Trigger warning, this is about depression in quite a visceral sense.
I know what it feels like to be depressed from my own past experience. As much as anything that means I have an understanding of the physiological effects as well as the mental, which can be important because, as a mental illness, it is often discussed in purely mental terms.
But those physical effects can be horrible, almost indescribably so. It isn't just the lethargy and the headaches, in some manner similar to the experience of a bad cold, but the curious fear that accompanies them. Colds come and then they go, following a familiar and understandable self-limiting pattern. They are grim and they can vary in severity but they make sense and have an end that can be anticipated while the physical symptoms of depression merely persist. And the longer they persist the more the anxiety over that persistence becomes a physical thing in itself; a gnawing in the gut that feels like maybe you ate something wrong and oh god what if you might get sick for real and...
I imagine that this is similar to many other chronic illnesses, which I am aware have the capacity to feedback into mental illness. I also am certain that other mental illnesses have their own set of physical symptoms which I have never felt and will probably never know. It is interesting that I am better able to imagine the mental state of someone with mania than I am the physical feeling of it and it fascinates me, in part because the physicality of my own depression is a huge part of the way I understand it.
I said I know what it feels like to be depressed because what I realise is that I don't know what it feels like to become depressed. I can imagine that it must be terrifying on that purely physical level because there's no frame of reference for why your body suddenly feels the way that it does - it can be terrifying for me and I know that it's coming and that it will, eventually, pass.
Those games which do model mental illness seem for the most part to be focused on its onset - on the shift-point between sanity and madness. Once the illnesses are contracted, and they are contracted, imposed into the sanctity of a character's mental cradle by the agencies in the external world, they become modifiers on play rather than lived and vital experiences. Or worse, they signify the end of playability.
But mental illnesses are progressive, not binary. Those acquired later in life do not snap into being, fully-formed in the sufferer's mind, but are wrought out of experience and predisposition. Of course, to make a secret list of the illnesses your character might develop would be a curious exercise, and to roll your winnings on the genetic lottery on a random table at the point of phenotype expression is functionally, if not teleologically, the same action as rolling at birth.
It makes me wonder what a game would have to do to actually embody the experience of being mad - to genuinely get at at the phsysicality of it without resorting to glitch or distortion, to showing things which aren't there when it's already in a world that isn't there and anyway can't we just get over the idea that hallucination is the be-all and end-all of being mad?
One game which makes a stab at this is Depression Quest. It's a good stab, and I like the core idea of having, in a choose-your-own-adventure, greyed-out choices. It says that the core of being depressed is knowing that there are things you could do, but nevertheless being unable to do them. Unfortunately the rest of it lets it down.
Really, it's doomed from the name onwards. The idea that depression is a quest already suggests that it has a win-condition, that no matter how many times the authors tell you that it is something you must learn to live with fundamentally they view it as something that can be beaten. And that it can be beaten by the sufferer. For some people that may be the case, but unfortunately the game clearly isn't talking about an isolated episode of depression as experienced by an otherwise healthy person, it's talking about the chronic kind. The kind I've got. The kind that isn't a game.
It's odd for me to say that because, perhaps unsurprisingly, I've gamified my own depression. When I was sixteen, and heavily self-harming, I sat in a park at night somewhere near Three Bridges and I made a deal with myself that if I was to commit suicide then I would have lost the game I was playing. I didn't know what the win condition was back then, I still don't, but that was a clear loss. It helped. It gave me a point of power and control and it's kept me going. But some of the worst mistakes I've made have been to, even unconsciously, project that system onto other suffering people, because it has seriously fucked up my relationship with them.
That's the problem with systems. Unlike events, for which you can disclaim universality, systems imply their applicability to all situations. Depression Quest allows that it doesn't describe every depressed person's experience, but it implies that it models it. Ignoring the use of static and glitch as signifiers, they may be tired but they are at least uncontroversially deployed, the first thing you notice when you load up the game, especially if you are used to playing games, are the three gauges at the bottom of the screen. Again, suddenly, there's a win condition, and it's when those gauges say the right things.
It almost doesn't matter that those gauges represent a hopelessly proscriptive view of what depression is and how it should be managed. The fact that they are there at all is enough to imply that failure in this game of coping is the fault of the player, the very thinking the game aims to subvert with it's greyed-out choices. It isn't the case that you can't try these options because you are unwell, it's because you rejected meds and meds always help. If you'd gone to the therapist you'd get to have sex with your girlfriend and enjoy it, but you didn't, so fuck you. You're just not thinking about your illness in the right way, because if you were you'd know how to fix it.
I should be clear, I think medication is wonderful if you get the right stuff, but because we don't know exactly how these illnesses work it is always a compromise. I think therapy can be an incredibly useful tool, but it can also become a very expensive sideshow, even more addictive than the supposed addictiveness of the drugs, and again it depends on so many factors I can't even begin to explain them here.
I stated earlier that I wondered what a game that truly embodied the experience of being mad was like but I'm not sure I actually want to know. I was imagining things like haptic feedback on controllers that flooded your limbs with dull current. Characters that controlled sluggishly, like you were pushing them through treacle. All those similes we employ, writ large on the screen. The thing is, I'm not sure I want to know, really. I wanted to love Depression Quest's core mechanic, but I ended up hating the execution.
I still think that the best expressions of what it is to be depressed come through in Douglas Adams' adventure games. It's in the loneliness of Starship Titanic or the sheer bloody-minded hostility of the world in Hitch-hiker, but the systems of those games are not the vehicle for that expression. I want someone to show me a system that works as well as that, and I admire that people are trying, but I can't not point it out when those noble failures look like propagating further harm.