This Video Game Lies to Players to Try to Simulate Mental Illness

As I pushed through illusions and hacked my way through the minions of the foul raven god Valravn, I heard a familiar whispering.

“When darkness speaks, it changes everything, turning home into a foreign land and loved ones into strangers,” the voice said. “Exile makes sense when you realize that you were never really home in the first place.”

The illusions, dark whisperings, and strange insights are part of a video game called Hellblade: Senua’s Sacrifice and, in this context, the darkness is a metaphor for mental illness. I know this because it’s part of how the game advertises itself. Hellblade developer Ninja Theory has been open about its desire to use video games to tell a story about mental health issues.

Hellblade tells the story of Senua—a warrior woman on an Orpheus-style quest to free the soul of her dead lover. To do so, she must journey through Viking hell and face her personal demons as well as the horrors of the afterlife. Those personal demons are well-researched and more terrifying than any of the game’s more conventional challenges.

Here’s the thing, Senua suffers from psychosis. That’s the clinical termmore common in the UK (where Ninja Theory is based) than in the US—for a broad range of symptoms usually bundled under the diagnosis for schizophrenia. Senua, like some other people with that condition, hears voices that aren’t there and sees things that aren’t real.

Image: Ninja Theory

The way Ninja Theory conveys this in the game is equal parts brilliant and frustrating. Voices float in and out of the player’s speakers. They fill in the backstory, warn the player of danger, and give contradictory advice on what to do next. During a melee brawl, one voice might tell me to dodge and another might tell me to block. I’ve had them warn me of impending danger only to turn, frightened, and see nothing. But they’re still right half the time so you don’t follow their advice at your own peril.

Other mechanics layer on the frustration. The game offers no instruction on how to play. There’s no combat tutorial, no good explanation of its save deleting despair mechanic, and no way to know what’s real and what’s not. The game had me second guessing myself. For example, Senua’s supposed to be able to block in combat, but I can’t always get her to do so.

At first I thought it was my controller’s button giving out, but I switched to a different keyboard and nothing changed. I can’t find anyone online who’s having the same problem and it’s frustrating. I also die a lot. It’s not particularly hard, just unforgiving. It’s similar to Dark Souls in that way.

Not dying is important because every death causes Senua to rot a little. “If the rot reaches Senua’s head, her quest is over,” the developers claimed. “And all progress will be lost.”

This adds to the stress of every death because it implies Hellblade will delete your save file if you suck at it. But that might be a lie. The team over at PCGamesN tested the permadeath feature by sending Senua up against an enemy on the hardest difficulty and letting her fail over and over. After a total of 50 deaths with no consequences, PCGamersN declared Ninja Theory’s promise to delete saves a “bluff.”

Others online aren’t so sure. Redditors claim the game resets the rot meter every checkpoint. Those checkpoints are frequent enough that it’s almost impossible to lose your save. No one I could find has actually reported losing their progress. It’s stressful and confusing and means the developers might be lying. It makes you second guess everything they’ve told you. That’s the point.

Hellblade isn’t the first game to tackle mental health issues or mess with the player. Metal Gear Solid’s Psycho Mantis boss fight freaked players out by messing with their TV and reading their save file. The Gamecube’s Eternal Darkness pretended to delete save files. Call of Cthulhu: Dark Corners of the Earth, Darkest Dungeon, and Bloodborne all use the mental health of their characters as a kind of secondary health bar.

Image: Ninja Theory

Ninja Theory takes it a step further. The developer wants to put players in the headspace of someone suffering from mental illness. Lying to the players about consequences, finicky controls, and contradictory advice from NPCs are all part of that journey. It’s frustrating and obnoxious and frequently not very fun. That’s by design.

“The game’s protagonist experiences psychosis, and suffers from depression and anxiety. Her ‘journey into hell’ is a manifestation of her mental health,” Dominic Matthews, Ninja Theory’s product development manager told Motherboard in 2015. “When you put players in the position of a character with a mental health condition, it can help them understand what it is to suffer, and break through some of the stigmas attached to mental health.”

The developers spent a lot of time working with mental health professionals and interviewing psychosis patients. These people playtested the game, made suggestions, and helped Ninja Theory craft Senua’s experiences based on their own. Ninja Theory even included a 25 minute long documentary about the process with every copy of Hellblade.

Mental health issues run in my family. There’s a fair bit of depression and suicide. As I played the game and the voices told Senua’s story and urged me on, I heard familiar speeches. Words I’d heard my family say to themselves. Words I’d heard in my own head.

Before Senua set out to free the soul of her dead lover, she spent time in the wilderness in exile from her tribe. “She resolved to fight on and kill that which had become part of her,” one of the voices explained. But it didn’t work. “It was so naive to think she could banish it on her own.”

“There is no such thing as victory when it comes to the darkness. It’s like it doesn’t want to kill her…yet,” the voice said. I instantly thought of conversations over Christmas dinners about depression and suffering. That feeling that the depression is a physical force outside yourself. One that doesn’t want you to die…yet.

“You think you can overcome the darkness,” the voice continued in the game. “Make sense of it. And once relief settles in, it strikes out of nowhere, throwing you helplessly back into the maelstrom. Drowning the mind in fear, deeper, deeper, dragging you down so far into the void that maybe this time, there is no coming back. With every battle the darkness grows stronger. Every victory bringing her closer to defeat. Unfair isn’t it?”

It feels very unfair. People with mental health issues are often on the frontlines of a battle in their own mind. One that can last their entire life. One where every victory reminds you of the consequences of defeat. One where you might go years without symptoms only to find yourself in the throes of an episode after hearing the wrong song or eating the wrong meal.

Of all the books and all the movies and TV shows I’ve ever seen about mental health issues, I’ve never seen anything that recreates the feeling as well as Hellblade: Senua’s Sacrifice. That alone makes the game a triumph. Even if it isn’t always fun to play.