Depictions of Mental Illness in Video Games: Breaking the Stigma

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Editor’s Note: This article contains spoilers for Celeste and Spiritfarer and slight ones for Stardew Valley and Baldur’s Gate 3.

In story-driven games, you are meant to feel the weight of the choices you make, while challenging puzzle games and platformers might emphasize the idea of perseverance and accomplishing a goal set out for yourself. Video games have always been made for very specific audiences, and it is in these games where many people seek out reflections of themselves.

Mental illness is one such human condition that has broken into the gaming sphere. While mental illness has had a place within certain game characters and narratives for many years, games that form their entire message and story around specific experiences involving mental health have shifted the way in which gaming can be a platform for destigmatization. Video games usually have the intention of impacting the player in some way, and through representing aspects of ourselves that aren’t often talked about, this impact becomes even more powerful.

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In games like Celeste, a platformer by indie studio Extremely OK Games, anxiety drives the main character’s progression through the story and uses in-game mechanics to represent methods of coping with these intense emotions.

Celeste is about a young woman, Madeline, who aims to climb Celeste Mountain. On the way, we learn more about her struggles with family and her own self-image, which eventually manifests itself into the main antagonist of the game, a personification of her biggest fears named Badeline.

Badeline’s main goal is to stop Madeline’s ascent up the mountain, which reaches an extreme when Badeline physically takes Madeline down to the very beginning of her ascent. This occurs after hours of gameplay, and as the player, you begin to feel the same frustration and hopelessness that Madeline fights for most of the game.

After an intense fight with Badeline, who Madeline often refers to as “Part of Me,” you watch as Madeline falls down the summit, passing obstacle after obstacle, knowing that you will have to do it again. And so you do. After a moment of restarting the climb, Madeline says to herself, “She was right. I couldn’t climb the mountain,” and yet, just after that cutscene ends, the climb continues. 

Eventually, Madeline begins to understand that Badeline is driven by fear. She is, in its purest self, her own anxiety. When Madeline encounters Badeline again, she says, “I know you’re scared,” and eventually convinces her that they need to work together to reach the summit. With their powers combined, Madeline’s ability to climb the mountain dramatically improves. 

The goal of Celeste was never to fight Madeline’s anxiety—any conflict with Badeline only hindered Madeline’s own progress up the mountain. Instead, the game is about cooperation and understanding. Madeline had to make room for the parts of herself that she tried to ignore. With Badeline’s help, she could climb the mountain. Without it, she would only fall further down.

Other games are not so much about working through mental struggles as they are about what comes after. In Spiritfarer, you play as Stella, who takes on the role of transporting spirits to the afterlife. You meet spirits, build their temporary homes aboard your boat, and eventually help them through their past and struggles until they are ready to move on.

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The game mechanics of Spiritfarer are relatively simple. It is a management game in which you care for crops, cook food, and gather resources. You grow closer to the spirits aboard your ship through their quest lines, but you can still interact with them through other ways, whether it be through learning their favorite foods or simply giving them hugs. 

All of the spirits that Stella encounters knew her in their past lives. One such character is Jackie, who worked with Stella at a hospital before his death. Jackie struggled with burnout and depression during his time working at the hospital, which manifested dialogue in which he questioned the purpose of life. Jackie struggles with self-doubt until his journey to the Everdoor, the place where Spirits would fully cross over to the afterlife. On the journey there, Jackie thanks Stella for taking care of him, but also says “I know I didn’t deserve it.” While Jackie reaches a state of acceptance before he crosses over, as all the spirits you meet eventually do, he doesn’t eliminate his doubts.

Just as in Celeste, the internal struggles of the spirits that Stella meets are a part of them. After a spirit crosses through the Everdoor, their home still stays on the boat, empty. Eventually, a flower grows inside, reminding the player of the loss they’ve witnessed through a symbol of beauty. In Spiritfarer, none of the characters prepare for the Everdoor in the same way, and none of these characters heal in the same way. 

The first spirit you meet, Gwen, struggles with suicidal thoughts when she reaches the final stage of her terminal illness. Just as with every other character, the player, as Stella, helps them move on. Your character is the main method of healing for nearly every character you meet, yet the way in which you help Gwen isn’t by stopping her inevitable death, but instead it is by bringing upon acceptance. Overall, Spiritfarer addresses the complexities of mental illness purely through the nuances of grief and loss.

The game establishes that there is no set solution, and there is no one-sided depiction of the mental struggles that these characters go through. The characters don’t all solve their own issues, yet in some way, all of the spirits heal and all of the spirits move on.

Depictions of mental illness are becoming exponentially more represented in video games, even in games where the core story does not revolve around one character’s struggles and internal thoughts. Many games lightly touch upon the topic of mental health through their side characters.

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In Stardew Valley, the character Shane struggles with alcoholism and depression, while Kent, a character who doesn’t arrive until Year 2 of the game, experiences PTSD from his military service. 

In newly-released Baldurs Gate 3, you navigate through the main story alongside many characters with traumatic backstories and personal baggage. As the game progresses, they reveal more about their pasts and you, as the main character, move alongside them as they learn how to heal and survive in a world that they don’t exactly fit into.

While different games include depictions of mental health to varying extents, it is undeniable that all of these depictions help change the way in which mental health is discussed. Misinformation and misrepresentation are some of the biggest proponents of the stigma around mental health, and video games represent a unique platform in which these experiences that not everyone has can be felt very intimately. It is extremely important for those going through these same issues to find characters and stories that they can relate to, but it is also just as important for these characters to heal. 

Overall, representations of mental health are incredibly important in all forms of media. Video games have the opportunity to reflect authentic human experiences, and through this, can rewrite harmful narratives around those who experience mental illness. While all platforms run the risk of perpetuating harmful stereotypes through poor depictions of mental illness, well-researched attempts to include positive representations of these human experiences can lead to more empathetic bystanders. Conversation is the driving factor behind destigmatizing mental illness, and through games that make its players feel truly seen, the conversation can move beyond the screen and into the real-life narratives of those around us.