Mental Illness Represented in Games

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HazardousCube

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The release of "Hellblade:Senua's Sacrifice" got me thinking. The game is presented through the eyes of someone who has psychosis and that made me realize that I can barely recall any games that show (let alone portray) Mental Illnesses (probably other than LISA:The Painful RPG). so tell me, are there games that portray Mental Illness or is this something that the Games Industry avoids like the plague. If there are games out there, which do you recommend?
 

Xprimentyl

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Spec Ops: The Line. If you haven?t played it, I don?t want to ruin it, so I?ll spoiler-ize it below and let you decide?

well, not entirely spoil; I?ll just say it has an extremely powerful portrayal of Post-Traumatic Stress Disorder.
 

Johnny Novgorod

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Spec Ops: The Line is a good recommendation.
A lot of horror games try to deal with psychological repression. Silent Hill 2 is the most engrossing, as far as I care. Also Rule of Rose, which is nowhere near a good game, but it has a very interesting take on childhood trauma and the effects of bullying.
 

Silentpony_v1legacy

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I always felt video games exaggerated the effects of mental illness for plot convince. What I mean is that when someone hallucinates, its sorta there, and mostly just a foggy memory. Rarely, if ever, do people actively hallucinate legions of demons, blood towers falling from the sky, the streets turning to hell's highway, their dog is not a 80000ft tall lava monster, they're punching something in the hallucination only to realize they're just sitting on the couch and none of that ever happened. Most of us just call that dreaming. And we're expected to believe these people are actively interacting with their hallucinations? The cyber blood rape daemon cuts them with its rage sword, and their body actually bleeds? They're physically hurt from the phantom sword and actually die? Why don't they ever just stop hallucinating instead? I die in dreams all the time, yet here I am, the world's best ghost typist.

Mental illness in games always seems so...interactable, so vivid and real. Not that mental illness isn't real, but someone with depression tell me, every time you look outside is it raining? It is literally always night, and raining? Do you, literally, never see the sun anymore and actually feel phantom raindrops on your skin when you step out? Because in video games, nighttime raining is shorthand for depression.

I've heard of mentally ill people who think others are monsters in disguise, sure. Lizard people, grays, werewolves, the works. Sure, good, great. Hell, some people even believe X and Y can be possessed!
But never have I heard of someone having a throwdown duel with Satan over the blood river of eternal pain, having lasting physical injuries from said duel, only to realize they've been cooking gumbo the whole time...
 

DoPo

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Johnny Novgorod said:
A lot of horror games try to deal with psychological repression. Silent Hill 2 is the most engrossing, as far as I care.
Well, they try to but it's not in a very realistic manner. Manifesting your demons as monsters doesn't happen too often in real life, as far as I know. And SH2 in particular deals a lot with the subject but, again, it's set in a literally magical setting - it's like a very dark version of Alice in Wonderland. And speaking of, there is Alice: Madness Returns which does deal with mental trauma but it's literally in Wonderland.

OT: There is Depression Quest which deals with (unsurprisingly) depression.

It's hard to do a fair representation of mental illnesses in media in general, hence why most try to avoid it. Some exceptions do exist like psychosis, schizophrenia and dissociative identity disorder[footnote]you may know it as "multiple personality disorder" which is the old obsolete term.[/footnote] which seem to be used more often than most others - psychosis/schizophrenia just tend to be the go-to for "crazy" (rarely is it even distinguished which one it is) which means that a character can be portrayed as being super insane or even having quasi (or more) supernatural powers of understanding. DID is also often lumped with schizophrenia, even though the two are not in any way interchangeable but if you need somebody who acts as a "double agent" in some capacity, then say they have multiple personalities and you're done with it. How or why are rarely discussed. Something else that crops up somewhat frequently in media is relatively milder things like sleep disorders - insomnia or sleepwalking. It's "safer" since it doesn't really need to delve a lot into it nor does it need to make the viewers uncomfortable.

Vampire the Masquerade - Bloodlines has three Malkavian characters. The Malks as a whole are all insane and two of the characters do manage to be shown decently. The third one has general "crazyness" and actual magical insane powers that seem to stem from psychosis/schizophrenia mixed with some other stuff. If you choose a Malkavian as a player character, they also get some semi-magical form of schizophrenia that manifests in weird speech patterns and the occasional ability to predict the future through that. So, not really "real", again.
 

Neurotic Void Melody

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The Town of Light: Based on the horrific true treatment of 1940's mental institutions, this one specifically focusing on one lady called Renee in Tuscany, Italy. Its' psychological horror is that of human nature in such times. It's not really a game for 'enjoying' due to evident reasons.

