Fighting depression in the video game world, one AFK at a time

Matt Hughes took his own life in the fall of 2012. He was a freelance reporter covering the video game industry, and before he committed suicide, he sent emails to some of his editors, noting that he wouldn't be able to turn in more stories for one simple reason: He'd be dead.

His suicide surprised nearly everyone who worked with him. Speaking with Kotaku days after Hughes' death, his former editors said things like There weren't any red flags and This was a complete shock. Hughes wasn't the only person in the video game industry to take his own life that year, and as the tragedies piled up, it became impossible to ignore their commonalities. Complete surprise. No one knew. She seemed fine.

For Russ Pitts and Susan Arendt, two editors who had worked with Hughes and regularly interacted with dozens of other freelance reporters, these suicides were more than a shock. They were a wakeup call.

"As we were more aware of the issue, the easier it was to see it and the easier it was to talk about it," Pitts says. "The lack of awareness of mental health issues, it's not exactly passive. I think there's a lot of misunderstanding, and the stigma contributes to this sort of feeling that mental health issues are to be avoided at all costs."

Pitts and Arendt didn't want to mourn more of their colleagues -- they wanted to help. In 2012, they established Take This, a blog for people in the industry to share their own stories of depression, suicidal thoughts and anxiety. It was a huge success, with hundreds of people eager to share their stories and hopefully help others.

Today, Take This is a nonprofit organization that encourages people in the video game world -- players, developers, reporters and everyone in between -- to talk about mental health. The group sponsors a space called the AFK Room at a handful of major gaming conventions, providing a quiet area and licensed clinicians for people who feel overwhelmed, anxious, depressed or suicidal. The charity wants to reduce the stigma around mental illness and show people in the gaming industry that they're not alone, before it becomes too late.

Before diving into the specifics, let's take a step back: Mental illness is not unique to the video game world. However, the industry attracts specifics types of people and encourages an environment that may make these problems more prevalent.

Roughly one in five adults in the United States experiences mental illness every year, according to the National Alliance on Mental Illness. That's 43.8 million people debilitated by depression, anxiety, schizophrenia or other issues at least once every 12 months. Plus, one in five young adults age 13 to 18 struggles with a severe mental disorder at some point in their early lives.

"We have anecdotal data to suggest that that's much higher in the video game community," Pitts says. "And we know there are causes for that. We know that the industry contributes to a lot of worsening of mental health symptoms because of the stresses of working on video games, the stresses of changing jobs frequently -- unique factors built into video game studios."

Russ Pitts (seated) discusses the AFK Room's goals. (Image: Flying Saucer Media)

The video game industry is volatile. Layoffs are common and success can be hit-or-miss at any level, from independent development to billion-dollar AAA studios. "Crunch time" -- a period of high-pressure work over increased hours, usually right before a game's release -- is also an ingrained aspect for many studios. The 2015 IGDA Developer Satisfaction Survey found that 62 percent of developers experience at least one crunch a year.

Independent developer Michael Levall knows how it feels to be pushed to the limit in the gaming industry. He's building Please Knock on My Door, a game about his own experiences with depression, and he sees the mind-melting stresses of development every day.

"I have met many people in our industry who either are or have suffered from depression, and it shouldn't come as a surprise," Levall says. "For many of us, our work is our passion. The downside to that is that working overtime leads to burnout, which in itself is a gateway to depression. There is also the economical stress of working as an indie developer, or the stress of knowing how hard it is to find a new job should your studio go bankrupt or your project be shelved."

Game developers may be more susceptible to living with untreated mental illnesses, as well. In three years of running Take This, Pitts has heard the same thing from hundreds of clinicians and advisers: Generally, the more educated or technically sophisticated a person is, the less likely he or she is to seek help for mental issues.

"The sense is that because it's a mental issue and they're highly skilled in mental areas, they can think their way out of it," Pitts says. "And a lot of people try that, and it doesn't work."

Please Knock on My Door was inspired by Levall's fight with depression. (Image: Levall Games)

It's not just developers, either. A handful of studies demonstrate that some players use gaming as a coping mechanism for various mental illnesses, including depression and anxiety.

"We know that video gamers demographically are more susceptible to mental health issues and are more likely to be attracted to the community as an escape from these issues," Pitts says. "And the community is not always positive reinforcement for that."

Plus, in an industry hungry for new technologies and streamlined solutions, many developers, players and gaming journalists end up working remotely or cultivating online-only relationships. These can be threadbare lifelines: You can't see body language, hear tone of voice or pick up on other clues that someone might be experiencing a mental breakdown.

"In a digital relationship, you only get what people share with you," Pitts says.

Gaming conventions like GDC, E3 or PAX throw these facets of the gaming industry into a giant pressure cooker. Many developers attend conventions to find new jobs, which is a stressful task on its own. Or, people go as part of a highly anticipated event with friends, which triggers a kind of self-imposed stress. Many attendees don't get enough sleep during major events; they're encouraged to network instead. Meanwhile, conventions are crowded affairs filled with long lines. All of these factors increase the chance of a crisis.

