Mental Illness

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deactivated-5d6bb9cb2ee20

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#1 deactivated-5d6bb9cb2ee20
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Mental illness is a controversial issue to begin with, even now, and video games are hardly the medium known for sensitivity and tact when it comes to dealing with issues- and yet, I'm gonna argue that there is no medium that is as well suited to exploring mental illness as video games are, in the end.

There are two or three reasons I think this to be the case, and they're based either on my own experiences with mental disorders such as they are, or my own experiences as a storyteller. To lay them down beforehand, I'd say it's because of two reasons: interactive response, and the atmosphere that arises from a fusion of multiple other kinds of media.

To get into the actual nitty-gritties, explored from both angles, that of playing the game when depressed, and that of depicting mental illness in a game. I'm also largely going to be restricting this post to depression, and to my experiences with it, because that is the only mental disease I have experience with, and I cannot presume to speak for the other diseases, or to others' experiences with them:

  • Interactive response is a very important one here- it's actually the most important one in my experience. Interactive response is important here, because mental illness in general, and especially the most widespread ones such as depression, wreak havoc on your attention span, often reducing it to almost nothing. This makes engaging with just about any media very difficult, if not outright impossible, because you have a general passive disinterest arising from an inability to focus on what you're doing.
    The nature of other media means this problem is endemic to them and unavoidable- a book will set its story up in the beginning chapters, or it will risk rushing through its major plot beats- nothing that can appeal to someone with a truncated attention span. Movies, ditto (though on a faster scale, ad with accompanying visual stimulus, I suppose). TV shows are more exacerbated than movies when it comes to this, but less than books.
    Video games aren't like this- they have immediate payoff in some form or the other even when they are slow with the story or slow with the gameplay, because one or the other thing can engage you right away. It's a widely derided Bioware quote, but I think it can be used here without cynicism- you push a button, and something happens. that's immediate reinforcement. That's necessary and important- depression at its fundamental level is a degradation of a sense of self to such an extent that even the smallest reinforcement can help as a coping mechanism. Video games offer that with an immediacy not found in other media.

    From a storytelling perspective exploring depression, video games are, again, more suited than any other form of media- but this is harder and more abstract to explain. The long and short of it is, mental disease is highly complex, and it is an interaction of multiple physical, physiological, neurological, and psychological factors. Generally speaking, no two people tumble down the path of mental illness in the same way- by definition, an exploration of mental illness needs to have that kind of variability taken into account, meaning a fixed path exploration, narratively or otherwise, cannot and will not suffice if one wishes to explore mental illness. The perspective of malleability, taking into account unique circumstances (or the illusion of variability, which is just as important, especially when you are the patient of the illness engaging with the media- if you think the media you are engaging with respects your unique situation, you will be more willing to continue your engagement with it) is very important. Only video game are capable of providing that experience (even if, admittedly, they largely have not).
  • Atmosphere from fusion. This was very hard to articulate, but I think the gist of the point here is this: video games are ultimately a fusion of just about every other form of media, or they can be, taking the best of literature, music, art, film, and even TV, and putting it into one package. They are suited to shoring up the strengths of all the other forms of media they encapsulate, while compensating for their weaknesses. From the perspective of a person suffering from depression playing a video game- I start playing either 999 or Persona 4 Golden while depressed, these are both games with slow starts, and they are practically novels- but where I would stop reading a novel with a slow start, I don't and can't stop playing 999 or P4G. Part of this has to do with the point mentioned above, which is immediate feedback (interactivity), but I think another important point to consider here is that the sum of literature, art, TV, film, and music can be greater than any one of them taken on their own- so even if the slow start of P4G or 999 should have had me tune out, I didn't and couldn't, because the music, or the visual stimulus, kept me engaged and kept me interested enough to continue on to those parts of the game where there was payoff- as a matter of fact, the payoff and reinforcement was greater because of the buildup and pent up investment, meaning it was more effective than the immediate feedback that video games usually constitute. But only video games could have retained attention long enough to have me stick with the story in spite of a slow start, because where in a novel, there's only text if the start is slow, and where in a movie, I have no control (or no illusion of control) over the pace of the story, in a game, each weakness of all other forms of media is compensated, and each strength amplified. You stay with the story, you invest more, and you get more payoff.

    From the perspective of exploring mental illness, we again come to the central conceit that mental illness has too many moving parts to be adequately done justice in any one form of storytelling. The big advantage that a story told via video games can have in this case is variable pacing, pacing left to the player- a movie trying to explore depression is limited by how much time it can spend exploring any one stage of depression, for instance, by its run time: a video game theoretically has no such restraint. I can spend as much time in the build up of the depression as I want, rushing through it if it is uncomfortable, or taking my time to truly understand it if I wish to.

So, TL;DR: Video games are absolutely the most effective and suited format for mental illness: they are best suited for someone suffering from mental illness, such as depression, because of their very nature rooted in their interactivity and the ensuing illusion of choice, and they are a fusion of all other forms of media, which helps them amplify strengths and cover for weaknesses. These same strengths also make them best suited for exploring mental illness, more than any other format in any case- at least ideally, such a perfect hypothetical video game that does so properly doesn't exist yet.

---

With all of this said: which video game(s) do you think explore(s) mental illness well? In my experience, I have found the following experiences particularly resonant:

  • Persona 3
  • Persona 4
  • Proteus
  • The Witness
  • Shadow of the Colossus

I am very interested in checking out Hellblade, because it seems to be tackling this issue.

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#2  Edited By A-new-Guardian
Member since 2015 • 2458 Posts

This is so wonderfully written I could only say hats off to you char.

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#3  Edited By jg4xchamp
Member since 2006 • 64037 Posts

Haven't played Proteus, not enough The Witness, But i'd say you're missing something if that game is about mental illness to you.

