Depictions of Mental Health in Games

[Moonface]

With May being Mental Health Awareness Month, it got me thinking about depictions of mental health in video games. So what games do you think do a good job of depicting a character struggling with their mental state in some capacity?

I have quite a lot of games come to mind that do this, and I found that pretty often it seems that PTSD is a pretty common thing to try and depict. Metal Gear Solid 4 does it, Dead Space does it, and so does The Last of Us Part 2. I can't speak much about MGS4 because I've only watched it and even then so much of it is batshit insane that the only reason I know it depicts PTSD is because I read about it on a wiki. Dead Space 2 however does it really well, with it really becoming prominent during the chapters that see Isaac having to return to the Ishimura, the setting of the first game. I know Dead Space 3 does a lot with mental health too but I don't know what exactly it's trying to do because I haven't played it and all I can remember is a lot of hallucinations.
The Last of Us Part 2 is a game that does it incredibly well also, despite not becoming apparent until the final stretch of the game. All it takes is a lamb to knock over a shovel in a barn for Ellie to utterly lose her shit and break down into a full panic attack while experiencing an incredibly traumatic (and far more dramatic) replay of Joel's death.

[Monocle]

Just finished one of those 3D CG visual novels you see all over Steam. They look like they're all about sex and nothing else but this particular one was very character heavy and story based. Yeah it had sex scenes but you could tell they weren't the focus.

It's about a guy who was depressed but finally started to move forward and has many other women but one in particular has depression and was suicidal. It depicts how others see her depression and how she herself expresses it verbally. She seems happy at many points and seems to be doing better but, in actuality, she isn't. The end of one of the chapters is her going to commit suicide and she's almost successful. Game even has warnings about not seeing those scenes if you're struggling and you can choose to skip them.

The author said he wrote the VN for hours daughter who committed suicide when she was a teenager. He wrote it to let others know how it is to struggle. That chapter with her attempted suicide killed me because I have friends who used those exact words she used.

"I'm making your life worse."
"I'm just so tired."
"I'll never be normal."

I cried preeeeetty damn hard honestly.

Dunno if anyone would want to read it but it's called Leap of Faith.

[Moonface]

@Monocle: I'm surprised the author felt a need to include any sex scenes in that game judging that it seems to be focused more on messages about suicide and mental health, which gives me an up front impression that it wouldn't need sexual scenes at all. Unless they're meant to be playing into the theme further with issues of body image or stuff like that maybe.

I could imagine a lot of games in the VN genre having a focus on mental health issues though since those games are so heavily character focused, perhaps more so than any other genre.

[Monocle]

@Moonface It's the curse of the genre unfortunately, especially the western 3D CG ones. It wouldn't have attracted as much attention without it. Once it got the attention, it didn't need it.

It does slightly deal with that theme though. One character doesn't like her appearance. Another character can't be her true self and is always on a role. One had to leave to protect someone she loved. They aren't a group of perfect people.

There's are hardly any scenes of sex though. Plenty of nudity but not much outright sex.

[Moonface]

Ah, I see. I wonder if the genre would ever get to a point where games can commonly become successful without needing sexual content in them to get a good amount of attention. The only VN style game I know of that's notable and didn't have anything sexual in it (to my knowledge) was Doki Doki Literature Club, but I vaguely recall it became notable due to going around on Twitch or something like that.

Thinking of games that deal with suicide outside the VN genre, the only one I know about that has anything involving a contemplated suicide is Metal Gear Solid 4. I wonder if suicide is just a rare thing to cover in AAA games or I'm just not aware of games in that space that do make a message with it.

[Monocle]

well, there's Phoenix Wright, Zero Escape, Steins;Gate, Clannad, and Danganronpa. None of those have and sex in it.

then the opposite, some of the biggest started as VNs with sex. Fate/stay night being one of the biggest IPs in the genre was a VN with sex.

while not AAA, notable games that deal with mental health are Celeste, Edith Finch, and Hellblade.

[ShiraNoMai]

I think one of my favorite depictions of mental health has to be the Feather scene from Celeste. I actually reference it for my own self-help whenever I have moments of anxiety that can spiral.
For those that haven't played or gotten to said scene, aside from the fact the game is a metaphor for overcoming a large mental hurdle, this scene shows Madeline having a clear panic attack and an NPC named Theo is there to direct her through it by teaching her to close her eyes and picture a feather floating and your breathing (inhaling and exhaling) made it fall faster or rise higher, the trick being to try and make it stay floating in a middle ground.

