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How can games engage with the complex realities of mental health?

From Celeste to Gris.

The idea of a video game about mental illness can feel like an oxymoron; we think of video games as fun, bombastic and progressive, and mental illness as miserable, colourless and static. But games that convey the experience of depression and grief – particularly indie games – have flourished in the past few years, both through exploiting the aptness of games for immersive, intimate, environmental storytelling and pushing the limits of the form, subverting our basic assumptions about what gaming is supposed to be and how it’s supposed to make us feel.

The elegant puzzle-platformer or dark visual novel about mental illness has become common enough to almost reach cliché status: examples include Celeste, Gris, Spirifarer, Night in the Woods and OMORI, all of which are beautiful and rightly praised. However, ‘depicts mental illness’ can be considered praiseworthy enough in its own right that we don’t think more deeply about the ways gaming jars with depictions of mental health, and how different games deal with that friction. What do games do well when conveying depression? What traps do they fall into?

Maddy.Watch on YouTube

Out of every common form of media, gaming is the one that makes you the most singular, important, and responsible. Music, film, television, radio and books all have rich and complex relationships with their readers, viewers and listeners, but there’s always a sense that the reel of tape would still be spinning, even if you weren’t there. Gaming is different: most games are designed to wrap themselves around you, to make everything feel like it wouldn’t be happening if it wasn’t for you. You solved the mystery. You saved the princess. You are this little world’s God. Defeating the game’s problems – or, at least, enough of them for the game to be satisfying – is both inevitable, storyline-wise, and entirely down to your skill and talent. When it comes to games about depression and grief, working within a medium with that kind of history is difficult.

Mental illness is personal and people can do personal work to improve it, but it’s also social and economic and chemical and random and cruel. It’s difficult to create any sort of game where things feel partly, but only partly, within your control, because that’s a lot of variables to deal with. The 2013 interactive fiction game Depression Quest, a pioneering example of a game about mental illness, seems initially to convey what I’m talking about: you can’t just brute-force your way out of depression. The best dialogue choices are initially locked away, because your character physically cannot make them. But playing it, I was struck by how, in a different sense, it still falls afoul of the logic that if you make the exact right choices when they arise – go to therapy, take meds – you will win at depression, even if the win-state isn’t problem-free.

That’s not me saying antidepressants and therapy aren’t helpful for depression. Quite the opposite. But games about depression can sometimes feel conspicuously fair. You hit predetermined obstacles at precise points, and you know that the game will let you overcome them. Maybe we need stories like that. But maybe they can make depression feel simpler, cleaner, than it really is.

Gris.Watch on YouTube

Games that treat depression, grief and mental illness as experiences more than challenges can avoid some of the common pitfalls around ‘fighting’ depression, in the same way that physical illnesses like cancer aren’t simplistically ‘fought.’ Visual novels, which decentre the player’s agency and resemble immersive fiction or film more than traditional gaming, are thus a good form here. But more active puzzle games do have fascinating potentials for depicting mental health. Gris, a dialogueless platformer about a girl’s grief after her caregiver’s death, does something novel with directionality: you move sideways and downwards and upwards through different areas, but you never have a good sense of where you are in the world. The environment gets richer as you progress, but you don’t start at the bottom and work your way upwards to a visible goal. Progression can involve sinking or being thrown into unknown areas, too. Gris still falls into the idea of moving upward and away at the end – Gris climbs up into the clouds, supposedly leaving the world of grief behind – but the desire to depict grief and depression can lead to new ways to move through a game, as you try to balance the ability to grow and change with the rejection of a linear trajectory.

There are also regions of complexity and darkness that games can tap into by taking risks with negative player emotions, like frustration, boredom and anger. Games like Pathologic and Papers, Please! would not be the artistic experiences they are if they weren’t at times cruel, unfair and tedious, and if they weren’t willing to break one of the core assumptions of gaming: that you will be rewarded for your efforts. Thankless, morally good tasks in these games will not earn you good-boy points. Materially, you’ll probably be punished for them. There are no easy options, which means you enter rich, complicated worlds of profundity and empathy and difficulty.

I’d argue that the best games about depression aren’t about depression as a single person’s affliction, but are about the mental health repercussions of a community’s struggle, which is why adventure game Night in the Woods is perhaps the paradigm for games about mental illness for me. It would have been so easy to make the game just about Mae and her struggles, but instead it’s about a community living within an economic depression, enmeshed within a web, helping each other, hurting each other, unable to escape by going away or by coming back. Every time I play it I’m stunned by how the same town can be a site of such warmth and such horror, which is maybe the most accurate representation I’ve seen of being in a community full of people struggling with mental illness.

We have reached something precious through the work of game developers who have bored down into the core assumptions of gaming, creating games that are willing to explore mental health, and to be quiet, experimental and challenging. It will be deepened further if we keep in mind the inherent tensions between a form that is meant to be enjoyable, protagonist-focused and satisfying and an experience that is distressing and diffuse, and if we don’t just turn being a ‘game about depression’ into chic indie cachet in a way that smooths out the spiky, risky, communal potentials of the genre.

If you need someone to talk to, the Samaritans are there to help. They can be called, for free, on 116 123 in the UK and Ireland, or emailed on / Lines are open 24 hours a day, 365 days a year.

In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at Befrienders Worldwide.

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