How Video Games Can Help With Depression

By Kotaku on at

By Joe Donnelly

I felt like Tony Soprano.

What was it he had said about therapy again? “This psychiatry shit. Apparently what you’re feeling is not what you’re feeling and what you’re not feeling is your real agenda.” His analysis perhaps a little crude, but I nonetheless agreed with its sentiment: how could I possibly be expected to describe to someone else, a stranger no less, something I couldn’t even explain to myself? So as I sat nervously on the edge of my chair opposite my counsellor for the first time, I couldn’t help but think of the mob boss from Jersey.

In 2008 my uncle committed suicide following a very private battle with depression. I found it very difficult to deal with the loss, and my own depression and anxiety which followed. I finally sought professional help at the beginning of 2014. My GP recommended a course of antidepressants, which was eventually augmented with counselling; a dual-pronged approach to restoring my mental health.

Up until then, taking medication had been easy. I’d suffered a little fatigue at first, but sticking to my pharmaceutical obligation after a few hours down the pub at night had perhaps been my biggest challenge. Counselling, on the other hand, was a different beast, entirely.

“Between one and six – six being ‘repeatedly’, one being ‘never’ – how often have you felt helpless this week?” was the first question on the Likert scale my counsellor handed me. I circled six, filled in the rest, and scored 22 in total. This was high, I was told. I spent the rest of my debut hour reluctantly speaking in broken thoughts and muddled memories as I struggled to communicate just about anything that was in my head. Week two was the same and week three not too dissimilar.

In the meantime, I was playing games. I’d written before about how video games helped me come to terms with my depression, but for some reason I’d never really appreciated that games could offer a helpful nudge in getting the most from my remedial treatment. I was well aware of the games that tackled themes of depression and anxiety, but I’d purposely avoided them, scared they might make matters worse for me. I was wrong.

Atrax Games’ Sym and Will O’Neill’s Actual Sunlight were two games in particular that I began playing. “Originally, we hadn’t planned for Sym to talk about depression, it was inspired by the art,” admits Atrax’s Sebastian Morando. “Our artist designed the black figure with only an eye and that was the primary inspiration. After that, we built a story around that piece of artwork.”

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Sym's side-scrolling layout makes the player explore light and dark.

The protagonist in Sym is tormented by a crippling form of social anxiety. Taking the guise of a side-scrolling puzzle platformer, the lead character must alternate between a light and dark abstruse world representative of his inner, reclusive self, and an external ‘real’ world. Francesco Lanciai, the game’s artist, compares this split persona to Yin and Yang, the two faces of the problem, suggesting the protagonist wishes to both live inside of his mind, but also outside of its constraints alongside others. Both worlds depict dangers that the player must overcome, and an inner monologue writ across the game’s abstract spaces serves to illuminate the anguish the character endures. “There is a little bit of me in it because I have had some problems,” continues Morando. “Especially when I was a teenager, when speaking with others. I think games have the potential to be more than games: they can talk about problems, they can explore things which are difficult to simply speak about.

“A game is something that can help people, even more so than books or movies because you are inside the world. Unlike other mediums [sic], you are surrounded by this world and you have to make decisions inside it.”

Will O’Neill’s Actual Sunlight takes a more obvious approach to depression by offering what he views as a “realistic” interpretation of an unmarried, isolated, video-game-addicted individual in their early thirties. Instead of depicting a character who has the means to eventually turn things around, the game’s protagonist Evan Winter spirals into a state of irrevocable mental illness, culminating in his suicide. Playing Actual Sunlight is a very sobering experience, particularly as it progresses cleverly towards its conclusion, forcing choices upon the player as if driven by an external force; in this case, depression and suicidal tendencies.

Those of a depressive disposition should play with caution, but O’Neill’s aim was merely to realistically portray something he could relate to – and something he was sure others could, too. “I did get a lot of responses from people who said: ‘I really feel like you’ve captured my life in the way that I feel about things,’” says O’Neill. “But a lot of the people who played, and a lot of people who wrote about, Actual Sunlight were not 30-something, single white guys in North America.

