May is Mental Health Awareness Month, and as part of our mental health coverage, I spoke to two psychologists from Take This — a non-profit dedicated to reducing the stigma of mental health in the gaming community, as well as raising awareness of the areas in which games and mental health intersect — about all the good things video games can do for your mental health. You've probably heard all the bad ones already!
In fact, you may remember the lovely Dr Boccamazzo and Dr Kowert from last year's article on how to return to Animal Crossing after a long break without feeling guilty — but this time we chatted about the positive effects that video games can have on that lump of grey goopy think-meat inside of your skull, and how to make sure that their effects stay positive.
Everyone needs to calm down about video games
Dr Kowert starts off strong. When I tell her that I searched "mental health and video games" before the interview, and found a bunch of headlines about games making you depressed and lonely, she wastes no time, calling it "moral panic and clickbait," while Dr B just asks, "is there a way to properly represent big sigh in print?"
It's safe to say that psychologists have heard the headlines enough, and their counter-arguments are simple: Just because someone has mental health problems and enjoys playing games does not mean that the games are the cause.
In fact, people often turn to games as a way to escape or lessen those feelings. “What do people do when they’re feeling like hot garbage as so many of us do these days?" asks Dr B. "You do something fun. Video games are fun. They’re accessible.” People have "internal processes" that govern the way they feel, he says, which lead to "external manifestation" of those feelings. You feel sad, so you eat junk food; you feel stressed, so you play games. It doesn't mean that you're sad because of junk food, or stressed because of games. "Judging someone’s internal process by external behaviour is always going to be a bit faulty," Dr B tells me.
Dr Kowert says this is particularly a problem with parents and younger children, because children don't always have the experience and vocabulary to describe or understand their internal processes. "I see my child is feeling anxious or depressed," she says, "then I see my child is playing lots of video games, and I’m not seeing the processes that are happening internally in terms of his emotion regulation, or connecting with his friends, or whatever it might be — but what I’m seeing is, he’s playing a lot of games and he’s depressed. So, these two things must be related, but it’s not."
"Be curious, not judgemental"
If you're a parent that recognises this behaviour in your kids, though (or even if you're a friend or a partner of someone who seeks solace in games), what can you do about it?
"Be curious, not judgemental," says Dr B. "You want to learn about what they’re doing without inciting defensiveness on their part." If you understand why your child/friend/roommate/partner is gaming so much — maybe it's depression, anxiety, stress — "then you can work with it, instead of trying to stamp it out."
Distraction is helpful, avoidance is not
But on the flip side of that, it's good to be aware that distraction and avoidance look very similar from the outside. Distraction is good — Dr B describes it as "I need a break from this right now so I can handle it later" — but "avoidance is going la la la la la. I can’t do this. La, la, la, la, la," which just leads to you not facing and dealing with your problems.
Dr B says that the key to finding out the difference is to ask yourself, or your child/friend/roommate/partner: "Are you taking a break because you need a really long break because you’re that overloaded, or are you taking a break because you don’t think you can handle what you’re avoiding?"
Dr B even has his own extreme example of how distraction can be life-changing, as he told me a sweet story about his childhood:
"I was diagnosed with Crohn’s disease and the diagnosis process was very, very painful. Without getting into details, after one particularly horrific [procedure] that was just ridiculously painful, my mum took me to a local store that sold video games in the Seattle area and she pointed out to the original, you know, the Game Boy games and said, "go pick one".
"The original Kirby’s Dream Land just came out, and I was super excited… she bought it for me and when we went to her office and I sat down with my Game Boy and I started playing this just amazing game, I don’t know, all the bad stuff that just happened to me an hour or two prior disappeared and for that time, everything was okay. Everything was hopeful, and I got to feel on top of the world, and as I was playing this game, all the excruciating pain just melted away."
Games can provide agency to kids (and adults!)
One of the reasons distraction through gaming is so powerful as a tool for people is that it can make us feel powerful. Not just because we get to play as a supercharged beef-man who can punch through walls, but because it provides structure, agency, and control — things that many people with mental health conditions lack or struggle with in their day-to-day lives.
Dr B describes his own childhood as an "undiagnosed autistic": "I certainly didn’t get my peers, my peers certainly didn’t get me," he says. He found solace in Nintendo Power, the NES, and the SNES. "They gave me a sense of competence and accomplishment when I was in a landscape of confusion when it came to my peers. Video games had rules. They made sense."
[Games] gave me a sense of competence and accomplishment... [They] had rules. They made sense.
Dr Kowert highlights how online multiplayer games can also be a great way of communicating at your own pace, which can lessen the anxiety many people feel with real-world socialisation. "It’s not weird if there’s a delay in-between [messages]. It’s not seen as strange if you craft and recraft and make it perfect before you send it, because you have a million built in excuses... I was farming the grass, or the driver came by, or I was AFK [Away From Keyboard]."