The notion that Persona 3, 4, and Shadow of the Colossus, and Shadow of the Colossus is one of gamings finest in terms of telling a story through the fucking gameplay, convey mental illness shit through systems, and in the case of the animes known as Persona 3 and 4, well? Get the **** out. Consuming a bunch of darkness or whatever because you're trying to get puss or whatever, isn't exactly that subject matter handled with grace.

I'd say the only game I've touched that handled the subject in a somewhat tasteful manner was actual Depression Quest, the problem? It more or less fucking implies that you can overcome depression by just making the correct life decisions. Which is fucking insulting, and I'm sure it wasn't the actual intent, except that's what it conveys when the systems are presented the way they are in that game. I don't think video games are any better about reinforcing someone than any other form of entertainment. You just replace the joy of a video game, with stories that are genuinely positive, and endearing.

I think games can totally explore the subject matter, it's just you know it's not usually handled all that well, or it's done in pulpy shit like Persona were all the nuance of the subject matter is taken out. Because it's not really there for some greater reflection or to be thought provoking, it's there for basic entertainment and give a character a flaw or something.

Also "Atmosphere from fusion. This was very hard to articulate, but I think the gist of the point here is this: video games are ultimately a fusion of just about every other form of media, or they can be, taking the best of literature, music, art, film, and even TV, and putting it into one package."

^Imagine my level of disagreement lol

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#4  Edited By iandizion713
Member since 2005 • 16025 Posts

Pokemon GO helps cure depression by promoting sunlight and exercise. Nintendo be Boss.

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#5  Edited By uninspiredcup
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#6  Edited By deactivated-5d6bb9cb2ee20
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@jg4xchamp: I mean I do admit that the hypothetical game that does this can do this doesn't exist so far lol. I just think that hypothetically, video games at their peak could achieve something like that.

As for Depression Quest, that was a game I have been meaning to play for a while now, but I am now starting to have doubts about whether I should.

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#7 deactivated-5d6bb9cb2ee20
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@a-new-guardian said:

This is so wonderfully written I could only say hats off to you char.

Thanks buddy, this was a topic I felt needed to be made.

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#8  Edited By Maroxad
Member since 2007 • 23883 Posts

As someone who is mental. I agree to some extent.

Video games do indeed fuse the various elements together. The music, gameplay, and atmosphere design, can work together to provide a cohesive product to express emotions. They can empower the player, more so than any other medium, make the player go through relatable issues by actually taking part in these conflicts, and come victorious and stronger from the ordeal.

Games excel at self empowerment.

Edit: The game isnt out there yet... depression quest came the closest, but still was rather naive in its execution. Depression comes a lot down to hormones, and a if the hormonal balance is wrong, depression wont be overcome by merely making the right choices in life.

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#9 aroxx_ab
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#10  Edited By deactivated-5d6bb9cb2ee20
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@Maroxad: Self empowerment is what I find important and necessary for video games that helps distinguish them from other media when one is suffering from mental illness like depression. It's not even a conscious realization, but just the notion of you doing something and you getting immediate feedback from it is extremely reinforcing.

I have not yet played Depression Quest, I have wanted to- but it sounds like I shouldn't, at this point.

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#11  Edited By lamprey263
Member since 2006 • 44539 Posts

The thing about games though is only gamers seem to know how to play them, watching non-gamers trying to game is like watching a monkey trying to play, the movie medium is the most accessible medium, though I'd argue there that less and less people know how to watch movies these days. People always displaying poor etiquette watching movies like texting on their phones or talking. Nobody I know owns a sound system to go with their TVs either by choice or circumstance (like living in apartments with thin walls and shitty neighbors).

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#12 Sushiglutton
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Interesting and well written! Playing devils advocate there's of course a huge factor working in the other direction. Games are superb for escapism, which can mean that you play games instead of confronting that which gives you anxiety. This could lead to that you don't do the productive things you need in order to improve your situation in life. At worst gaming can be a massive time sink, almost to the extent that you do it instead of life. If so it's extremely harmful as negative reinforcement imo (you play games to ecape, which means your problems get worse, which means you need to play more games etc).

Anyway I thought of this dev diary for Hellblade as I read your post. :

Loading Video...

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#13 Moistcarrot
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Silent Hill 2 is a good game to play when depressed.

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#14 deactivated-5d6bb9cb2ee20
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@Sushiglutton: That's actually a very important point- games can provide small doses of self reinforcement, and that can get addictive and it can potentially cause the player to focus on that at the expense of all else and ignore things in real life that are potentially harder to face, with less reinforcement, more degradation, and longer, more sustained effort necessary than a game. In that sense, a video game is potentially the worst thing you could give to a person who is depressed and addictive.

I do find this an interesting counterpoint, mostly because I have an addictive personality, and yet when I was depressed, in spite of the escapism that video games were very clearly providing me with, I never found myself emphasizing them over dealing with my real life troubles- instead I used the reinforcement and ego gained through playing the games and used that confidence to tackle the issues getting me down in real life.

I imagine it varies from person to person, in that regard- but it is definitely an important point to note, the dark side of video game reinforcement during depression. It would be no different than alcoholism brought on by, and reinforced by, after reinforcing, mental illness, and that can be life rending.

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#15 Blabadon
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Have you played Actual Sunlight?

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#16  Edited By deactivated-5d6bb9cb2ee20
Member since 2006 • 82724 Posts

@Blabadon said:

Have you played Actual Sunlight?

I have not. I think I remember you recommending a game to me pertaining to mental illness once before, though, is Actual Sunlight it?

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#17 cainetao11
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@charizard1605: Well Max Payne 3 seemed to deal with Max's depression at one point.

But as someone with experience with depression, anxiety, bi polar disorder I'll concur. Sometimes I get low enough that I cant game. But other times the act of putting on a Halo game, playing the campaigns that I love, can lighten my mood within an hour.

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#18  Edited By Blabadon
Member since 2008 • 33030 Posts

@charizard1605: yes, although with the warning that the game can be controversial with what the writer says. I'd still recommend it.