In the game, you do actually get to control this feather with inputs and keep it central to the screen.

There's also the obvious title, The Depression Quest, the infamous text adventure that spurred Gamer Gate to happen (it was made by Zoe Quinn). It's really well done, imo. Takes you through the realities of dealing with depression, with answers to scenarios become dead ends because the depression is too strong, or there are just no options present that have positive outcomes cuz your head is just too fucked to have such a option available to you, as is with real depression.

Another good depiction, depression and anxiety aside (as they are the most commonly represented imo) there's some neat autistic representation I've seen. Horizon Forbidden West is the most recent example I can think of, with a pair of siblings you encounter as bomb/explosive vendors. One of them is very clearly autistic coded with the way they have a very specific hyperfixation on explosives and even goes on a quest by themselves without telling anyone because they had an idea for a thing that needed to be addressed promptly. The neurotypical sibling misunderstood their intent and thought they had scared them off/insulted them and ran away, but when you find them, they had no such awareness that their actions were perceived as such.

[Moonface]

I think one of my favorite depictions of mental health has to be the Feather scene from Celeste. I actually reference it for my own self-help whenever I have moments of anxiety that can spiral.
For those that haven't played or gotten to said scene, aside from the fact the game is a metaphor for overcoming a large mental hurdle, this scene shows Madeline having a clear panic attack and an NPC named Theo is there to direct her through it by teaching her to close her eyes and picture a feather floating and your breathing (inhaling and exhaling) made it fall faster or rise higher, the trick being to try and make it stay floating in a middle ground.

In the game, you do actually get to control this feather with inputs and keep it central to the screen.

You just know if this game was ported to the 3DS that it would have had to use the feature of blowing into the microphone for this moment, and if it did so it would've been a rare case of blowing into the microphone actually having a good use in a game.

There's also the obvious title, The Depression Quest, the infamous text adventure that spurred Gamer Gate to happen (it was made by Zoe Quinn). It's really well done, imo. Takes you through the realities of dealing with depression, with answers to scenarios become dead ends because the depression is too strong, or there are just no options present that have positive outcomes cuz your head is just too fucked to have such a option available to you, as is with real depression.

Based on what you wrote here, I'm not sure how I feel about the idea of a game about depression having scenarios where it just ends because things are too negative. I get that it makes for a good representation of actual depression, but even in a sound state of mind I don't know if I'd cope well with getting presented with something that is nothing but bad and that's it. I'd hope the game would at least provide something helpful in those moments, even if it's just taking you back to reframe something from earlier so you can learn actual coping mechanisms in those moments and not just be left with "Well, everything sucks, game over" which is the impression your comment gives me about the game. I'm certainly not comfortable enough to go finding out for myself first-hand about what it actually does right now.

Another good depiction, depression and anxiety aside (as they are the most commonly represented imo) there's some neat autistic representation I've seen. Horizon Forbidden West is the most recent example I can think of, with a pair of siblings you encounter as bomb/explosive vendors. One of them is very clearly autistic coded with the way they have a very specific hyperfixation on explosives and even goes on a quest by themselves without telling anyone because they had an idea for a thing that needed to be addressed promptly. The neurotypical sibling misunderstood their intent and thought they had scared them off/insulted them and ran away, but when you find them, they had no such awareness that their actions were perceived as such.

I actually forgot about those two characters and thought you were going to bring up the one character in the main plot who clearly has a lot of struggles mentally due to the amount of abuse and controlling she's known for her entire existence, as well as how multiple times Aloy is unable to keep her cool in conversations with that character when those struggles come to the forefront, but Varl is never shown having any trouble with that same character. I liked how Aloy being unable to deal with that baggage is a mixture of failing to understand, conflicting personalities and showing that sometimes even when we want to help someone it's too much for us to deal with at times and isn't always the best approach, both for the person needing help and the person trying to help them. She doesn't ever give up, but she does recognize when she has to tap out and give the reigns over to someone else, or even rants about this other character "not getting it" to Varl who provides a good perspective of understanding for both sides in those moments, where neither is unjustified but also nothing will come from both being stubborn and not wanting to make a change that ultimately allows both Aloy and this other character to reach a better understanding. You can't always expect someone to change their stance mentally about themselves or a situation if you yourself are insisting on digging your own heels into the ground too.