Living with any form of mental health issue is challenging to say the least. Not only do you face the intricacies of your own specific struggles, but also the stigma against mental health sufferers that still pervades modern society.
That stigma is slowly diminishing, thanks to a variety of organisations and initiatives working to raise awareness and understanding of what it's like to live with mental health issues, but there is still more work to be done.
One person stepping up to this plate is Emily Mitchell, a young game developer who has lived with severe anxiety almost her entire life. Mitchell has just published her first game, combining her hobby with a cause that's particularly close to her heart.
"It would be amazing to see big companies doing more about mental health in games. The more it's talked about, the more we can reduce the stigma around it"
"Gaming has basically been my outlet -- when I am gaming, I can forget the world," she tells GamesIndustry.biz. "I really wanted to bring the two things together, bring my experiences with mental health into the gaming world. I thought it would be something others might be able to resonate with too."
Her debut game is Fractured Minds, a first-person puzzle adventure for PC and consoles. She developed the entire game on her own when she was 17 to enter the BAFTA Young Game Designers competition -- and she won. Working with Wired Productions and new mental health charity Safe In Our World, Mitchell has been able to polish and publish the final game, which has already sold tens of thousands of copies.
Split across six chapters, it takes players on a journey through the human psyche and key aspects of life as a mental health sufferer. Naturally, Mitchell drew on her own experiences with severe anxiety, but the presentation could equally apply to anyone with depression, paranoia or other conditions.
"I wanted to allow people to interpret it how they wanted to," Mitchell explains. "So there's quite a lot of symbolism in the game -- like how in the first level you can't find the right key and it gets more and more frustrating. Each level is like a different aspect of mental health, different frames of mind people can experience in all types of conditions."
With the whole gamut of mental health problems available to explore, but only a limited time to complete the game, Mitchell decided to hone in on experiences she was particularly interested in. The second chapter, for example, centres around loneliness, which Mitchell describes as "like a birthday party that no one has come to."
"I wanted to get across how anxiety and depression or any other conditions can make you feel really alone," she says. "This is something that people have commented on a lot since they have played the game, and actually just acknowledging the fact that we all go through it can really help."
"There's still quite a few challenges for me to overcome with my anxiety [but] I'm hoping to use my experiences to make games that resonate with people"
Mitchell says it was "super tricky" getting the balance between explicit and implicit symbology right, adding that this can make "doing a game about mental health... quite risky."
Fractured Minds is also a short experience, easily playable in one sitting of about 20 to 30 minutes. This is partly down to the constraints of the original BAFTA competition -- Mitchell had just nine months to build the entire thing -- but also to maximise its impact.
The hope is the game will help players better understand what people with mental health issues are going through, as well as to assure those people that they are not alone in how they feel.
It has also been a cathartic experience for Mitchell as she has learned how to better deal with and accept her anxiety -- and not just through developing the game. Winning the BAFTA prize, helping to market and promote the game, and even doing this interview have all been steps forward for her on her own journey.
"It was definitely a creative outlet for me," she says. "I took a lot of time off school due to my anxiety and this helped me hugely work towards a goal. It has also helped me now that it's been released as I've learned to be a lot more open about my anxiety and talk to people about it more.
"Having a video of me speaking about my anxiety as the launch trailer was pretty scary but really helped me overcome my worry about talking to people about it."
As mentioned before, gaming was initially a hobby for Mitchell, a means of escape. But now the self-taught games developer -- thanks to "lots of YouTube tutorials" -- is planning her next move. In fact, 40% of proceeds from the game's sales go to funding her future in games.
"I definitely want to pursue a career in the industry," says Mitchell. "I've got lots of ideas and I loved making Fractured Minds -- but if i'm totally honest there's still quite a few challenges for me to overcome with my anxiety.
"I'm hoping to keep using my experiences with anxiety and depression and mental health as a way to keep making games that resonate with people."
As a gamer, Mitchell is also hoping to see more major games firms explore the subject matter at the heart of Fractured Minds. While there are a number of indie titles that tackle this sensitive topic, higher production games such as Hellblade are few and far between.
"It would be amazing to see big companies doing more about mental health in their games," she concludes. "I think that the more it's talked about, the more we can reduce the stigma around it.
"[Developers should] speak to real people who have gone through this type of thing, really put their voices and their experiences at the heart of the game. Making games about mental health is not without risk -- it's about finding the right balance with the tone of the game -- and sometimes subtle messages can be really powerful."