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#19  Edited By R3FURBISHED
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I'd argue that a book/novel is still the best and most long lasting media for treating or allowing one to understand...well, anything.

With a video game everything is handed to you, it does not require as much use of imagination a page of text would -- where the reader must become actively involved in allowing oneself to be shepherded to another world (or actively involved in escaping that world). A video game, exactly what it is, what it wants, is presented directly in front of the player.

If you want an example, explore Flowers for Algernon. A form of mental illness explored from the perspective of the man himself as well those closest to him -- often hauntingly close.

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#20 deactivated-5d6bb9cb2ee20
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@Blabadon said:

@charizard1605: yes, although with the warning that the game can be controversial with what the writer says. I'd still recommend it.

I'll give that a go, then. Vita, yes?

@cainetao11 said:

@charizard1605: Well Max Payne 3 seemed to deal with Max's depression at one point.

But as someone with experience with depression, anxiety, bi polar disorder I'll concur. Sometimes I get low enough that I cant game. But other times the act of putting on a Halo game, playing the campaigns that I love, can lighten my mood within an hour.

Yeah, maybe it's the familiarity of inhabiting a universe we like, and the empowerment from immediate response, or maybe it's just the positive reinforcement and sense of control one gets from a game, games can definitely help as a coping mechanism.

I will add that I do agree with you- there have been some occasions that I have been too depressed to even play games, but yes, that is I suppose more about the extent and degree of depression at that point than it is about video games as a medium themselves (unless the popular stigma associated with video games somehow combines with a general sense of worthlessness, with one reinforcing the other, and that is what stops you from playing games).

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#21 Blabadon
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@charizard1605: yep, it's cheap and about 40 minutes. It's straight up about depression though.

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#22 deactivated-5d6bb9cb2ee20
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@R3FURBISHED said:

I'd argue that a book/novel is still the best and most long lasting media for treating or allowing one to understand...well, anything.

With a video game everything is handed to you, it does not require as much use of imagination a page of text would -- where the reader must become actively involved in allowing oneself to be shepherded to another world (or actively involved in escaping that world). A video game, exactly what it is, what it wants, is presented directly in front of the player.

If you want an example, explore Flowers for Algernon. A form of mental illness explored from the perspective of the man himself as well those closest to him -- often hauntingly close.

Thank you for the book recommendation. Now that I am in the later stages of recovery, I have started to try and build up my reading habit again (though I must admit that personally, my experience with depression wreaked havoc on my reading habit for precisely the reason you list above- my attention span was so truncated that I didn't have the patience, will or gumption to engage in something that required that much effort from me upfront anymore), and it's been coming along well (the good news is that I am still as fast a reader as I used to be if not faster- that was something I was proud of then, so it's good to see it still holds).

The book you mentioned, I looked it up, and it seems wonderful. It will probably be the next one I read once I am through with what I am reading these days, it sounds like it will be a disturbing experience, but also it is something that I feel I owe myself to read.

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#23 deactivated-5d6bb9cb2ee20
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@Blabadon said:

@charizard1605: yep, it's cheap and about 40 minutes. It's straight up about depression though.

Alright. My own list of games in the OP is admittedly one with 'forced applications' in that while these games are definitely good at storytelling, and they even have some thematic depth and meaning, they generally are not about depression as much as I have projected my experiences on to them, and find them to be fitting and applicable to depression as well. It will be interesting to see what a game that is about depression in a very straightforward manner will be like, though.

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#24 SolidTy
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Was this a portion of a paper/piece written and modified for school and then placed in this forum? It has a strong academic feel.

Regarding the issue, I'm of the opinion that gaming and other interactive media is worth exploring. That said, I think reading has always helped me most when I feel down.

As someone with quick reflexes, the kinds of fast paced games I like I find I get far too distracted by my own personal issues to competently enjoy the product. It's easier for me to get lost in books (passive entertainment) when dealing with grief or any mental issues I've had in the past.

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#25  Edited By SolidTy
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@charizard1605 said:
@R3FURBISHED said:

I'd argue that a book/novel is still the best and most long lasting media for treating or allowing one to understand...well, anything.

With a video game everything is handed to you, it does not require as much use of imagination a page of text would -- where the reader must become actively involved in allowing oneself to be shepherded to another world (or actively involved in escaping that world). A video game, exactly what it is, what it wants, is presented directly in front of the player.

If you want an example, explore Flowers for Algernon. A form of mental illness explored from the perspective of the man himself as well those closest to him -- often hauntingly close.

Thank you for the book recommendation. Now that I am in the later stages of recovery, I have started to try and build up my reading habit again (though I must admit that personally, my experience with depression wreaked havoc on my reading habit for precisely the reason you list above- my attention span was so truncated that I didn't have the patience, will or gumption to engage in something that required that much effort from me upfront anymore), and it's been coming along well (the good news is that I am still as fast a reader as I used to be if not faster- that was something I was proud of then, so it's good to see it still holds).

The book you mentioned, I looked it up, and it seems wonderful. It will probably be the next one I read once I am through with what I am reading these days, it sounds like it will be a disturbing experience, but also it is something that I feel I owe myself to read.

Yeah, I enjoyed Flowers for Algernon (I read it in grade school) and it's short too, so you can knock it out quite quick.

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#26 deactivated-5d6bb9cb2ee20
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@SolidTy said:

Was this a portion of a paper/piece written and modified for school and then placed in this forum? It has a strong academic feel.

Regarding the issue, I'm of the opinion that gaming and other interactive media is worth exploring. That said, I think reading has always helped me most when I feel down.

As someone with quick reflexes, the kinds of fast paced games I like I find I get far too distracted by my own personal issues to competently enjoy the product. It's easier for me to get lost in books (passive entertainment) when dealing with grief or any mental issues I've had in the past.

