Featured Image - Tyler Ronan riding boat to Delos Crossing

5 Examples of Mental Health Representation in Video Games

Video games allow players to experience things that they could never experience on their own.

In recent years, developers have found more and more ways to create realistic depictions of mental health issues and solutions. This has given players a better understanding of what their peers go through on a daily basis, and gives people with mental health issues more support and reinforcement that they matter. As someone who experiences depression and anxiety on a daily basis, these few games created in the past 5 years have made an impact on a large number of people, myself included.

Warning: There are spoilers for each game here. Do not read if you plan on playing them.

Life is Strange

In DONTNOD’s award winning 2015 hit Life is Strange, Max Caulfield returns to her childhood home of Arcadia Bay, Oregon to attend the prestigious Blackwell Academy. After witnessing a man shoot her childhood best friend Chloe Price, Max discovers she has the ability to rewind time. Max uses her powers to solve the disappearance of Rachael Amber, a girl who Chloe fell in love with after Max moved to Seattle.

Max comforting Chloe after they find out the truth about Rachael
Max comforts Chloe after they learn the truth about Rachael | Screenshot taken from Life is Strange

Chloe depicts many different signs of depression, specifically related to abandonment. Throughout the game Chloe is shown to be stuck in life: she has dropped out of high school, taken up smoking, and she and her step-father are always at each other’s throats. In her most vulnerable moments, Chloe admits that she basically gave up on life after her father died and Max moved away. After this incident, she attempted to run away, started rebelling against her school and has developed suicidal thoughts. It was when she met Rachael that she was given a spark of hope. Chloe and Rachael planned to run away to Los Angeles and start a new life. When Rachael disappeared this sent Chloe back a few steps, although with the newfound determination to find her missing friend.

Stardew Valley

Stardew Valley is a game about an office worker who gets tired of the city life and retires to a farm that their grandfather leaves them. You arrive at the town of Stardew Valley ready to start your new life. You must clear the land and prepare it to be farmed, raise animals, fish, and mine in order to create a successful farm. The game also features a social system where the player can interact with their fellow townsfolk and even enter relationships with them. One such townsfolk is Shane, he lives on his aunt Marnie’s Ranch with Marnie’s niece Jaz who he looks after.

Shane appears to have 5 o’clock shadow, old worn-out clothes and is not very nice to anyone who attempts to talk to him. He works at the local JojaMart every weekday and then can be found in the pub drinking or at home drinking. If you choose to develop a relationship with him you will find out that he suffers from depression, which he uses alcohol to treat. This has worsened his mood and affected his relationship with Marnie and Jaz. Several times Shane can make suicidal threats that he never goes through with. However, once the player has developed enough of a relationship with him, they will find him drinking on a cliff. One of the responses he can give if the player confronts him aggressively about his drinking and attitude is that he should just jump off the cliff there and then. Regardless of the outcome of this event, the player takes Shane to the hospital, where the doctor suggests that Shane quit drinking. If the player furthers the relationship, then events will play out to find that Shane has switched from drinking alcohol to drinking soda, and he is using his extra money to pay for gifts for Marine and Jaz. He spends his spare time with Jaz or playing games at the arcade. This seems to have improved his mood since he will interact happily with the player and others from this point on.

Night in the Woods

Night in the Woods starts with Mae returning to her hometown after dropping out of college for unknown reasons. The game follows Mae around as she hangs out with her friends, runs errands, and attends local events. Eventually, it is revealed that Mae dropped out of college because she developed a dissociative disorder about half way through the year. Through conversation and her own thoughts that the player can navigate, she is shown to be quite depressed after dropping out, often talking aloud about how much of a failure she is to anyone who questions her on college. This is made worse by her parents putting pressure on her to attend and succeed in school, since she is the first of her family to actually attend a post-secondary school.

Some conversation that Mae makes indicates that she used to see a therapist about her anger problems after dissociating during a baseball game and beating a kid with the bat. The therapist suggested that Mae keep a journal to write down her emotions as a way to keep her anger in check, this had the other benefit of keeping Mae in the present and preventing disassociation.

Hellblade: Senua’s Sacrifice

Throughout Ninja Theory’s award winning game Hellblade: Senua’s Sacrifice, Senua experiences hallucinations that she believes are because of a curse but are really a product of a psychosis. The player is never really sure which hallucinations are real and which are not, this is helped by having multiple voices playing in her head, dragging her down.

Paul Fletcher, a professor of Neuroscience at Cambridge University, was one of the many experts contracted to provide input and work with the studio to create a realistic experience of psychosis. He recently talked at the International Video Game Summit on Mental Health, explaining the reasoning behind the choices made in creating this game.

Tell Me Why

In DONTNODs latest game, Tell Me Why, two siblings, Alyson and Tyler Ronan, return to their childhood home, which they haven’t been to since an incident that occurred there 10 years ago. They aim to sell the property so that they can finally move ahead in their lives. The game is set in the fairly relaxed small Alaskan town of Delos Crossing, where most of the characters live. Through their shared ability to see each other’s thoughts and recall the past, the twins relive the event that caused them to be separated. Tyler and Alyson remember the night their mother, Mary-Ann, died. Alyson stabbed Mary-Ann with a pair of scissors after she had threatened Tyler with a shotgun. This caused Mary-Ann to fall from the dock into the lake. Tyler decided to admit that he stabbed Mary-Ann in self-defense, in order to protect Alyson. The twins are found by the Chief of police Eddy, who takes the kids back to the police station.

Alyson gasping for air as she suffers from a panic attack
Alyson gasping for breath as she has a panic attack | Screenshot taken fro Tell Me Why

The courts decide that the twins should be split up and that Tyler should be sent to a Juvenile correctional facility. Eddy takes over guardianship for Alyson and sends Tyler to Fireweed Juvenile Detention Center in a nearby town. The courts suggested that Alyson and Tyler are not to be allowed to have any contact with each other. 10 years later the twins are 21 years old and reunite after they decide to sell the house. In those 10 years Alyson developed a form of anxiety over her involvement in her mother’s death. This included panic attacks and keeping to herself. Throughout the game, Alyson will react to others immediately and harshly, she will start to panic and try to escape stressful situations, and she will seek out her own methods of calm and peace. There is even a point in the game where she has a complete breakdown; which sees her run outside into the freezing cold weather, turn on her phone, and utilize a calm breathing app to help stabilize her.