Escapism & Mental Health: the Double-Edged Psychology of Gaming

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It’s been a long day at work. You’ve just come home from a gru­el­ing com­mute, an incom­ing dead­line, and a par­tic­u­lar­ly rough meet­ing for the week ahead. On any other day, you’d be able to han­dle the stress. But on the way home from work, you start­ed to panic. It came in short waves, just from the back of your neck. But then your hands grew numb, your stom­ach queasy. Your chest tight­ened as your breath­ing grew short.

At last, you reached home. You felt like you could bare­ly make it. Now that you’re away from work, you know that you need to calm down, just to put the day behind you. So the first thing you do after you step inside is take off your shoes, lay down on the couch, and turn on your Wii U to play a round of Turf War on Splatoon.

Suddenly, the ride home seems to melt away. The week ahead feels man­age­able now that you’re cov­er­ing the map in ink.

Sounds famil­iar, no? Videogames pro­vide an escape from the stress­es of every­day life. That isn’t nec­es­sar­i­ly a bad thing, either. Like most hob­bies, gam­ing is a skill that is acquired over time. Players put their time into games they care about, with the hope that they’ll advance and earn in-game suc­cess. Not to men­tion, in-game con­flicts have very lit­tle bear­ing on the real world, so gam­ing pro­vides an enclosed space for play­ers to sit back and relax.

But, it can be dif­fi­cult to for­get about the out­side world when deal­ing with depres­sion, anx­i­ety, and other mood dis­or­ders. Even when you’re play­ing Splatoon, stress seems to just creep back in no mat­ter what. So, can videogames help these play­ers cope with their men­tal ill­ness­es? Do videogames let play­ers bet­ter under­stand and process infor­ma­tion? Are there any psy­cho­log­i­cal ben­e­fits to play­ing videogames?


A bat­tle scene from Luftrausers

Coping with the Design

Arguably, yes. Gaming relies on the player’s abil­i­ty to make deci­sions and respond to in-game events, and most games are advanced by resolv­ing con­flicts. So play­ers that spend a lot of time play­ing a spe­cif­ic videogame have a bet­ter chance of under­stand­ing the game’s mechan­ics, and solv­ing in-game chal­lenges. In turn, this lets play­ers learn problem-solving skills that can be applied back to every­day life.

Granted, each game comes with its own skillset — and some games are hard­er to learn than oth­ers. For instance, new­com­ers to Vlambeer’s aer­i­al shoot-’em-up Luftrausers sim­ply have to learn how to dodge incom­ing fire and score combo kills, where­as Relic Entertainment’s World War II strat­e­gy game Company of Heroes 2 forces play­ers to spend hours at a time learn­ing team builds, unit place­ment, and strate­gic choke­points on the in-game map.

That said, play­ers nat­u­ral­ly solve chal­lenges faster as they become more famil­iar with a game’s mechan­ics. Advanced Company of Heroes play­ers can mul­ti­task unit place­ment across the bat­tle­field. Luftrausers fans can dif­fer­en­ti­ate enemy fire based on bul­let pat­terns. Experienced play­ers know a game’s mechan­ics so well that they can quick­ly pin­point con­flicts and exe­cute a solu­tion. In other words, play­ers that spend time learn­ing from their in-game fail­ures become bet­ter problem-solvers.

But do these skills trans­late into every­day life? One 2013 review from the American Psychological Association found that strat­e­gy videogames enhanced problem-solving skills in young chil­dren, and had the poten­tial to increase “emo­tion­al resilience” in daily life. In-game fail­ures aren’t a dead end for chil­dren, the report argues; rather, when pre­sent­ed with a con­flict, young play­ers cre­ate cop­ing mech­a­nisms that help them advance through the game.

In real life, invest­ing ener­gy into every­day life can be an over­whelm­ing expe­ri­ence for gamers with mood dis­or­ders. The sheer abun­dance of neg­a­tive thoughts and feel­ings from depres­sion can make the out­side world feel too com­plex to han­dle. However, videogames are designed with a solu­tion in mind for the play­er to achieve. They present an inter­ac­tive space for the play­er to over­come con­flicts with­out any real world con­se­quences for fail­ing. In gam­ing, we tend to believe, there’s no such thing as a per­ma­nent loss — just restart­ing.