No haha, I actually wrote it on a whim and then just posted it within a span of I want to say ten minutes. I suppose I shall take that as a compliment then :)

I definitely do not want to downplay reading and its power, especially because my line of work is inextricably tied to literature as a medium, but I suppose in my own experience, my reading habit was the first thing to suffer and take a hit as my depression grew and my attention span fell. With that said, I do think you raise two important and interesting counter points: a) Reading is passive (at least on a physical level, I would argue that intellectually it is more involved than anything else), and during depression, that can have a strong appeal that endears reading over other forms of entertainment, certainly. Your second point regarding the preference in games is also equally important- a depressed person is not likely to feel up to playing a game like Street Fighter or Counter Strike much, and for multiple reasons- what you mentioned, certainly (or the counterpoint of feeling too sluggish and slow to keep up with the games; or conversely, having to deal with a toxic community detrimental to one's sense of self in case of a multiplayer game). I suppose in my case, it helped that the kinds of games I like playing (RPGs, adventure games) lent themselves well to my situation. But I could easily see it being different for someone else.

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#27  Edited By deactivated-5cf0a2e13dbde
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From having a severe panic disorder since I was 16, I do not want my mental illness to be explored in videogames. It is not cathartic for me to keep my panic attacks at the forefront of my mind, always talking about them and reinforcing that I am some sort of victim, or special for the affliction I have. I play videogames to experience different realities, to cut people down with medievil swords, laser guns, and nukes, not to realize I feel empty in crowds. Damn.

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#28 deactivated-5d6bb9cb2ee20
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@hillelslovak: I can respect that- video games are powerful tools for flights of fantasy and escapism. I can certainly see why them doing anything that may remind you of what it is that you are trying to escape from would be an unwelcome and unpleasant prospect.

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#29 deactivated-5cf0a2e13dbde
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@charizard1605 said:

@hillelslovak: I can respect that- video games are powerful tools for flights of fantasy and escapism. I can certainly see why them doing anything that may remind you of what it is that you are trying to escape from would be an unwelcome and unpleasant prospect.

It's not merely reminding me of my mental problems, but rather it seems games that deal with these issues tend to mythologize these issues.

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#30 deactivated-5d6bb9cb2ee20
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@hillelslovak said:
@charizard1605 said:

@hillelslovak: I can respect that- video games are powerful tools for flights of fantasy and escapism. I can certainly see why them doing anything that may remind you of what it is that you are trying to escape from would be an unwelcome and unpleasant prospect.

It's not merely reminding me of my mental problems, but rather it seems games that deal with these issues tend to mythologize these issues.

Definitely, there don't seem to be any games dealing with sensitive issues such as these with tact or respect. The ones I list in the OP for example are what I tend to think of as 'forced applications' in that they are not games about depression (in my case), but I can adequately project my experiences with depression on to them. But no, no actual game dealing with the issue with grace seems to exist (I was under the impression Depression Quest was it, but it seems to be hamstrung by its medium; Actual Sunshine is, according to Blabadon, controversial, so I don't know if I would list it here).

The problem is with games either downplaying these issues, or overblowing them- I suppose it is actually a problem with how society at large perceives them, but it is definitely jarringly apparent in games.

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#31 oflow
Member since 2003 • 5185 Posts

If anything video gaming is causing more harm than good in my opinion. Look at how the online gaming community embraces anti social behavior, bullying, sexism, racism and anonymous obnoxiousness in general.

Sure everyone in gaming doesnt act this way, but in general the bulk of the community accepts it as a culture norm. Like telling someone to 'die in a fire' or sexually harassment of female gamers is commonplace.

Gaming provides a safe haven for lots of people with mental and self esteem issues. Escapism is not always a good form of therapy. Not to mention gaming feeds addictive behavior.


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#32 Maroxad
Member since 2007 • 23883 Posts

@charizard1605 said:

@Maroxad: Self empowerment is what I find important and necessary for video games that helps distinguish them from other media when one is suffering from mental illness like depression. It's not even a conscious realization, but just the notion of you doing something and you getting immediate feedback from it is extremely reinforcing.

I have not yet played Depression Quest, I have wanted to- but it sounds like I shouldn't, at this point.

Indeed, and it is a lot of this psychology good game design can rely on. Help you escape from the real world anxieties, and perhaps even tackle them in a more controlled environment. And it will be you, the player who conquered them, not the narrative.

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#33 deactivated-5cf0a2e13dbde
Member since 2005 • 12935 Posts

@oflow said:

If anything video gaming is causing more harm than good in my opinion. Look at how the online gaming community embraces anti social behavior, bullying, sexism, racism and anonymous obnoxiousness in general.

Sure everyone in gaming doesnt act this way, but in general the bulk of the community accepts it as a culture norm. Like telling someone to 'die in a fire' or sexually harassment of female gamers is commonplace.

Gaming provides a safe haven for lots of people with mental and self esteem issues. Escapism is not always a good form of therapy. Not to mention gaming feeds addictive behavior.

Those problems are not the fault of the medium. That is the fault of the people who lack measure, and the milk of human compassion.

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#34  Edited By oflow
Member since 2003 • 5185 Posts

@hillelslovak: the community is a product of the medium so its partially the fault of the people that create the medium and nurture or ignore the effects of the medium they create.

We can circle around the argument eternally though. Its the same as saying guns dont cause violence.

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#35 cainetao11
Member since 2006 • 38032 Posts

@SolidTy said:
@charizard1605 said:
@R3FURBISHED said:

I'd argue that a book/novel is still the best and most long lasting media for treating or allowing one to understand...well, anything.

With a video game everything is handed to you, it does not require as much use of imagination a page of text would -- where the reader must become actively involved in allowing oneself to be shepherded to another world (or actively involved in escaping that world). A video game, exactly what it is, what it wants, is presented directly in front of the player.

If you want an example, explore Flowers for Algernon. A form of mental illness explored from the perspective of the man himself as well those closest to him -- often hauntingly close.

