MMOs And Anxiety: How The Best Game Design Helps Me At My Very Worst

How do you con­struct your men­tal health tool­box? While not a per­fect fit for every­one, I’ve found that MMOs (mas­sive mul­ti­play­er online games) are a par­tic­u­lar­ly use­ful mon­key wrench when I’m in a jam.

While I won’t deny the onset of help­less bore­dom that comes with slay­ing fif­teen crea­tures in a row for a five-part quest or run­ning around gath­er­ing herbs over and over and over, I soon learned keep­ing my atten­tion span bare­ly above water had a way of slow­ing down my heart rate like a mug of warm tea. While I adore offline RPGs like Pokémon and Okami, online mul­ti­play­er games’ very nature as a liv­ing, breath­ing, dynam­ic enti­ty gives them a cer­tain immer­sion that can’t be found in an iso­lat­ed title with a more spe­cif­ic begin­ning, mid­dle and end. Neither is bet­ter or worse — they’re sim­ply dif­fer­ent. The unique­ness of MMOs lies in a truly spe­cial com­bi­na­tion that chips away at panic attacks, bol­sters my imag­i­na­tion and keeps me from sink­ing into frus­tra­tion and exhaus­tion.

To have an anx­i­ety dis­or­der is to be in a severe state of panic when the dan­ger has long since passed (if it were there at all). Your immune sys­tem with­ers at the con­stant drain­ing of your body’s nat­ur­al resources at every slight provo­ca­tion and you get used to being too nau­seous or too ner­vous to do daily tasks like shop­ping or eat­ing out. A minor social faux pas or every­day risk can turn into a debil­i­tat­ing whirl­wind of fear­ful what-ifs that can take up half your day. As such, assem­bling your men­tal health tool­box becomes cru­cial in buffer­ing anx­i­ety’s wear and tear. I’ve taught myself how to breathe, count­ing each inhale and exhale like my ten­u­ous health’s very own metronome, and learned how to focus my atten­tion on sen­so­ry details to stave off dis­as­so­ci­a­tion brought on by panic. I even have to trick my own brain into obsess­ing over minor mun­dan­i­ties rather than the dooms­day sce­nar­ios that make me want to lie down all day long. This is where MMOs come into play.


Note I did­n’t say ‘videogames’ — MMOs have their own par­tic­u­lar brand of immer­sion. Adventure games, for exam­ple, are meant to inspire a sense of won­der while plat­form­ers delight in organ­ic and tex­tured game­play. Role-playing games are a draw for those that love large char­ac­ter casts in com­plex sto­ries and shoot­ers can let out some pent-up frus­tra­tion. MMOs? Escapism honed to a paper-thin edge. Everything from the afore­men­tioned grind to the per­son­al­ized sto­ries NPCs (non-player char­ac­ters) spout at you from all cor­ners of the map to the count­less play­ers run­ning to and fro cre­ate an envi­ron­ment that’s pure, unfil­tered fan­ta­sy. An entire world with­in a world that you can access with a few clicks of your mouse. Sometimes, you real­ly want to feel like you’re just some­where else. Somewhere bet­ter.

Chronic anx­i­ety dis­or­der, as well as its exten­sive sub­cat­e­gories obsessive-compulsive dis­or­der and panic dis­or­der, affect at least a quar­ter of the American pop­u­la­tion at any given time accord­ing to ongo­ing stud­ies con­duct­ed by the ADAA (Anxiety and Depression Association of America). Considering the stub­born­ly preva­lent stig­ma around men­tal ill­ness it’s more than like­ly this num­ber is a lit­tle high­er, too. Even worse is the sys­tem of men­tal health­care and, while I won’t speak for other coun­tries, America is fair­ly infa­mous for its abject refusal to give the men­tal­ly ill the resources they need with­out them going broke. As such, not every­body has steady access to cog­ni­tive behav­ioral ther­a­py, med­ica­tion or even a part-time job that can give their symp­toms a lit­tle lee­way. Building and stock­ing your men­tal tool­box is not a lux­u­ry — it’s a neces­si­ty to just live your life.

Getting to that some­where bet­ter when you’re broke and sad and strapped for time is a rhetoric any­one men­tal­ly ill can relate to with gusto. For me, it means I’m tired. I’m always tired. Sometimes it’s all I can do not to suc­cumb to the nigh-constant suck­ing of my ener­gy and crawl into bed twice per day. Getting out of said bed can be even hard­er. Following through with my projects, my pas­sions, can be the hard­est damn thing around. When I boot up my PC and open up Final Fantasy XIV: A Realm Reborn or World of Warcraft these MMOs act the part of a com­plex and shiny place­bo, invit­ing in my will­ing­ness to put real­i­ty on hold and reward­ing me emo­tion­al­ly for doing so. Distraction is some­thing I need to ward off gru­el­ing panic attacks and a lit­tle emo­tion­al invest­ment with­out a lot of work can keep me from nap­ping for two hours. Even tak­ing on the avatars of a badass cat girl dra­goon or a shapeshift­ing magi­cian who gar­ners the respect of near­ly every char­ac­ter she comes across works as a salve for the raw blis­ters soci­ety has given me.


