Time to Get Better: Games and Mental Illness

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Time to Get Better: Games and Mental Illness

Let’s not mince words: videogames have a certain reputation in the mainstream, and it’s not a flattering one. Whether they’re whimsical and childish, or hyper-violent and brutal, videogames are an easy target for people looking to slap around popular culture or take pot shots at any of the past four or five generations. The sad truth is that it’s a reputation that games often deserve, especially when it comes to confronting issues of real consequence, and there’s no better example of that than the way the majority of games portray mental illness.

Mental illness is a very personal issue for me. My father has battled crippling schizophrenia his entire adult life, and as a result has opted to paralyze and stupefy himself with a numbing cocktail of prescription drugs rather than deal with the horror of unfiltered reality (actually, it’s a matter of opinion whether that’s the route my father chose for himself or if it was chosen for him by healthcare providers and other people in his life, but that’s an entirely different and very complicated discussion.) It’s not that prescription drugs are universally bad—they help a huge number of people, many of whom I know personally. My point is that his condition is so extreme that it left him with two bad choices, and he chose (hopefully) blissful stupefaction over a living nightmare. Watching this process has, as you might imagine, shaped my feelings about mental illness.

I’ve also been in a handful of romantic relationships with people battling various types of mental illness, and witnessed firsthand the destructive whirlwind of collateral damage to a person’s personality and relationships caused by intense mental duress.

Most importantly, I myself have struggled with anxiety and depression (and elements of my father’s illness) for almost my entire life, and the more we learn about people’s interior lives, the more I begin to suspect that almost every human being has experienced some degree of the ailments we wrap in that big euphemistic blanket “mental illness.” Perhaps it’s time to stop referring to issues like these as illnesses and start addressing them more as part of the core of the human condition, but I digress.

All of this is not to say that I’m uniquely qualified to judge the way mental illness is represented in videogames, but it does mean that it’s something I always put a lens on and examine closely when it shows up, and something that’s always interested me about our industry, especially as it spasms through its first real spurt of growing pains.

Like most mediums, when gaming was in its infancy it took an infantile approach to most issues, mental illness included (as did film, which still gets it wrong at least as often as it gets it right). We got silly tropes borrowed from other mediums, like the mad scientist (as portrayed by, say, Dr. Wily in Mega Man) all the way through the paper-thin psychos served up by games like Manhunt and Dead Rising. The most nuanced portrayals of mental illness we saw in videogames’ adolescence were killer clowns with chainsaws and Bond-villain-ish megalomaniacs.

As gaming has matured, though, the space it fills has broadened and we see more and different approaches to things like personal storytelling and social issues. Recent games are increasingly creating room where it’s not only acceptable to address serious themes like mental illness (or grieving, or sexual identity, or political repression), but also commercially viable.

This is an important step. It’s one thing for individuals to make games like this in the comfort and privacy of their own homes, never intending to release them to anyone but a handful of their friends. And, to be clear, I’m all for this, in the same way I support art therapy—I imagine making a deeply personal game (that makes you feel deeply vulnerable) can be a powerful and cathartic experience. But what I’d really like is for more of these projects to see the light of day, to follow in the footsteps of games like Depression Quest.

Depression Quest was lauded for its bravery, and rightly so, for presenting such a personal, difficult narrative in a medium where storytelling is so often an afterthought. Depression Quest is a piece of interactive fiction that gives players a taste of what it’s like to live with depression, offering them a menu of choices as they navigate the social landscape of someone suffering this most prevalent strain of mental illnesses. It works because it’s such an effective window into how someone being pulled constantly down by the weight of depression suffers through even the most basic interactions with other people, or the simple tasks that shape our daily lives.

It’s a very intimate, personal piece of art, and it will always be an act of bravery to expose yourself and your perceived flaws to a broad audience, especially when you’re simultaneously shining a light on an illness that’s associated so deeply with private shame and that’s still thought of by an embarrassing number of people as imaginary and self-indulgent. We like to talk about the progress we’ve made in terms of researching and treating mental illness, but as someone who’s seen the system operate and seen how people react to discussions like these, I can confidently say we have a lot of work left to do.

We are making progress, and I do think videogames are growing up. And it’s not just the independent space that’s taking strides forward (though indies are definitely leading the charge)—there have been vast improvements in triple-A games too. Just look at that most unlikely candidate for a mature, thoughtful presentation of mental illness, Spec Ops: The Line. A game that by all rights should be a forgettable SOCOM clone ends up telling a nuanced story about a descent into madness.

It’s an old story, another take on Heart of Darkness, but like Conrad’s semi-biographical novel it manages to convey how a deeply alien setting, far removed from all the comfortable touchstones we rely on to anchor ourselves, can slowly strip away a man’s mind and expose the naked core of his id. It illustrates how any unthinkably vast wilderness harbors an innate hostility to man’s sanity, which is actually a manufactured product of socialization and interaction with other human beings within the cultural structures of civilization.

It’s about as far removed from a game like Depression Quest as Call of Duty, but it’s a magnificent example of how games don’t have to center on global conspiracies or alien invasions, and can tell deeply personal stories about human nature and the psychology of their characters. Spec Ops show us that “going crazy” can happen to the best of us, that no one’s immune to the possibility of it, that somewhere in all of us there’s a (usually) well concealed instability.

It’s not all roses, though. It would be easy and very lazy to imagine a throughline from the earliest interpretations of mental illness, mostly to excuse the villainy of videogame antagonists (“We’ve got to stop him! He’s crazy!”), through slightly more complex takes, like presenting mental illness through the eyes of playable characters (like the protagonists in Condemned: Criminal Origins, or Eternal Darkness), to games like Depression Quest and Spec Ops. But we still regularly get videogame villains whose atrocities are excused because they’re “madmen,” who are two-dimensional cookie cutters and the result of either a tragic lack of effort or an even more tragic ignorance. We still, as a subculture, associate mental illness strongly with “evil.”

We need to do better, and I believe we can. I think that the audience that’s buying videogames, who we’ve underestimated the same way TV executives long underestimated their viewers, will appreciate the effort and show that appreciation in the most tangible way, by opening their minds and their wallets. I think that we’ll find, just as HBO did, and Showtime, and now every major over-the-air network, that if we make smart content for smart people we can perpetuate this renaissance and, God forbid, maybe even motivate some social change.

As someone with a personal stake (or several stakes, really) in where this trend drives us, I’m very happy to see this medium making progress. I don’t need, or even want, every game to be a personal exploration of some writer’s psychoses or interior struggle with whatever demons they’re wrestling; we all strive with our own issues and I do believe in the value of games as an escape hatch. But I need people like my father, like myself, to be represented in a way that feels three dimensional and fully realized. And it’s not just a selfish desire to be reflected in a realistic way, it’s also my need as a fan of storytelling and immersion to play games populated with characters that are believable, that feel like they fell out of the real world, not cookie cutter personalities that feel like they were spawned in a vacuum of ignorance.

This isn’t an appeal for social justice. It’s an appeal to make games better, to make them feel more mature and intense and like they belong at the big kid’s table. We still fuck it up more than we get it right where mental illness is concerned, we still get “psychos” with no motivations other than that they’re “crazy,” but for the first time since I started playing games I feel like there’s light at the end of this long tunnel. And it feels good.


Alan Bradley is a freelance journalist, vagabond, and aspiring ornithologist (some of these descriptors may not be strictly accurate). Find his work on GamesRadar or follow him on Twitter @chapelzero.

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