Planning moves on the bat­tle­field of XCOM: Enemy Unknown

Approaching XCOM

As a gamer myself, I was curi­ous how other play­ers thought about in-game mechan­ics. So I decid­ed to reach out to Charlotte Park, a good friend of mine and fel­low gamer.

Firaxis’s XCOM: Enemy Unknown is a favorite of Park’s. Not unlike its pre­de­ces­sor XCOM: UFO Defense in the 1990s, the 2012 reboot of the clas­sic turn-based strat­e­gy series is extreme­ly dif­fi­cult. Players must fight off an alien inva­sion while main­tain­ing the inter­ests of the XCOM initiative’s mem­ber nations, who also con­trol the project’s fund­ing. Most new­com­ers strug­gle through the Classic dif­fi­cul­ty option, as mem­ber nations grad­u­al­ly drop out of the game.

Park was a fan of the orig­i­nal XCOM series from the 1990s. On a friend’s sug­ges­tion, she decid­ed to give the remake a try on Classic. But she quick­ly bumped the dif­fi­cul­ty level down.

I need­ed to switch to Normal just to get a feel for every­thing with how bru­tal XCOM can be,” she said. “Eventually I man­aged to work my way up to Impossible, though I find myself hav­ing dif­fi­cul­ty slog­ging through the cam­paign again at that level of dif­fi­cul­ty — because, y’know, your guys die. A lot.”

Park brings up an inter­est­ing point: XCOM also lets play­ers choose Easy or Normal dif­fi­cul­ty options for a much more man­age­able expe­ri­ence. In most sit­u­a­tions, in-game risk has been dimin­ished to the point where play­ers sim­ply have to use cover and pri­or­i­tize enemy tar­gets in order to win mis­sions. So as the play­er learns the game’s mechan­ics at their own pace, they can also become more con­fi­dent in their abil­i­ties to suc­ceed, and sub­se­quent­ly move onto the hard­er dif­fi­cul­ty lev­els. This is par­tic­u­lar­ly impor­tant for play­ers with depres­sion or anx­i­ety, who might have a low thresh­old for in-game chal­lenge. Afterwards, they can take on the hard­er dif­fi­cul­ty lev­els.

Likewise, Park under­stands why play­ers would remain at the eas­i­er dif­fi­cul­ty lev­els, and agrees there’s a stig­ma around them. While she admits that she’s ambiva­lent about the issue, she also does­n’t mind casu­al gam­ing.

Not every­one has the time or ener­gy to ded­i­cate to ‘git gud’, not every game real­ly needs to be Dark Souls level of hard,” she told me.

There’s noth­ing wrong with being a casu­al play­er, there’s noth­ing wrong with just want­i­ng to pick up a game and have fun. Escapism is a nice thing some­times.”


In SPARX, you fight gloom, over­come prob­lems, and engage in other ther­a­peu­tic game activ­i­ties [source: SPARX trail­er]

Science Behind the Escape

Of course, escapism doesn’t inher­ent­ly help at-risk play­ers over­come their men­tal ill­ness­es. Nor does self-confidence. In most cases, behav­ioral and cog­ni­tive ther­a­py are nec­es­sary for improv­ing men­tal health. However, sci­en­tif­ic stud­ies show that the skills play­ers learn dur­ing play intro­duce cog­ni­tive ben­e­fits in every­day life. In other words, games teach play­ers how to bet­ter under­stand their sur­round­ings.

Take one arti­cle review pub­lished in the American Journal of Play, “Video Games: Play That Can Do Serious Good.” According to the authors, action, puz­zle, and strat­e­gy videogames enhanced log­i­cal and visu­al infor­ma­tion pro­cess­ing capa­bil­i­ties for their play­ers. Extended time play­ing the strat­e­gy game Rise of Nations, for instance, improved “task switch­ing, work­ing mem­o­ry, and abstract rea­son­ing” among indi­vid­u­als suf­fer­ing from age-related cog­ni­tive declines. Likewise, action and puz­zle videogames improved play­ers’ abil­i­ty to pri­or­i­tize deci­sions and quick­ly switch between tasks. Alongside cog­ni­tive ther­a­py, videogames help the brain oper­ate more effi­cient­ly while observ­ing and under­stand­ing infor­ma­tion.