That's why Take This focused on mental health at conventions first. In 2012 and 2013, when Take This was still a blog, its founders and contributors held panel presentations at some of these big gaming gatherings. They talked about their own issues with mental health and provided resources for anyone else who happened to be struggling. The panels were a huge success. People would regularly walk up to the presenters afterward in tears, asking for hugs.

Take This founders Dr. Mark Kline, Russ Pitts and Susan Arendt. (Image: Flying Saucer Media)

"It was this weird, powerful thing where we realized how desperate people were for affirmation that what they were dealing with was normal," Pitts says.

Building on this momentum, Take This unveiled the AFK Room at PAX East in 2014. It's a quiet space staffed by volunteers and licensed clinicians who can speak with people who feel overwhelmed, anxious, depressed or suicidal at conventions. The AFK Room doesn't dispense therapy, but it helps attendees get their bearings and calm down -- and it's often the first time some of these people interact with a mental health professional. The rooms generally see 500 attendees a day.

While the AFK Room introduces attendees to local clinicians, it also demystifies the gaming community for mental health professionals. Pitts vets the staff beforehand; it's an important step, because many of the clinicians he talks to preach abstinence right out of the gate. If someone comes into their office and says, "I'm depressed. Also, I play video games," many clinicians will immediately recommend cutting out games entirely. Pitts doesn't agree with that course of action.

Gaming is often a coping mechanism for players who suffer from depression and other issues; it's not the root of their problems. Levall, the developer of Please Knock on My Door, was actually inspired by his own gaming habit and how it interacted with his depression.

"This game was simply called Alone, and with it I tried to capture the gray, lifeless routine I was stuck in," Levall says. "For example, I didn't play games because I enjoyed it; I played because I needed to waste time until the clock hit 10 p.m. and I could go to sleep. Alone later on became the prototype I used to lay the foundation for Please Knock on My Door."

While helping attendees, the AFK Room also educates its clinicians on the importance video games have in some people's lives.

"That's the other, secret motive for the AFK Room," Pitts says. "We bring these people in, in an almost archaeological sense, to give them an experience with the community. So the guests in the room get the experience of meeting with a clinician demystified, and the clinicians get the experience of working in this community demystified. It was an accident, but it's great. It works."

On top of the AFK Room, Take This provides crisis training to staff and volunteers at large gaming events like PAX, PAX East, QuakeCon and GDC. For example, if an attendee is being belligerent in line, that person may not be a troublemaker; he could be having a panic attack or be highly depressed. She may need help, not punishment.

One of Take This' goals is to give staff a tool other than doing nothing or calling 911. "Most of the time, people can tell when someone needs help, but they just don't know what to do," Pitts says.

Take This isn't all about conventions, though. It aims to start broader conversations about the silent, lethal force that has claimed the lives of too many people in the gaming industry. But people are reluctant to talk about mental health issues, Pitts says.

"You spend five minutes talking to someone about mental health and they're going to try very hard to talk about something else," he says. "That affects us at an institutional level."

Other people misunderstand mental illness entirely. Take This attempted to set up an AFK Room at one big gaming convention in recent years, but the show's CEO didn't want the gathering to be associated with "wackos," and so the effort fell apart. Encounters like this illustrate the massive task of educating the industry that Take This still has to tackle.

Developers like Levall are doing their part to start this conversation, too. Please Knock on My Door is a tricky game to develop: Its subject matter, depression, is inherently un-fun. But Levall has done his best to create something that engages players while offering a look at the darker side of mental health.

"I sincerely believe that it is easier to help someone widen their perspective on a topic while entertaining them -- something skilled comedians do to great effect," Levall says. "While Please Knock on My Door is not about making you laugh, my goal is to leave you with a perspective on mental illness that is wider than when you started playing."

One of the misconceptions about mental health that Levall frequently runs into is the idea that people can simply "get over" depression. This is akin to telling someone to get rid of a cold by "trying harder." Depression is a medical condition, not something anyone can willfully overcome.

Levall turns his message of compassion and understanding on himself, too.

"I feel like the misconceptions can come from both ways," he says. "If you have been deeply depressed, and maybe even suicidal, you shouldn't tell someone who is going through tough times that they are not depressed because they haven't reached the depths you've been to. I feel like the key is to be attentive to other people's situations and accept that we all deal with hardships differently."

The AFK Room at PAX South 2015 saw 500 visitors per day. (Image: Flying Saucer Media)

Pitts understands this first-hand.

"It wasn't until the second year of Take This before I saw a therapist for the first time and started treating my own issues," he says. "I didn't know. For the longest time, I didn't know I was dealing with depression."

As the conversation around mental health grows in the video game community, plenty of other players, fans, developers and reporters may have similar epiphanies. The difference is that, now, they'll have somewhere to turn.

If you or someone you love could benefit from a supportive community of video game fans, check out TakeThis.org for blog posts and expert advice on depression, anxiety and other mental health issues. For those in crisis and in need of immediate help, please visit the National Suicide Prevention Lifeline or call 1-800-273-8255. You're not alone.

Disclaimer: Susan Arendt, co-founder of Take This, is former managing editor of Joystiq, which was owned by Engadget's parent company, AOL. Prior to working at Engadget, the author was a writer at Joystiq, reporting to Arendt. The above story was conceived and completed independently of this relationship.