolves around being “outside” and “exercise” but even these can be incredibly difficult goals to achieve. But once again, video games are on hand to help support those who may not feel comfortable in a public exercise setting or gathering.
Exercise games aren’t really anything new. We have been exercising digitally throughout the retro era. With games such as Wii fit and Kinect later on and finally Ring Fit Adventure. There are plenty of opportunities to release dopamine and serotonin without the need to worry about communal showers and sharing the cross trainer.
The more recent development is in VR technology. Which will only improve with age. The ability to fully immerse in a world and interact with characters on a more personal level is already integral in increasing the levels of escapism that many people crave. But with the inclusion of games such as Beat Saber, where the added, Tetris like, focus of hitting targets combined with the fast paced rhythm mechanics of Guitar Hero mean that both physical and mental needs are met with ease.
Final Thoughts and Thanks
This was one heck of a rabbit hole to fall down. I could spend, and indeed have already spent, countless hours pouring over research and anecdotes. I can safely say I have barely touched the surface and as such will have missed ideas and even games that might have helped people. For that, all I can do is apologise and ask you to share as much as possible. Mental health is something we will all have an experience with, but often won’t share.
If you ever feel you need more support, I urge you to reach out to local organisations, friends, family, anyone! Its OK to not be OK. I want to thank those people who shared their thoughts, feelings and experiences with me as well as you dear reader for accompanying me on this journey. I hope you found something of help.