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.
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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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