Thank you for the book recommendation. Now that I am in the later stages of recovery, I have started to try and build up my reading habit again (though I must admit that personally, my experience with depression wreaked havoc on my reading habit for precisely the reason you list above- my attention span was so truncated that I didn't have the patience, will or gumption to engage in something that required that much effort from me upfront anymore), and it's been coming along well (the good news is that I am still as fast a reader as I used to be if not faster- that was something I was proud of then, so it's good to see it still holds).

The book you mentioned, I looked it up, and it seems wonderful. It will probably be the next one I read once I am through with what I am reading these days, it sounds like it will be a disturbing experience, but also it is something that I feel I owe myself to read.

Yeah, I enjoyed Flowers for Algernon (I read it in grade school) and it's short too, so you can knock it out quite quick.

Really interesting book. I read it a long ways back. Check it out char

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#36 deactivated-5cf0a2e13dbde
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@oflow said:

@hillelslovak: the community is a product of the medium so its partially the fault of the people that create the medium and nurture or ignore the effects of the medium they create.

We can circle around the argument eternally though. Its the same as saying guns dont cause violence.

The community in a game cannot be the cause, as the people that form this community form other communities as well. People do not become assholes because they play a game, they bring their asshole nature into the game, and into the community. It is our society as a whole that encourages these sort of thought patterns and behaviors.

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#37 mmmwksil
Member since 2003 • 16423 Posts

I read your post. It was a good post. Can't say I share your thoughts on the matter, though.

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#38  Edited By oflow
Member since 2003 • 5185 Posts

@hillelslovak: I thoroughly beg to differ on this account. A game's community can definitely turn players into assholes. Any early pvp game that allowed griefing and WoW are both easy examples of games that did this.

The dynamics of the gameplay itself can easily change people's behavior. In most MMOs prior to WoW the communities policed themselves because your actions and attitude had consequence. MMOs prior to WoW often required grouping and following etiquette to advance. WoW made MMOs soloable and changed loot rules that effected how people behave. Like Ninja looting had no consequence in WoW in its infancy.

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#39 deactivated-5cf0a2e13dbde
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@oflow said:

@hillelslovak: I thoroughly beg to differ on this account. A game's community can definitely turn players into assholes. Any early pvp game that allowed griefing and WoW are both easy examples of games that did this.

The dynamics of the gameplay itself can easily change people's behavior. In most MMOs prior to WoW the communities policed themselves because your actions and attitude had consequence. MMOs prior to WoW often required grouping and following etiquette to advance. WoW made MMOs soloable and changed loot rules that effected how people behave. Like Ninja looting had no consequence in WoW in its infancy.

So, there is no responsibility on the people themselves? Are you not putting forth another one of the old "Violent videogames turn people violent." arguments?

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#41  Edited By MirkoS77
Member since 2011 • 17657 Posts

@charizard1605 said:

Mental illness is a controversial issue to begin with, even now, and video games are hardly the medium known for sensitivity and tact when it comes to dealing with issues- and yet, I'm gonna argue that there is no medium that is as well suited to exploring mental illness as video games are, in the end.

There are two or three reasons I think this to be the case, and they're based either on my own experiences with mental disorders such as they are, or my own experiences as a storyteller. To lay them down beforehand, I'd say it's because of two reasons: interactive response, and the atmosphere that arises from a fusion of multiple other kinds of media.

To get into the actual nitty-gritties, explored from both angles, that of playing the game when depressed, and that of depicting mental illness in a game. I'm also largely going to be restricting this post to depression, and to my experiences with it, because that is the only mental disease I have experience with, and I cannot presume to speak for the other diseases, or to others' experiences with them:

  • Interactive response is a very important one here- it's actually the most important one in my experience. Interactive response is important here, because mental illness in general, and especially the most widespread ones such as depression, wreak havoc on your attention span, often reducing it to almost nothing. This makes engaging with just about any media very difficult, if not outright impossible, because you have a general passive disinterest arising from an inability to focus on what you're doing.
    The nature of other media means this problem is endemic to them and unavoidable- a book will set its story up in the beginning chapters, or it will risk rushing through its major plot beats- nothing that can appeal to someone with a truncated attention span. Movies, ditto (though on a faster scale, ad with accompanying visual stimulus, I suppose). TV shows are more exacerbated than movies when it comes to this, but less than books.
    Video games aren't like this- they have immediate payoff in some form or the other even when they are slow with the story or slow with the gameplay, because one or the other thing can engage you right away. It's a widely derided Bioware quote, but I think it can be used here without cynicism- you push a button, and something happens. that's immediate reinforcement. That's necessary and important- depression at its fundamental level is a degradation of a sense of self to such an extent that even the smallest reinforcement can help as a coping mechanism. Video games offer that with an immediacy not found in other media.
    From a storytelling perspective exploring depression, video games are, again, more suited than any other form of media- but this is harder and more abstract to explain. The long and short of it is, mental disease is highly complex, and it is an interaction of multiple physical, physiological, neurological, and psychological factors. Generally speaking, no two people tumble down the path of mental illness in the same way- by definition, an exploration of mental illness needs to have that kind of variability taken into account, meaning a fixed path exploration, narratively or otherwise, cannot and will not suffice if one wishes to explore mental illness. The perspective of malleability, taking into account unique circumstances (or the illusion of variability, which is just as important, especially when you are the patient of the illness engaging with the media- if you think the media you are engaging with respects your unique situation, you will be more willing to continue your engagement with it) is very important. Only video game are capable of providing that experience (even if, admittedly, they largely have not).
  • Atmosphere from fusion. This was very hard to articulate, but I think the gist of the point here is this: video games are ultimately a fusion of just about every other form of media, or they can be, taking the best of literature, music, art, film, and even TV, and putting it into one package. They are suited to shoring up the strengths of all the other forms of media they encapsulate, while compensating for their weaknesses. From the perspective of a person suffering from depression playing a video game- I start playing either 999 or Persona 4 Golden while depressed, these are both games with slow starts, and they are practically novels- but where I would stop reading a novel with a slow start, I don't and can't stop playing 999 or P4G. Part of this has to do with the point mentioned above, which is immediate feedback (interactivity), but I think another important point to consider here is that the sum of literature, art, TV, film, and music can be greater than any one of them taken on their own- so even if the slow start of P4G or 999 should have had me tune out, I didn't and couldn't, because the music, or the visual stimulus, kept me engaged and kept me interested enough to continue on to those parts of the game where there was payoff- as a matter of fact, the payoff and reinforcement was greater because of the buildup and pent up investment, meaning it was more effective than the immediate feedback that video games usually constitute. But only video games could have retained attention long enough to have me stick with the story in spite of a slow start, because where in a novel, there's only text if the start is slow, and where in a movie, I have no control (or no illusion of control) over the pace of the story, in a game, each weakness of all other forms of media is compensated, and each strength amplified. You stay with the story, you invest more, and you get more payoff.
    From the perspective of exploring mental illness, we again come to the central conceit that mental illness has too many moving parts to be adequately done justice in any one form of storytelling. The big advantage that a story told via video games can have in this case is variable pacing, pacing left to the player- a movie trying to explore depression is limited by how much time it can spend exploring any one stage of depression, for instance, by its run time: a video game theoretically has no such restraint. I can spend as much time in the build up of the depression as I want, rushing through it if it is uncomfortable, or taking my time to truly understand it if I wish to.