And it's not just these "asynchronous forms of communication", as Dr B describes them, which provide a sense of control and agency — it's also the ability to construct your own avatar, dress them however you like, and act however you like.
"[Games] can help me construct my identity as I want it to be, or as I see myself, as opposed to the way other people expect me to be," he says. "[Autistic people] are constantly pressured to do what’s expected of us, instead of what is kind of our natural impulse to many of us — to stim, [or] many of us just want to dive into our special interests, and we’re suddenly in many cases overtly told, no, that’s bad."
Exploring tricky topics? Play a game about it
You probably already know this, dear reader, since you are into games enough to be on a dedicated gaming website, but video games are unlike any other medium. In fact, they're pretty much the only medium that offers the viewer control over the story, or at the very least, over the way they move through the story. The interactivity of games, and the role-playing nature of many of them, makes games a tool for teaching empathy through virtual "lived" experiences.
"Games are uniquely able to add game mechanics as an element in which to experience [mental health issues]," says Dr Kowert. She talks about how Hellblade: Senua's Sacrifice, a game that deals with psychosis, helped people better understand their friends and family members who suffered from the same thing. "People sent in comments saying, 'I played this game and now I understand what my sister goes through'," Dr Kowert recalls. "It is so emotional."
Other games to try out include Celeste, which tackles anxiety, depression, and self-doubt; Night In The Woods, which is all about a young college drop-out wrestling with her own depression and disassociation; and What Remains of Edith Finch, which has storybook-like renditions of substance abuse and self-harm.
Obviously, there's a caveat to this. "There is no definitive representation in media of any mental health challenge," warns Dr B, citing the nine different diagnostic criteria for depression, which someone needs only five of to be clinically depressed — meaning tens of thousands of different combinations. "You do not understand somebody’s experience fully just because you played a video game."
Be alone, together
A particular phrase came up during our chat: Alone together. This is a style of play, or even just socialisation, where two or more people are in the same space, doing different things. Maybe one of you is playing handheld Switch while the other watches TV, or maybe you're both playing Switch in bed — and it can sometimes feel like you're somehow doing socialisation wrong, because you aren't connecting.
You don’t have to be actively socially interacting to feel the social benefits of it
But the fact is, you are making a meaningful connection, and alone together (or "parallel play") is something that's been facilitated in a big way by technology. "You don’t have to be actively socially interacting to feel the social benefits of it,” says Dr Kowert.
Dr B highlights how parallel play and "alone together" socialisation can actually be a huge help for neurodivergent gamers: "For a lot of us, in a cooperative fashion if we’re moving towards the same goal, that is often so much easier than the sort of nebulous socialising that the rest of the world expects us to do."
You don't even have to be in the same room to be alone, together — Dr Kowert recalled a time when she was very alone, having just moved to California and gone through a breakup, but kept her community of friends through World of Warcraft:
"I had graduated from college and I moved to California to get my masters, and it was a very low point in my life. My romantic relationship was not in a great place, and I was moving to a new state where I didn’t know anybody, and I was starting a graduate degree, which is already stressful.
"The ability to take my laptop and take that with me and have my social community go with me and help bridge the transition from one state to another, one school to another, leaving a romantic relationship and not being in it anymore, was unbelievably invaluable."
Better living through gameistry
Games aren't just an education tool or a means of escape, either — we can gamify our entire lives to find better coping techniques.
As an example, autistic people and people with ADHD (Attention Deficit Hyperactivity Disorder) are more prone to "hyperfocus" on tasks, which is an intense period of doing one thing, often to the detriment of others. Games are really good for this. But why? And what can we learn from that?
"Games induce a state of flow," says Dr Kowert, "which is when the challenge perfectly meets the skill of the player.” Research done on ADHD gamers found that they were able to concentrate very well when playing games — but the wrong conclusion was drawn. "This was often framed as, "people with ADHD are more prone to game addiction"… [but] what we know more now is that actually, games are really good at inducing a state of flow, and flow is really good at holding concentration."
"When you think about it," adds Dr B, "[games are] a series of small, individual, novel tasks and challenges and that’s something that really hits people with executive functioning challenges… And if you can take that principle in real life and create shorter, manageable goals that are interesting to you that also have some sort of reward at the end, then that is a potential way of helping with that attention."
So, you heard it here: Make your life into a series of side quests, with potential rewards for doing things. It might sounds silly, or even childish, but who cares, as long as it works?
A big thank you to Drs Kowert and Boccamazzo for chatting with me again, and another thank you to video games, without which many of us would have really struggled.
Also, the kind doctors asked me to promote their upcoming Dr Mark Awards, which celebrate games that portray mental health in a compassionate way — nominations close on Tuesday, May 31st, and the winners will be announced at PAX West in September 2022. You can nominate games, and find out more about the awards, here:
Now, tell me — what has gaming done for you? Has it helped you get through a period of grief, or helped you better understand the wellbeing of those around you? Give us your stories in the comments!