I was 22 when I had my first psychotic episode. I had dropped everything and moved to Austin with a girlfriend who was not a good fit for me, pursuing my dream of (somehow) becoming a professional actor. None of this was going well; the relationship and the jobs I was working were all dead ends that I wasn't really acknowledging or dealing with.

Eventually all the stress and self-deceit came to a head in a giant fight, and I started thinking things that were decidedly false. I came to believe that I was the center of a conspiracy of surveillance, Truman Show style, that was being run by my friends. Every detail that I noticed confirmed this: I saw a car make a weird U-turn which to me was proof positive that it was following me. A dump truck passed the window with a flashing yellow light; this was clearly someone trying to signal to me that they were in on the conspiracy. A cat sitting on the hood of a car must have been some kind of sophisticated spy camera.

I never experienced hallucinations, I was never violent and I didn't cackle maniacally like every single clueless, no-effort depiction of mental illness in Hollywood and elsewhere. The only thing that was missing was my capacity to critically examine my own ideas.

You know how when you're thinking super hard about something for a long time, and you finally figure it out, and you get that big rush of endorphins like "ahhhhh I finally got it." It's a great feeling, but you have to work to get there right? You have to come up with and reject a lot of ideas before you find the one that fits. Well, I was having that "ahhhh" feeling with every fleeting notion. You don't realize how many thoughts you reject as nonsense until you lose the ability to do so.

You might see a squirrel run toward you and think "Wouldn't it be cool if that was some kind of little robot?" then immediately reject that idea without a second thought. That rejection is what was broken in me; even the most momentary flight of fancy became the unassailable truth. I saw the squirrel and it was self-evident that it was being remotely-controlled as a way to keep tabs on me. Not a single thought in my mind that any of this stuff was wrong.

Public mental health facilities in Texas at the turn of millennium were about as you'd expect. I was there involuntarily and kept trying to escape, so I spent a lot of the first few days restrained (more than 20 years later I still get a panicky feeling in my chest when I think about being strapped to that bed). I was shot up with Haldol that left me a drooling, twitching mess. At no point did I receive anything resembling therapy. After a few weeks the doctor assigned to my case finally came back from vacation and I seemed fine so they basically shrugged and let me go.

"Depression with psychotic features" they called it that first time. Eventually, after experiencing more episodes and being institutionalized and re-diagnosed a few more times, they settled on the diagnosis of Bipolar I disorder and I've been stable on lithium for over a decade now. I was lucky and got basically the happiest possible outcome. I don't think that's the case for most people dealing with mental health issues, especially psychosis.

Mental health is like sexuality, in that we as a society are obsessed with it but only seem to engage with it in the most unhealthy ways. In our entertainment media, references to insanity are constant. Calling someone's sanity into question is an easy and common insult. After every mass shooting, the airwaves are crammed with politicians scapegoating the mentally ill. We're finally to the point where (in some circles) it's considered unacceptable to use "gay" or "retarded" as insults, but nobody bats an eye if you call someone "crazy" or "psycho".

But for all of that, it's basically unheard of for someone in power to say anything meaningful about mental health. When Hollywood approaches the topic, the results are universally rancid. Games tend to fall into two camps: crazy-person-as-horror-villain studio hack jobs, or autobiographical indies that actually bring some experience to the picture.

And that's why Hellblade stands out so much to me. It's not an indie; it has the full weight of a storied and talented (albeit small) studio behind it. But they've done the work to actually try to depict psychosis in a realistic way, that brings the player into the experience as an exercise in empathy, not just a cheap aesthetic choice.

It was a marvel to me how the puzzles in the game are built around seeing patterns that aren't really there, exactly like I did during my psychotic episodes. The scene where all the trees have eyes, but they're really just tricks of the light, was so incredibly true to my experience. I never saw things that weren't there; I saw things that were there but misinterpreted them in critical ways, just like Senua.

And Senua? Possibly my favorite protagonist of any game. Melina Jeurgens gives it so much of herself, and her character design is such a breath of fresh air in an industry full of gross fan service. She looks like a real person! She's still pretty, but doesn't look like a RealDoll that someone dressed up in cosplay gear.

I could only play this game in short sessions because it's so damn intense. The story hits hard, and Senua's agonizing deaths were challenging. Mechanically, the game is really quite light. Only a couple gameplay verbs are made available as the story progresses very linearly. Hellblade aims to challenge the player on a sensory, emotional and intellectual level more than a gameplay one. For me, it was deeply effective and affecting.

With the sequel on the horizon it's exciting to imagine what Ninja Theory has in store for us next. It really feels like the conversation around mental health is starting to turn; the crazies are finally out telling their stories, taboos and misinformation be damned. I love how indie developers have stepped up and started raising the level of discourse around mental health and I really hope that more and bigger studios follow suit. Fear of retaliation or judgment can make mental illness a really isolating experience. It really does feel good to feel seen, and playing a game like Hellblade is really great reminder that I'm not alone.

Reviewed on Sep 16, 2023


7 Comments


7 months ago

This is an amazing review and one I can only imagine was hard to write so thank you for opening up.

I wasn't a fan of it as a game, but I absolutely appreciated what they were doing from a mental health point of view but equally I wasn't the target audience for this and that's fine. I'm genuinely happy that it resonated so well with you and what you went through and I hope the sequel is as nuanced.

7 months ago

Echoing what FallenGrace said, incredible and insightful write-up, and a very personal one.

7 months ago

This is one of the AA games I love. So much profound quality, care done with enough research and passion. Short, but doesn't need to be long. It's telling enough to lure the player deeper with the main character. And Senua I would say rises above the mettle to describe what mental illness does to a person. How they cope, what they suffer from, and the audio design complements and enhances the immersion to an insane degree. Nailing the atmosphere in so many scenes. While keeping it grounded. Seriously playing with headphones is such an experience. And the added developer commentary videos inside the game made me appreciate the game further. Seriously the devs did a lot of work behind the scenes to accurately depict mental illness. It was an incredible learning experience. Translating well in seeing how & why Senua struggles with Psychosis and so much more. I was enthralled, horrified, and most of all curious about how her journey would end before the credits rolled. It is a touching, heartfelt story just as your personal history given in this review which I feel elevates your text further. Fantastic review! Can't wait to see what the sequel offers as well!

Tangentially related, this game also made me seek out other characters with similar mental illnesses, and the closest I found was a character in Fire Emblem Three Houses. Not going to say the name since it's technically a spoiler to what the character undergoes, but I found their development like Senua incredible to witness by the end.

7 months ago

Damn. I appreciate when a person has the confidence be so real, in a review of all places, it makes your last line hit twice. Thanks.
I had to put this down when I was in a bad place myself, because it was just too viceral, especially the Sound design. This makes me wanna give it the chance it deserves.

7 months ago

Wow. I'm speechless. A phenomenal write-up and I'm really glad you shared your experience here. Keep it up <3 <3 <3

7 months ago

Killer write-up as always. Thanks so much for sharing your experience and perspective, it's fantastic that you've been able to find "the happiest possible outcome"!

3 months ago

“Mental health is like sexuality, in that we as a society are obsessed with it but only seem to engage with it in the most unhealthy ways.“
that was some wisdom i didn’t expect to hear on a backlog website AND from a gamer. others praised ur whole review (rightfully so), but thank u specially for this part too. you don’t know what small part of ur words would make someone feel more ‘normal’ on this strange planet.

+also i’m glad (as of now) my like made ur review the top most liked review of this game : ) it’s correct spot.