“It was far less specific than I thought, and I think that the way in which I depicted depression and the myopia it creates is something that resonated much further than I initially expected. That was really surprising to see. Also just the depth of resonance it had with people: I really felt like people would merely acknowledge that it was kind of what they went through, but a lot of people were saying it was exactly what they went through.”

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Actual Sunlight's protagonist, Evan Winter.

Following the release of Actual Sunlight, one thing O’Neill found particularly interesting was the comments sections of articles online. Almost immediately, players began posting thoughts and reflections relevant to their own real life experiences and how these related to their encounters with the game. O’Neill was writing and designing a game about his life, and he wasn’t trying to project a preventative message per se, but it was abundantly clear that Actual Sunlight had the scope to touch many more people than he’d first thought.

Suddenly, my therapy became comments sections. As naff as it may sound, it was true: the internet is plagued by spite and hatred and vitriol from individuals who capitalise on the anonymity of the world wide web, but here with Actual Sunlight this anonymity was working for good. If I was able to harness the emotions and set-pieces I’d played through in Sym and Actual Sunlight, I could better explain how I felt in real life. I didn’t know my counsellor outside the bounds of our one-hour appointment, therefore I could treat our relationship with the same mentality. I pulled upon the monologues from Sym and the helplessness of Actual Sunlight. The floodgates opened.

I’m from Glasgow, and Scottish suicide rates are worryingly high. In 2012, the suicide rates in Scotland were 73 per cent greater than those of England and Wales. Between 2009-2012 there were 3,059 deaths from ‘probable suicide’. Of those figures, 58 per cent had been prescribed at least one mental health drug 12 months prior to their death, and at least 20 per cent had been offered a psychiatric outpatient appointment in the 12 months prior to death. (Scottish Suicide Information Database, 2014).

These statistics unfortunately show that therapy doesn’t always work, but for me, although I never seriously considered suicide, both Actual Sunlight and Sym were invaluable support mechanisms while dealing with therapy, which was at first such a daunting prospect.

“I think the bottom line with it is that video games can address some of the issues of well-being,” says psychologist Berni Good, who specialises in how humans interact with technology. Good highlights how games in a more general sense can help people to cope, and why people are often drawn to games during tough times as a coping mechanism. “I keep coming back to the motivations of why people play games, and I think it’s similar to why people turn to these environments when things are not good. It will excuse them from the real world, and they can become immersed within games, particularly if it’s a game where there are characters involved and they get an opportunity to almost be someone else.

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More from the gameplay of Atrax Games' Sym

“We understand that this drive for attachment is incredibly strong when it comes to people engaging in media, particularly within interactive media. Essentially it’s a soft place to fall. I think the key is that it’s more about the sense of competence they can get when they’re in this virtual, fantasy-type world, in that quite often when people feel quite low, I would suggest that it’s this ability to be competent about something, when actually in the real world it almost feels like that ability to be competent is not there. If you make good progress in a game and you feel this sense of competence, it’s going to add to this sense of making you feel better, and lifting you out of yourself.”

Good mentions that some individuals who don’t play video games may struggle to understand this need for escapism. I ask her if it’s possible that when people delve into video games in times of crisis that they could be putting their problems off. “Yes, of course. There’s no research to suggest that’s the case – in fact there’s little research around this area at all. You tend to find that when things aren’t going well for people it’s so difficult to cope with everyday situations or everyday tasks, so certainly gaming is a form of escapism; a way to get away from things.

“There are bound to be people who will turn to [games] to avoid dealing with the raw emotions that they’re having. Actually, though, if that raw emotion amounts to: ‘shall I hurt myself? Shall I harm myself?’ or worse, a game could be a good distraction, would you not think?”

I’ve now successfully completed therapy and although I’m still completing my course of medication, I feel I’m well and truly on the road to recovery. In essence, there’s always hope. Writing about firsthand experiences can be self-indulgent, but if even one other person can relate to my circumstances, and perhaps seek help – the kind of help that video games can sometimes offer – then it has been worthwhile.

UK Samaritans: 08457 909090
US National Suicide Prevention Line: 1-800-273-8255