Hard data also shows that videogames can improve cog­ni­tive func­tion­ing, dimin­ish the effects of depres­sion and anx­i­ety dis­or­ders, and can even be designed for ther­a­peu­tic pur­pos­es. According to TIME, the cog­ni­tive behav­ioral ther­a­py videogame SPARX suc­cess­ful­ly helped 44% of play­ers com­plete­ly over­come their depres­sion, with 66% expe­ri­enc­ing decreased depres­sion symp­toms after play­ing the game. Likewise, in a recent study at Michigan State University, researchers found that their shape-identification videogame “improved con­cen­tra­tion and less­ened anx­i­ety for the anx­ious par­tic­i­pants [who played the game].” Associate pro­fes­sor of psy­chol­o­gy Dr. Jason Moser even con­clud­ed there was a poten­tial to open a new mar­ket specif­i­cal­ly for videogame ther­a­py.

But I was still curi­ous how these stud­ies stacked up to every­day life. So I decid­ed to inter­view Grace Kroll, a fel­low gamer and friend of mine who suf­fers from depres­sion and anx­i­ety in her life. She told me that she prefers play­ing videogames that are easy to slip into and make progress.

As some­one who has depres­sion and anx­i­ety, games like Animal Crossing help me tune in and moti­vate myself to try to feel a lit­tle bet­ter while build­ing some­thing that mat­ters to me,” she said. “Even if I am build­ing a bet­ter fic­tion­al town, or advanc­ing my level in a game, it serves as a small relief to me, a short-term reminder that I am capa­ble of doing some­thing suc­cess­ful­ly while I wait for a larg­er, long-term sign of suc­cess in my life’s endeav­ors.”

Kroll makes an excel­lent point. Not just can games help fight men­tal ill­ness­es, but they can also change the ways play­ers think about every­day life. Escapism ends up being ther­a­peu­tic.

Some of my favorite games to play are those that don’t pres­sure me into play­ing heav­i­ly… I like to feel absorbed but lost, con­fused in search­ing and find­ing and learn­ing, but also aware and inter­est­ed enough to find out more,” she said. “I like games to be a learn­ing expe­ri­ence about the set­ting.”

Balancing Out

Scientific research alone shows that recre­ation­al gam­ing can help play­ers improve their men­tal func­tion­ing, and deal with mood dis­or­ders. However, while there are cer­tain­ly psy­cho­log­i­cal ben­e­fits from reg­u­lar­ly play­ing games, rely­ing too heav­i­ly on gam­ing for per­son­al hap­pi­ness can pre­vent any mean­ing­ful psy­cho­log­i­cal changes for play­ers suf­fer­ing from men­tal ill­ness­es. In fact, self-medicating with videogames can increase a player’s risk for devel­op­ing an addic­tion.

Earlier this year, VICE’s exposé on videogame addic­tions explored the dark­er side of escapism in gam­ing. In the arti­cle, jour­nal­ist Cecilia D’Anastasio dis­cussed sev­er­al gam­ing addicts who avoid­ed deal­ing with their day-to-day respon­si­bil­i­ties by spend­ing dozens of hours play­ing videogames. One addict, a young man named Brett, refused to show­er for six days in order to play over 100 games. Another play­er, a 69-year old named Patricia, refused to spend time with her hus­band and fam­i­ly in order to play World of Warcraft. While these addic­tions are explic­it­ly psy­cho­log­i­cal in nature, D’Anastasio found that videogame addic­tions are noto­ri­ous­ly hard to over­come — in some cases, they can even mir­ror “intense with­draw­al symp­toms sim­i­lar to those of cocaine: sleep­less­ness, anx­i­ety, and hal­lu­ci­na­tions.”

How could videogames cause this kind of severe reliance from their play­ers? The American Journal of Play notes that videogames release “the same chem­i­cals the brain releas­es when a hun­gry or thirsty per­son receives food or water, as well as when some­one takes one of the many com­mon­ly abused drugs,” con­clud­ing that dopamine lev­els acti­vat­ed in the brain dur­ing play “[resem­ble] that relat­ed to some recre­ation­al drug use.” But this isn’t nec­es­sar­i­ly true. As psy­chother­a­pist Mike Langlois points out on his web­site “Gamer Therapist,” reward-based chem­i­cal reac­tions in the brain do not inher­ent­ly cre­ate addic­tions to food or water in humans, nor are they entire­ly respon­si­ble for addic­tions in gam­ing. Rather, there are other rea­sons for the addic­tions that D’Anastasio dis­cov­ered.