So, TL;DR: Video games are absolutely the most effective and suited format for mental illness: they are best suited for someone suffering from mental illness, such as depression, because of their very nature rooted in their interactivity and the ensuing illusion of choice, and they are a fusion of all other forms of media, which helps them amplify strengths and cover for weaknesses. These same strengths also make them best suited for exploring mental illness, more than any other format in any case- at least ideally, such a perfect hypothetical video game that does so properly doesn't exist yet.

---

With all of this said: which video game(s) do you think explore(s) mental illness well? In my experience, I have found the following experiences particularly resonant:

  • Persona 3
  • Persona 4
  • Proteus
  • The Witness
  • Shadow of the Colossus

I am very interested in checking out Hellblade, because it seems to be tackling this issue.

Yo Char, that's one hell of a post bro. Point by point:

  • Interactive response: as someone who's endured Bipolar II since my late teens, I'm not sure I agree with this assessment. My depression robs me of all interest in the down periods, but that's not to say that I'm unable to focus on something once undertaken. It's just when my depression occurs, it is never undertaken. Impetus is the driving factor. It's simply getting to the point of acting upon my own volition, then all mediums relegate themselves distinct in their similarities but none distinguish themselves as more beneficial in addressing my depression than the other. The impact on my depression has absolutely nothing to do with the activity in which I partake in attempting to alleviate it. If it could only be so, I would be exuberant. Depression robs me of life. Of interest. It doesn't matter what it is, it doesn't matter what I do, and that is the true horror of this illness. Books, movies, gaming.....one does not sit higher than the other in rectifying what fundamentally transcends it in the first place. Depression is insurmountable.
  • Atmosphere from fusion: I mean no offense in saying this, but your whole argument seems to be predicated upon false premise: that mental illness can be treated or somehow subverted and benefited more through interactive means than passive ones (or any means for that matter). I don't think I can address your points specifically as all your examples fall under this umbrella. What you are saying is akin to saying that cancer can be treated through more "interactive" methods of cognition. Speaking as not only a survivor of Bipolar II but also of cancer since 20, this is a flawed assumption. Depression is a disease of the mind. A physiological impediment.

If I were to agree that depression were to be tackled by this medium in what sense it could best do it justice, it wouldn't be in any therapeutic degree. As it is a physical illness of the mind, it would be more about trying to enlighten the ignorant as to what it is like. I would love, for example, to see a game done about bipolar where it would demonstrate the dichotomy between hypo-mania and depressive episodes. Perhaps a combination of Ori and the Blind Forest, and say, INSIDE's aesthetic to lend insight into what the contrast of perspective is like. It would be great to see a game that varies in such temperament understood by only those held within the grip of its torment.

Truth be told, I don't know how healthy gaming is for depression. Speaking for myself, it is escapism. It affords me an avenue to avoid my problems. If it's to be argued that gaming is better than other mediums because they can retain our interest more, than it must be asked: to what end? To distract us from tackling pertinent issues? It's not like when I game it's getting to the core of why I'm depressed, I suppose the best that could be put forth is it retains attention, but even then depression holds a say.

But what exactly does that do for mental illness above anything else? It's a distraction, but I see no benefits.

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#42 Bigboi500
Member since 2007 • 35550 Posts

Does fanboyism count as a mental illness?

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#43 Heil68
Member since 2004 • 60702 Posts

Or games drive you insane due to difficulty, trolls or systemwars :P

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#44 me2002
Member since 2002 • 3058 Posts

But there could also be disadvantages.

Someone could get addicted to games they miss out on professional help, exercise, social interactions, outdoor activities and other stuff that helps with mental illness. It could become a form of escapism.

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#45 navyguy21
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One of the very few long posts that i enjoyed reading.

Well done and well written!

I also happen to agree 100%

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#46 jaydan
Member since 2015 • 8414 Posts

I would say the first few Dead Space games was a very interesting character study of Isaac Clark and his progression into post-traumatic insanity.

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#47  Edited By R3FURBISHED
Member since 2008 • 12408 Posts

@charizard1605 said:

The book you mentioned, I looked it up, and it seems wonderful. It will probably be the next one I read once I am through with what I am reading these days, it sounds like it will be a disturbing experience, but also it is something that I feel I owe myself to read.

You've never read it? Flowers for Algernon is amazing. I'd highly recommend it, but it is not happy and is difficult to read because of the material. (not to say it is a hard read, but it is very powerful)

But isn't that we're talking about? This is a story that will stay with you, in a very real way.

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#48 jaydan
Member since 2015 • 8414 Posts

Although, while your assessment is very well-written and carefully considered, I believe it's important to inquire that depression coping devices is purely subjective, and video game escapism is not going to work for everyone.