The Cat Lady: A bit more surreal, but having unintentionally seen a few clips of it recently, I really like the way it unapologetically dives headfirst into a deep depressive experience no other game I've seen dared to commit to. Quite hypnotic, unless you're averse to that kind of darkness. Yet again, not much a game for 'enjoying' as much as appreciating I guess?
 

Addendum_Forthcoming

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Xprimentyl said:
Spec Ops: The Line. If you haven?t played it, I don?t want to ruin it, so I?ll spoiler-ize it below and let you decide?

well, not entirely spoil; I?ll just say it has an extremely powerful portrayal of Post-Traumatic Stress Disorder.
It's more than just PTSD, but also an extraordinary case of depressive disorders leading to active hallucination and total dissociation (which can happen with severe depression). To the point you can make the argument that Walker already failed his mission, is actively disassociated from it after failing his commanders, and him 'reliving' the operation through Lugo and Adams. With Lugo representing his higher reasoning and perception of his better nature, and Adams his sense of practiced mental resilience, loyalty and his capacity to survive.

This is important when you take the natures of their deaths, when they happen, the dialogue they have between themselves (Lugo's "You know what this shit can do!" to Adams' "Adapt and Overcome.") and the fact that you only see Walker in the helicopter when it finally crashes.

You can even make the argument that Walker is the lone survivor of the 33rd. Him being a Delta operator is merely his attempt to find heroism in the entire sordid affair, and constructing a narrative whereby he might find a sliver of salvation but not truly being able to escape a sense of his pressing mortality and the weight of the extraordinary barbarism, chaos, and futility of their attempts to rectify their situation.

Spec Ops: The Line is one of those games I think it's impossible to spoil. Because once you get into it, you'll come away with your own explanation. Walker is twisted, but in a way that only experiencing his mind for yourself can make self evident.
 

Xprimentyl

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Addendum_Forthcoming said:
Spec Ops: The Line is one of those games I think it's impossible to spoil. Because once you get into it, you'll come away with your own explanation. Walker is twisted, but in a way that only experiencing his mind for yourself can make self evident.
Granted, but there?s to be considered the full impact of the final revelations; they lose some of their gravity if one knows the truth going in.
 

HazardousCube

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Silentpony said:
I always felt video games exaggerated the effects of mental illness for plot convince. What I mean is that when someone hallucinates, its sorta there, and mostly just a foggy memory. Rarely, if ever, do people actively hallucinate legions of demons, blood towers falling from the sky, the streets turning to hell's highway, their dog is not a 80000ft tall lava monster, they're punching something in the hallucination only to realize they're just sitting on the couch and none of that ever happened. Most of us just call that dreaming. And we're expected to believe these people are actively interacting with their hallucinations? The cyber blood rape daemon cuts them with its rage sword, and their body actually bleeds? They're physically hurt from the phantom sword and actually die? Why don't they ever just stop hallucinating instead? I die in dreams all the time, yet here I am, the world's best ghost typist.

Mental illness in games always seems so...interactable, so vivid and real. Not that mental illness isn't real, but someone with depression tell me, every time you look outside is it raining? It is literally always night, and raining? Do you, literally, never see the sun anymore and actually feel phantom raindrops on your skin when you step out? Because in video games, nighttime raining is shorthand for depression.

I've heard of mentally ill people who think others are monsters in disguise, sure. Lizard people, grays, werewolves, the works. Sure, good, great. Hell, some people even believe X and Y can be possessed!
But never have I heard of someone having a throwdown duel with Satan over the blood river of eternal pain, having lasting physical injuries from said duel, only to realize they've been cooking gumbo the whole time...
Well do you know of any games with a more subtle sense of Mental Illness?
 

Johnlives

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Depression Quest. Problem is there's no struggle. It's just pick the obvious best option and there we go.

Venom Snake's not doing too well in Metal Gear.

Max Payne has a few issues.

The Last of Us could also be argued. After all those people have lost, done and will never have many characters struggle with the world and how they connect with others.
 

Silentpony_v1legacy

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HazardousCube said:
No, not really. Mental illness isn't something people interact with, and video games are an interactive media. So...no.
The most subtle game I can think of is Silent Hill 2, and that has melted acid monsters, big titted nurse and Pyramid head charging about representing repressed memories, delirium, and depression.
Lot of people keep mentioning Spec Ops, but even that had ghosts and hallucinating corpses circa sixth sense. I don't have PTSD, sure, but I've never heard of a solider claiming the mummified corpse of a dead commander is sending ghost messages to him to commit warcrimes.
And that's about as subtle as video games get.
 

