Silent Killer: Mental Illness and Videogames as Therapy

By Carli Velocci | September 2, 2014 | 12:00pm

Video Games Features

Minutes after game developer Zoe Quinn got approval that her game Depression Quest was ready to launch on Steam, news of the death of Robin Williams by apparent suicide started spreading on social media. Therein lied a problem: Was the release too timely? Should she hold off? She took to her blog to explain why she ultimately decided to launch the game. It came down to the fact that people felt it was important despite the circumstances.

“Depression Quest has always been an attempt to make a tool to help people understand depression and reach out to others living with the reality of this disease,” Quinn said. “After agonizing over it and asking the general public, they’ve overwhelmingly responded with pleas to release it. Especially among depression sufferers.”

Beyond being just a game, Depression Quest, according to Quinn, is an experience for people to understand depression as an illness. It incorporates choices that demonstrate the indecision and the hopelessness, forging a realism that is eye opening for those who have never suffered from depression and creating a sense of belonging for those who have. For those who want to escape from reality in order to not face their depression, it’s a twist that tries to help people.

And it’s not the only one. Developers are putting down their experiences with mental illness, attempting to bring players into their world and to show others what it is like. In a way, games such as Depression Quest, Actual Sunlight and many others are bringing a form of therapy to players.

Matt Gilgenbach, developer of Neverending Nightmares, was one of these people. He created the game to explore his Obsessive Compulsive Disorder, which he says he suffered with in silence for 10 years. Having kept it inside for years, he decided to create a game that could not only get his thoughts out in the open, but could show other people what it is like to struggle with the illness.

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Neverending Nightmares

“I’m trying to illustrate what it’s like dealing with mental illness, so it has a really dark and oppressive atmosphere and I’ve actually been able to incorporate elements of things that have sort of haunted me due to mental illness into the actual game,” he said. These aspects include intrusive thoughts that work in the game similarly to how they do in real life, the horror bits adding well to a game about being in a home without a sense of escape. For him, it became more than just an experience of creating a game.

“I didn’t realize until I started that it’s really a great medium for communicating an experience because I could really design the game around certain emotions… that are things I struggle with because of mental illness. It’s been a great medium for me to express something I’ve struggled to express for a long time.”

Simon Karlsson, the developer of recently-Kickstarted game A Song for Viggo, said that part of the reason he worked on the game, which is about a family dealing with the loss of a child, is because of his own struggles with depression and a need to cement games in “everyday life.”

“If people have experienced similar aspects, like in the game, then I feel that they are not alone in this situation,” he said. “I kind of get mail every day from people that have lost their children talking about the project and how just the project itself existing kind of helps them in their own grief since it’s a difficult subject that people don’t often talk about.”

Will O’Neill, creator of Actual Sunlight, sought out to produce a work that mimicked his experiences. As he says, he wanted something that was about, as he calls it, a “middle 30s, overweight, depressed, spiraling toward nothing kind of lifestyle.” The game is dreary, with themes of suicide and depression, and the ending is bleak (and O’Neill wanted it that way, playing against more typical life-altering narratives,) but the issues it brings up are important. It resonated with people who played it despite the dark tone because it depicted something that few other games have attempted. O’Neill didn’t see it as therapeutic for him in the same way that Gilgenbach saw his game, but players saw it as hopeful.

Actual Sunlight

“I don’t really feel any better. I feel the same,” O’Neill said. “People who identify with it closely felt, I suppose, that it was kind of encouraging and kind of therapeutic, just to have something that resonated with them personally.”

If people can see their experiences mirrored on the screen or in art, then maybe they can seek out help or resources. Mental illnesses tend to fester in the minds of those who suffer from them. The subject is still relatively taboo in social circles and not fully understandable by people outside the field of psychology, the professionals that are around to treat. Those who suffer from mental illness often don’t get help for fear of ostracization and confusion about what is happening to them.

When I reviewed Depression Quest back in 2013 for Paste, I noted that, more than anything, the game is about spreading awareness, and either reaching out to others that have depression and providing them with motivation to seek help, or to serve as a learning tool for those who have no clue. Neverending Nightmares and Actual Sunlight don’t provide those tools directly, but they plant the seeds for people to notice the illnesses.

While not a source of therapy directly, videogames can be useful. In a more technical aspect, there’s Nevermind, an adventure horror title that utilizes biofeedback to affect gameplay. Developer Erin Reynolds and other members of Flying Mollusk are combining the game with Intel Realsense 3D cameras to track players’ stress levels. The more stressed a player is, the harder the game becomes. The environments become more difficult to traverse, for example, and they don’t calm down until the player calms down. Reynolds says that she’s not only excited for the game itself to be released, but she’s also excited for the “potential games have to help people with issues” such as anxiety, stress and post-traumatic stress disorders, working with behavioral professionals to go further down that route.

“The main goal is to help ‘everyday people’,” Reynolds said. “Bringing exposure to a lot of the psychological aspects of disorders and challenges that a lot of people have. Games are a really great way to open that dialogue and put people in each other’s shoes. That’s incredibly powerful and exciting.”

Like with any kind of therapy, playing a videogame that happens to tell a story similar to your own won’t always be helpful. They also don’t always help their designers. O’Neill emphasized that developing Actual Sunlight didn’t do anything for his mental health. But there’s the hope that maybe one person can see the serious subjects depicted in a game, realize others feel the same way, and that it’s okay to talk about it and get help or to seek support. Each of these developers mentions that they’ve gotten reactions from players, saying that the game has helped them in some way. Whether or not there is any professional value in using games as therapy, there is some benefit to some people. That could be enough.

Carli Velocci is a freelance journalist in Boston, Massachusetts. She has written for DigBoston and Gameranx and isn’t afraid of anything. You can find her on Twitter @revierypone.