I can tell you this, and because I have had a long history with depression since I was younger - and I can tell you that video games are among the last things I ever care to put up with when I am in my most manic state, and I'd feel stupid with myself to even attempt to play a video game because it always boils down with a dose of existentialism that I am just wasting my time and that it is pointless.

The best way I can describe a truly depressed person, is the feeling of hopelessness in just about everything you do, and most particularly your favorite things no longer hold substantial interest in your daily life.

I think for me personally, movies or music are the best getaway, and I think that's most particularly both mediums have a far more robust pallet of mental stability and emotions than video games have ever attempted. Music can feel very personal and when I listen to a band or artist that sings about the things that aren't going right for them, it brings me solace to realize that I'm not alone on my struggles. The same is said for movies - there are films that study the human mind and there are amazing psychological studies out there, some more personalized than others - once again I find solace to relate to other people, whether they're fictional characters on screen or not. I can go out of my ways to find a movie or a song about a depressed man than I can find a video game that does the same thing. I'm not saying video games are incapable of providing such themes but so far most of them are either superficial and un-relatable or completely fantastical that they're not meant to relate.

Everyone has different coping devices, and those happen to be among mine (yet not always efficient because I too can feel hopeless and "pointless" indulging in them too). I also have known people who use books as their coping systems, and it's perfectly understandable considering books are the most vivid medium of all when they rely on one's own imagination.

Perhaps it has a lot to do with personal-wiring as well. For you, I can understand why video games work so well. Perhaps your input into a video game has the capacity of doing fantastical things and it makes you feel purpose? Whereas for me I only think about how I'm just wasting my day away - my chemistry might have a lot to do with feeling purpose too but I think for me my sense of finding purpose has more to do with what I can do for myself in my personal life not what I can escape to.

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#49 deactivated-5d6bb9cb2ee20
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@oflow said:

If anything video gaming is causing more harm than good in my opinion. Look at how the online gaming community embraces anti social behavior, bullying, sexism, racism and anonymous obnoxiousness in general.

Sure everyone in gaming doesnt act this way, but in general the bulk of the community accepts it as a culture norm. Like telling someone to 'die in a fire' or sexually harassment of female gamers is commonplace.

Gaming provides a safe haven for lots of people with mental and self esteem issues. Escapism is not always a good form of therapy. Not to mention gaming feeds addictive behavior.

See, there are two things to consider here:

  • Community, which I absolutely agree can be harmful further for a depressed person when they decide to play video games online, and encounter toxic people (indeed, this was something I did delve into a bit more in response to SolidTy's post earlier in the thread);
  • Nature, which is a trickier issue to navigate. I do agree that video games are and can be addictive, and I agree that the release from minor reinforcement can be pathologically addictive, leading to the illusion of feeling better without actually focusing on real life problems

The first point, I would argue, has less to do with games and more to do with people (and would be applicable to any medium where one has to encounter other people in any other capacity- admittedly in my own post, and in my own experience, I mostly restrict myself to single player games at large). The second point I absolutely agree can be an issue, especially for people with depressive personalities, and is something I did not consider at all as I made this thread.

@MirkoS77 said:

Yo Char, that's one hell of a post bro. Point by point:

  • Interactive response: as someone who's endured Bipolar II since my late teens, I'm not sure I agree with this assessment. My depression robs me of all interest in the down periods, but that's not to say that I'm unable to focus on something once undertaken. It's just when my depression occurs, it is never undertaken. Impetus is the driving factor. It's simply getting to the point of acting upon my own volition, then all mediums relegate themselves distinct in their similarities but none distinguish themselves as more beneficial in addressing my depression than the other. The impact on my depression has absolutely nothing to do with the activity in which I partake in attempting to alleviate it. If it could only be so, I would be exuberant. Depression robs me of life. Of interest. It doesn't matter what it is, it doesn't matter what I do, and that is the true horror of this illness. Books, movies, gaming.....one does not sit higher than the other in rectifying what fundamentally transcends it in the first place. Depression is insurmountable.
  • Atmosphere from fusion: I mean no offense in saying this, but your whole argument seems to be predicated upon false premise: that mental illness can be treated or somehow subverted and benefited more through interactive means than passive ones (or any means for that matter). I don't think I can address your points specifically as all your examples fall under this umbrella. What you are saying is akin to saying that cancer can be treated through more "interactive" methods of cognition. Speaking as not only a survivor of Bipolar II but also of cancer since 20, this is a flawed assumption. Depression is a disease of the mind. A physiological impediment.

If I were to agree that depression were to be tackled by this medium in what sense it could best do it justice, it wouldn't be in any therapeutic degree. As it is a physical illness of the mind, it would be more about trying to enlighten the ignorant as to what it is like. I would love, for example, to see a game done about bipolar where it would demonstrate the dichotomy between hypo-mania and depressive episodes. Perhaps a combination of Ori and the Blind Forest, and say, INSIDE's aesthetic to lend insight into what the contrast of perspective is like. It would be great to see a game that varies in such temperament understood by only those held within the grip of its torment.

Truth be told, I don't know how healthy gaming is for depression. Speaking for myself, it is escapism. It affords me an avenue to avoid my problems. If it's to be argued that gaming is better than other mediums because they can retain our interest more, than it must be asked: to what end? To distract us from tackling pertinent issues? It's not like when I game it's getting to the core of why I'm depressed, I suppose the best that could be put forth is it retains attention, but even then depression holds a say.

But what exactly does that do for mental illness above anything else? It's a distraction, but I see no benefits.

Thank you, I was really hoping you would chime in on the matter!