Mcgeezaks

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Yeah Venom Snake from MGSV suffers from dissociative amnesia and dissociative identity disorder, for understandable reasons. The whole quest line for Paz in MGSV is pretty amazing.
 

Johnny Novgorod

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DoPo said:
Johnny Novgorod said:
A lot of horror games try to deal with psychological repression. Silent Hill 2 is the most engrossing, as far as I care.
Well, they try to but it's not in a very realistic manner. Manifesting your demons as monsters doesn't happen too often in real life, as far as I know. And SH2 in particular deals a lot with the subject but, again, it's set in a literally magical setting - it's like a very dark version of Alice in Wonderland.
Not every fantasy journey is "like Alice in Wonderland".

Alice in Wonderland is about Wonderland, not about Alice. She doesn't learn, she doesn't change, she doesn't want anything, she gains nothing and loses nothing. She's just our eyes, a random visitor in a place that responds to her as a random visitor, and functions equally regardless of who visits. Even the journey isn't particularly structured around any developing motif - you could switch around chapters and it would all be the same, so long as the story starts with Alice going in and ends with her coming out.

Silent Hill 2 is about its protagonist, about what's going on through his head - not about Silent Hill. There is no Silent Hill 2 without James Sunderland, no matter the mechanism behind the titular town itself, because the game is entirely about him - what drives him, what haunts him, what he thinks he knows. SH2's story is entirely in James' head, the town is just an excuse for us to see it.

As for its "lack of realism"... in the end games are a work of fiction and "realism" is just another artistic choice, not a token of truth. My Neighbor Totoro wouldn't be a better movie if they swapped Totoro out for whatever he's supposed to represent.
 

DoPo

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Johnny Novgorod said:
Silent Hill 2 is about its protagonist, about what's going on through his head - not about Silent Hill. There is no Silent Hill 2 without James Sunderland, no matter the mechanism behind the titular town itself, because the game is entirely about him - what drives him, what haunts him, what he thinks he knows. SH2's story is entirely in James' head, the town is just an excuse for us to see it.
Yet, the game isn't about mental illness itself, either. You are saying that there would be no SH2 without James but similarly, there would be no external representation of his inner thoughts, fears, guilt and so on without the titular town. You don't get to observe him in a normal setting, you don't see him struggle with this in his own mundane way, you don't see him overcoming or being crushed by all of this in his day to day life.

Johnny Novgorod said:
As for its "lack of realism"... in the end games are a work of fiction and "realism" is just another artistic choice, not a token of truth. My Neighbor Totoro wouldn't be a better movie if they swapped Totoro out for whatever he's supposed to represent.
No, but it equally doesn't make the work of fiction a good representation of the subject. The inclusion of the elements from James Sunderland's pshyche does make the story and the themes SH2 explores more nuanced and deep but by no means makes it a better look at mental conditions in general. If that were the case, is Hatred also worth recommending? How about the movie Sucker Punch? They have mental problems in them but regardless of how complex the portrayal is, without that realism they are about equally useful.
 

Johnny Novgorod

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DoPo said:
Johnny Novgorod said:
Silent Hill 2 is about its protagonist, about what's going on through his head - not about Silent Hill. There is no Silent Hill 2 without James Sunderland, no matter the mechanism behind the titular town itself, because the game is entirely about him - what drives him, what haunts him, what he thinks he knows. SH2's story is entirely in James' head, the town is just an excuse for us to see it.
Yet, the game isn't about mental illness itself, either. You are saying that there would be no SH2 without James but similarly, there would be no external representation of his inner thoughts, fears, guilt and so on without the titular town. You don't get to observe him in a normal setting, you don't see him struggle with this in his own mundane way, you don't see him overcoming or being crushed by all of this in his day to day life.
Again, the town is just an excuse to dramatize what's going on inside the protagonist. Silent Hill is the catalyst but the story is entirely fueled by James and is about him. And it's a story about remedying an illness, not living with it. I'm not saying a slice-of-life about impotence and repression isn't possible, just not in the interest of this game in particular.