The Azsuna area from World of Warcraft’s lat­est expan­sion [source].

In 2009, psy­chol­o­gy pro­fes­sor Dr. Zaheer Hussain col­lect­ed self-reported data on time spent gam­ing among mas­sive­ly mul­ti­play­er online role-playing game (or, MMORPG) play­ers. Hussain found MMORPGs had the abil­i­ty to mod­i­fy play­ers’ moods, cre­ate tol­er­ance to in-game rewards, and pro­mote a relapse among return­ing play­ers. He con­clud­ed that these traits “may be indica­tive of a ten­den­cy for some gamers to use online gam­ing as a mood mod­i­fi­er,” con­clud­ing that some users “may also engage in online gam­ing as a means of cop­ing with prob­lems in their every­day lives.”

Dr. Hussain’s find­ings were fur­ther sup­port­ed by a 2013 research study done at University of Missouri on videogame addic­tions. According to Department of Psychological Sciences doc­tor­al can­di­date Joe Hilgard, escapism was the “biggest risk fac­tor for patho­log­i­cal videogame use” among gamers.

Individuals who play games to get away from their lives or to pre­tend to be other peo­ple seem to be those most at-risk for becom­ing part of a vicious cycle,” Hilgard explains. “These gamers avoid their prob­lems by play­ing games, which in turn inter­feres with their lives because they’re so busy play­ing games.”

Not unlike alco­holism or worka­holism, games can become a mis­guid­ed solu­tion to sti­fle sad­ness, lone­li­ness, inse­cu­ri­ty, and rumi­na­tion. For play­ers already suf­fer­ing from pre-existing men­tal ill­ness­es, this can be espe­cial­ly dam­ag­ing. By repress­ing their anx­i­ety or depres­sion, addicts reject ther­a­py in exchange for play. This pre­vents play­ers from under­stand­ing their men­tal ill­ness­es, lead­ing to a self-destructive dead end.

When I talked to Park and Kroll, they both seemed to agree.

Aside from games based on the Skinner box model — gam­bling games and the like — I don’t find that games have any inher­ent­ly addic­tive mechan­ics with­in them,” Park said. “It’s like any other hobby — some peo­ple have dif­fi­cul­ty doing things in mod­er­a­tion and they let it con­sume them, but it has much more to do with indi­vid­ual per­son­al­i­ties than game design as far as I can tell.”

Meanwhile, Kroll stressed how addic­tions stem from the indi­vid­ual. “Addiction can be any­thing to some­one,” she said. “Some peo­ple can get addict­ed to any­thing, sim­ply because that’s the way they’re genet­i­cal­ly wired.”

My grand­fa­ther died of alco­holism, and my father strug­gled with many forms of addic­tion. Luckily, I’ve never expe­ri­enced this. I think it’s a mat­ter of know­ing how to bal­ance your life.”

Perhaps Kroll is right — in the end, gam­ing is all about mod­er­a­tion. Without con­fronting their addic­tion, videogame addicts are stuck in a cycle, never able to fully over­come the painful emo­tions and feel­ings lying under­neath their time spent in-game.

Escapism isn’t inher­ent­ly a bad part of videogam­ing. Just as read­ers love to escape the real world through books, gamers play videogames in order to shed the daily stress­es of every­day life. There’s noth­ing wrong with putting a large amount of time into gam­ing — in fact, psy­chol­o­gists agree that videogames pro­vide sub­stan­tial ben­e­fits to every­day life, and can improve the cog­ni­tive capa­bil­i­ties of their play­ers. It’s cer­tain­ly a great hobby for relax­ing after a long day.

However, videogames are not a sav­ing grace from men­tal ill­ness­es. Overuse presents real bar­ri­ers for behav­ioral ther­a­py, and rely­ing on a videogame for per­son­al hap­pi­ness can devel­op addic­tive habits in play­ers. Without healthy bound­aries and prop­er health care, men­tal ill­ness­es can fes­ter under gam­ing addic­tions.

Granted, that’s not to say that gamers should not be allowed to escape into their favorite worlds. Everyone needs to let go of daily life now and then. But even escapism must be done in mod­er­a­tion. After all, there’s a fine line between using videogames to relax, and using games to run away from solv­ing prob­lems. Without any seri­ous ther­a­py for ongo­ing men­tal ill­ness­es, no videogame can help a play­er over­come their every­day strug­gles.