To respond, for the first point, I suppose I can only use my own experience here, and it is really interesting to see how it has been for other people. My experiences with my own (very severe, suicidal) depression did see me in the kind of stage you are describing (at my very lowest, I didn't have any interest in any media after all, given that I had no interest in even living, so interest in media seems trivialized by comparison there). However, once the mood started to recede a bit (but I was still in a depressive state, mind), I found myself unable to engage with any form of media still- and the one exception here was video games, which I could engage with. I imagine here that the holistic experience of a video game (in terms of the mechanics of, say, music and visual stimulus covering for slower stories, as an example), combined with the immediate reinforcement, kept my attention where books, movies, and TV could not (though over time, as my depression continued to recede, my interest in other media returned accordingly).

And I absolutely did not mean to imply that with my second point, so my apologies if it has come off that way! As someone who has struggled with depression for a very long time now, I agree about depression, as with all mental diseases, having actual physiological bases- my implication was not that, but rather focused more on coping mechanisms, and how I find video games to fit into that setup (as well as one possible explanation for the mechanics of how they might work). Simply put, given depression, I find video games to be a rather effective coping mechanism, and I was trying to break them down into their constituent parts to try and explain why that might be so.

I do want to discuss the final point you raise, which is the end goal of video games and depression (or any other mental illness): I do agree that games are escapism, and that that escapism can either be trite, or sometimes further detrimental to one in the throes of mental illness (in fact, the specter of addiction is something that others have brought up numerous times in this thread). However, I do think that any therapeutic benefits of video games can be utilized constructively, too- again, I can only speak from my own experience, but the escapism I got from games helped me keep the overwhelming negativity of my depression at bay, helping me cope, and the release I got from the immediate and long term payoffs from investing into video games helped me form a base to reinforce my ego and self on, which I then channeled into confidence in tackling with some of the real life issues that beset me at the time.

I do not claim my case to be representative, and I imagine there are a thousand thousand other factors at play, and no discussion can meaningfully account for all of them- but I do think that there is scope for games to be constructive for someone suffering from mental illness. My experience certainly tells me they are.

@navyguy21 said:

One of the very few long posts that i enjoyed reading.

Well done and well written!

I also happen to agree 100%

Thank you!

@me2002 said:

But there could also be disadvantages.

Someone could get addicted to games they miss out on professional help, exercise, social interactions, outdoor activities and other stuff that helps with mental illness. It could become a form of escapism.

Indeed, addiction is a very real threat, and an important consideration when it comes to this matter- and I don't imagine there is any way to tell beforehand who would or would not get addicted to the rush of video games (assuming they help) in a depressive state (with the benefit of hindsight, I can state with confidence that it is a wonder that I was not, given my addictive personality).

@R3FURBISHED said:

You've never read it? Flowers for Algernon is amazing. I'd highly recommend it, but it is not happy and is difficult to read because of the material. (not to say it is a hard read, but it is very powerful)

But isn't that we're talking about? This is a story that will stay with you, in a very real way.

I have not. From what I gather, it is reading material in the US school system. Unfortunately, that was not the case in India.

I shall definitely give it a read now that I know about it, however.

@jaydan said:

Although, while your assessment is very well-written and carefully considered, I believe it's important to inquire that depression coping devices is purely subjective, and video game escapism is not going to work for everyone.

I can tell you this, and because I have had a long history with depression since I was younger - and I can tell you that video games are among the last things I ever care to put up with when I am in my most manic state, and I'd feel stupid with myself to even attempt to play a video game because it always boils down with a dose of existentialism that I am just wasting my time and that it is pointless.

The best way I can describe a truly depressed person, is the feeling of hopelessness in just about everything you do, and most particularly your favorite things no longer hold substantial interest in your daily life.

I think for me personally, movies or music are the best getaway, and I think that's most particularly both mediums have a far more robust pallet of mental stability and emotions than video games have ever attempted. Music can feel very personal and when I listen to a band or artist that sings about the things that aren't going right for them, it brings me solace to realize that I'm not alone on my struggles. The same is said for movies - there are films that study the human mind and there are amazing psychological studies out there, some more personalized than others - once again I find solace to relate to other people, whether they're fictional characters on screen or not. I can go out of my ways to find a movie or a song about a depressed man than I can find a video game that does the same thing. I'm not saying video games are incapable of providing such themes but so far most of them are either superficial and un-relatable or completely fantastical that they're not meant to relate.

Everyone has different coping devices, and those happen to be among mine (yet not always efficient because I too can feel hopeless and "pointless" indulging in them too). I also have known people who use books as their coping systems, and it's perfectly understandable considering books are the most vivid medium of all when they rely on one's own imagination.

Perhaps it has a lot to do with personal-wiring as well. For you, I can understand why video games work so well. Perhaps your input into a video game has the capacity of doing fantastical things and it makes you feel purpose? Whereas for me I only think about how I'm just wasting my day away - my chemistry might have a lot to do with feeling purpose too but I think for me my sense of finding purpose has more to do with what I can do for myself in my personal life not what I can escape to.

Thank you for a very considered, thought out response.

I do agree that the entire issue is extremely subjective- especially given how mental illness involves considerations of personal nature and circumstance as well, at least when it comes to coping mechanisms, which can in turn influence what does and does not work for an individual.

You do raise an interesting point, which is that video games, largely, deal with matters that appear banal and trite when one is suffering from depression, and that engaging with such a story can seem a waste of time- other media, especially books and movies (and music, as you rightly point out) deal with more meaningful stories tackled in a more sensitive manner, so that those stories are more resonant with you on a personal level. Games by comparison can seem like a waste of time and add to the sense of general worthlessness and hopelessness, especially given the stigma that is generally associated with them. This also raises the question of when, if ever, games will tackle issues such as this with grace- I hope they do, because I find the medium's potential in tackling subjects like this immense (albeit so far, no such game exists, I agree).

I suppose it does come down to personal wiring more than anything else, though, I agree- what medium works for you as you attempt to cope is down to your nature and your circumstances, and there is no one correct catch all solution.

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indzman

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#50 indzman
Member since 2006 • 27736 Posts

@a-new-guardian said:

This is so wonderfully written I could only say hats off to you char.