Johnny Novgorod said:
As for its "lack of realism"... in the end games are a work of fiction and "realism" is just another artistic choice, not a token of truth. My Neighbor Totoro wouldn't be a better movie if they swapped Totoro out for whatever he's supposed to represent.
No, but it equally doesn't make the work of fiction a good representation of the subject. The inclusion of the elements from James Sunderland's pshyche does make the story and the themes SH2 explores more nuanced and deep but by no means makes it a better look at mental conditions in general.
At no point did I say it was the perfect or ideal way to handle the themes the story wanted to handle, only that that's what they did and I value the story for doing it.
 

gsilver

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Actual Sunlight is one that deserves a look.
Probably closer to reality than most games that attempt it.
 

Gethsemani_v1legacy

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Silentpony said:
I always felt video games exaggerated the effects of mental illness for plot convince. What I mean is that when someone hallucinates, its sorta there, and mostly just a foggy memory. Rarely, if ever, do people actively hallucinate legions of demons, blood towers falling from the sky, the streets turning to hell's highway, their dog is not a 80000ft tall lava monster, they're punching something in the hallucination only to realize they're just sitting on the couch and none of that ever happened. Most of us just call that dreaming. And we're expected to believe these people are actively interacting with their hallucinations? The cyber blood rape daemon cuts them with its rage sword, and their body actually bleeds? They're physically hurt from the phantom sword and actually die? Why don't they ever just stop hallucinating instead? I die in dreams all the time, yet here I am, the world's best ghost typist.
While most games tend to go way over the top with their portrayal of delusions (Hellblade is a stellar example), psychotic people regularly interact with their hallucinations or delusions. I've met plenty of acutely psychotic people who think they are bleeding and desperately tries to staunch bleeding I can't see, or people who keep brushing imagined bugs of themselves or who gasp for air because they believe someone is poisoning the air. I've seen psychotic people eat imaginary meals or have long conversations with the news reader on TV (or the voices in their head). Someone who interacts with their hallucinations is one of the easiest ways to establish the severity of their psychosis.

Silentpony said:
Mental illness in games always seems so...interactable, so vivid and real. Not that mental illness isn't real, but someone with depression tell me, every time you look outside is it raining? It is literally always night, and raining? Do you, literally, never see the sun anymore and actually feel phantom raindrops on your skin when you step out? Because in video games, nighttime raining is shorthand for depression.
That's narrative convenience, but a lot of depressed people will tell you that the weather seems to be a sort of perpetual overcast with washed out colors. They don't remember or reflect on sunshine or thunderstorms or anything else, because what little they register of the weather is run through a lens of apathy and indifference. As an aside, feeling phantom raindrops would be a sensory hallucination and it is quite common for deeply depressed people to become psychotic. So yes, that happens, though their psychosis tends to be more paranoid in nature.

Silentpony said:
I've heard of mentally ill people who think others are monsters in disguise, sure. Lizard people, grays, werewolves, the works. Sure, good, great. Hell, some people even believe X and Y can be possessed!
But never have I heard of someone having a throwdown duel with Satan over the blood river of eternal pain, having lasting physical injuries from said duel, only to realize they've been cooking gumbo the whole time...
Then you haven't heard much. There's a pair of Swedish books written by a man who was treated for schizophrenia for many years and the nurse who treated him. In his book he details how he was Napoleon and was fighting demons in his kingdom to save the souls of all the patients from being dragged to hell. He describes this in very vivid detail, how he fights, hides and runs from these demons and how he involves the other patients to help him fight. The same episode in the Nurse's book recounts how he was either writing frantically on anything he could write on or was sitting rigid but totally silent in the common room.

As I said, games tend to go way over the top with how it portrays mental illness and more often then not they totally miss the mark. But psychosis is a terrible thing and many people who suffered psychosis and remembers it (many don't) will tell you that what they believed happened to them and what they think they did had absolutely no bearing on what they actually happened or what they did. To them they are in a race against time to disarm a bomb that will kill the royal family, to the nursing staff they are pacing awkwardly and binging coffee.
 

HazardousCube

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Xsjadoblayde said:
The Town of Light: Based on the horrific true treatment of 1940's mental institutions, this one specifically focusing on one lady called Renee in Tuscany, Italy. Its' psychological horror is that of human nature in such times. It's not really a game for 'enjoying' due to evident reasons.

The Cat Lady: A bit more surreal, but having unintentionally seen a few clips of it recently, I really like the way it unapologetically dives headfirst into a deep depressive experience no other game I've seen dared to commit to. Quite hypnotic, unless you're averse to that kind of darkness. Yet again, not much a game for 'enjoying' as much as appreciating I guess?

I never understood what it was about cat hoarding and crazy/homely women. I guess it signifies some type of personal deficiency, but why that animal and that type of woman idk. It's just an odd situation all-around.