The addi­tion­al ful­fill­ment that comes out of mak­ing a char­ac­ter and hav­ing them accom­plish hero­ic feats that are out of grasp in real life is some­thing to be com­mend­ed. You can do triple back-flips while defeat­ing a mas­sive tree ele­men­tal! You can spend your money willy-nilly and be assured you can get more in due time (prob­a­bly the most abstract of the fan­tasies). Socializing online can be eas­i­er than chat­ting face-to-face, sav­ing those with social anx­i­ety a few steps or five. But, MMOs are not quite sep­a­rat­ed from ‘real life’, either. They strad­dle that mid­dle ground, sim­u­lat­ing real-world con­se­quences for real-world peo­ple run­ning around a decid­ed­ly unre­al world. The game is script­ed, down to its last bina­ry code, and yet ‘ran­dom’ events and humor­ous encoun­ters with other play­ers or NPCs con­tin­ue to delight you as you’re mak­ing your way down a dig­i­tal dusty road. Even fight­ing and inter­ac­tion, the main func­tions of most MMOs, can still take a back­seat to relax­ing alter­na­tives like craft­ing rare items, play­ing card games and fish­ing. It’s all a del­i­cate bal­ance and MMOs become absolute­ly addict­ing as a result.

The first time I played Final Fantasy XIV was dur­ing the trial ver­sion, in which you’re allowed two free weeks of game­play with cer­tain fea­tures barred off until you buy the full pack­age. There are spe­cif­ic areas of the world you’re not allowed to visit, a hand­ful of actions in the game locked away and com­mu­ni­cat­ing is kept to a bare min­i­mum (like­ly to dis­cour­age spam accounts and trolls). The com­mu­ni­ca­tion fac­tor had proven fas­ci­nat­ing to me at the time, as I found myself unable to say what was on my mind (with­out alert­ing other users) when a friend­ly play­er went up and asked me about a quest. Over the next hour or so we pro­ceed­ed to fight mon­sters and deliv­er items to NPCs togeth­er, with my only respons­es to their ban­ter being emotes of the smil­ing, dra­mat­ic weep­ing and head nod­ding type. It was a funny sce­nario just shy of Journey or The Endless Forest, mak­ing me reflect on sim­ple inter­ac­tion and how it can lift me up even when I’m cul­ti­vat­ing my own spe­cial brand of alone time. Being able to fill up a men­tal pock­et­book of lit­tle moments like these is some­thing I find myself trea­sur­ing more and more as I play. I find it fits into my tool­box quite com­fort­ably.

Like any fan­ta­sy, it has to be care­ful­ly main­tained in order to retain its effec­tive­ness. A tip in either direc­tion can break immer­sion and make you lose inter­est entire­ly or, worse, turn into an unhealthy habit. I’ve had my fair share of rude com­men­tary aimed my way, such as a dun­geon group being decid­ed­ly unhelp­ful in favor of shoot­ing the shit with their friends or a play­er that got great plea­sure out of berat­ing every lit­tle thing I did. Every once in a while I have to slap myself on the wrist to keep from play­ing for seven hours straight. I also make it a con­scious deci­sion not to reveal that I’m a woman, because I know that’s an instant deal-breaker for other peo­ple’s fan­ta­sy. All of the above and more I mon­i­tor and keep at bay to keep my dig­i­tal med­ica­tion. Even this metaphor­i­cal tip-toeing helped me learn more about my lim­its and what I truly appre­ci­at­ed. While join­ing up with a guild was one of the last things I want­ed to do in FFXIV, it ended up pro­vid­ing me with fun con­ver­sa­tions and more relaxed dungeon-crawling than I would’ve got­ten play­ing solo. Hooking up with a friend­ly group or just using a few polite emotes in casu­al inter­ac­tions can estab­lish unex­pect­ed friend­ships or tem­po­rary cama­raderie on the field.

So I keep my identity(s) to myself and call out bad behav­ior with dis­cre­tion. I mon­i­tor my inter­ac­tions with care, but not too much care. I avoid cer­tain top­ics that I would nor­mal­ly engage in with a fer­vor on Twitter or the like. I let, for once, my faintest whims and deep­est emo­tion­al needs dic­tate what I want to get out of my expe­ri­ence. Like any good men­tal health tool, it’s for you and you alone. The blar­ing cho­rus of stig­ma and social pres­sure is reduced to sta­t­ic in favor of what you need, and only what you need, to take care of your­self. Even say­ing this aloud can be your first step to recov­ery. Need to dec­i­mate a horde of zom­bies with your troll war­lock to get through the day? Summon your demon com­pan­ion and breathe eas­i­er, friend.


Massive mul­ti­play­er online games keep me awake when I’d rather sleep. They help, believe it or not, with pro­duc­tiv­i­ty. Sometimes they just make me smile. It’s a mul­ti­fac­eted tool, one that works through defeat­ing demigods and danc­ing in bars with other goofy cat peo­ple. If you have chron­ic anx­i­ety or a sim­i­lar men­tal ill­ness as well as a lit­tle money to spare (or not, as many are free-to-play), then why don’t you try adding an MMO to your men­tal health tool­box? There are plen­ty of good ones to choose from, from the acces­si­ble, free-to-play fan­tasies of Guild Wars 2 and Blade and Soul or indus­try main­stays A Realm Reborn and World of Warcraft. Give Star Trek: Online or Eve a shot if you pre­fer sci-fi to fan­ta­sy. Play solo, recruit a friend or apply for a guild filled with new play­ers. Spend your time bet­ting on giant chick­en races or gath­er com­pan­ions to take down an ancient drag­on guardian.

Medication can come from the most sur­pris­ing of places.

Ashe Samuels

About Ashe Samuels

Illustrator and writer happily resigned to be forever obsessed with all things fantasy and science-fiction. Trying to make my mark on this world, however small, while I'm still here.