Blurring the Lines 3: Depression, Anxiety, and Spaceships

JMoravia 2018-05-02

Artwork by Mintaki.

In part one and part two of “Blurring the Lines,” INN explored several ways in which EVE Online reaches its fingers into a person’s real life. Sometimes this takes the form of players learning social skills in the game that help them blossom in the real world. Sometimes it means forging true friendships with people who become meaningful friends outside the game. Sometimes it even means finding a place to work through depression and anxiety.

That final sentence sums up a surprising number of stories I heard while preparing for the first two articles in the series. Anxiety and depression seem like a very common thread in many player stories – but why? And what about EVE Online makes New Eden a place where players can work through those issues?

Why do these particular struggles show up so frequently in player stories? Because they are, indeed, common. According to the National Institutes of Health (NIH), over sixteen million Americans experienced an episode of major depression in 2016 – one out of every 16 people in the country. (For those INN readers not from the United States, a quick Google search should turn up statistics for your home country.) Next time you’re walking down a busy street, take a look at the faces of the people around you and think about what it means for one out of every 16 of them to struggle with depression this year – and then a further one out of 16 the next year, and the next year, and the next. Anxiety disorders are even more common, with the Anxiety and Depression Association of America (ADAA) reporting that a staggering 40 million American adults – almost one out of every 5 adults in the country! – struggles with an anxiety disorder. Further, the ADAA also says that despite the stereotype of “depressed emo kids,” the median age of onset for major depression is 32.5 years old.

I think there is a widespread ignorance about just how common these issues can be. The New York Times reported in 2005 that “More than half of Americans will develop a mental illness at some point in their lives,” and a huge number of those will never seek formal treatment. The NIH, in the study linked earlier, reported that 37% of those with major depression received no treatment, while the ADAA gave a nearly identical statistic: 36.9% of those with anxiety disorders do not receive treatment. Even those who received “treatment” may not have actually noticed any relief from their ailment, with the NIH reporting that antidepressants are only 20% more effective than a placebo at alleviating symptoms of depression.

What does all this mean? It means that millions upon millions of Americans, and huge numbers of people in other countries, are struggling day after day with crippling feelings of doubt, lack of motivation, inability to perform daily tasks, and out-of-control emotions. As a teacher, I’ve seen these things in my students, but if you have no direct experience with depression or anxiety, then you can have no idea what it’s like to feel like you’re not in control of your own mind. You have no concept of how terrifying it feels when your emotions won’t obey, or when everything is great in your life but you still feel horrible. You cannot comprehend wondering every day if things are ever going to get better – if this awful cloud is ever going to lift. In light of all that, New Eden seems like a pretty inviting place.

Yet that is precisely the thing: Based on the stories players have told me, New Eden is not merely a place people go to forget about what’s happening in their real lives. It’s actually a place where they go to get better.

Player Story: Fighting the “Black Dog”

The next story comes to us from Djan Sma, an Imperium pilot whose story was the catalyst for this entire article.

“I’ve been on and off of EVE for at least the past decade. I never really took it seriously, for the most part I never really felt that I belonged anywhere. Then when the Casino War happened, I fell into a niche with Ghost Squad, our AUTZ cohort. I developed relationships with the people there and it helped me stick around. It helped me immensely, getting those interactions with people I felt comfortable around, and it kept me in the game and made me eager to do more.

“Most importantly, after developing these friendships and stepping back to look at myself, I recognized after much turmoil and therapy sessions that I had anxiety and depression. Pushing myself into EVE and learning to be confident in what I was doing allowed me to recognize that I grew up in an abusive household, and that regardless of what was going on, that I had people there that I considered like family. Being at ease with myself gave me the ability to push through to take on some added responsibilities in the alliance.

“Anxiety and depression speak to you in a way that tells you there’s something wrong with you specifically, and that if you actually talk about it, you’ll start being handled with kid gloves. One of the things that works so well in EVE, especially in a large community like GSF, you’ll find people who have gone through the same thing as you have, just some different circumstances. There’s still a bit of the anonymity that comes with being on the internet, so you do feel a little less unafraid to share with people you become close with.

“Basically the time you spend mining with 7G or Theta brings you a bit closer and lets you learn a few ways to cope with those mental situations until you’re a bit more comfortable talking about it in real life. That’s because in EVE you don’t really have that sort of pressure to perform, since it’s not real life. It’s still a game.

“I’m sure most people who do anything diplomatically in EVE have seen Sion’s video. Some people never shut up about it. If you haven’t seen it (what’s the matter with you), there’s a part where he mentions being able to put yourself on a shelf to take yourself out of the equation, so you can find the best foot forward in a discussion. My real world profession is that of a nurse, specifically a charge nurse. Nurses make sure the doctors don’t kill you, and the charge nurses make sure that the nurses don’t kill you. Of course this means I have to get involved in every dispute between staff members and patients, but the ability to box yourself and your emotions up, to find a clear path with as little bias as possible, is an invaluable tool. Constantly doing this in EVE has given me the confidence to be able to do this part of my job more effectively, keep my mind clear in hectic situations, and organize it all into manageable chunks.”

Healing Through Spaceships

What do depression and anxiety look like in the lives of people who struggle with them? This is an extremely broad question, as there are numerous different types of both anxiety and depression, but some general threads can be woven together.

The major symptom of depression, obviously, is a persistent and unshakable feeling of sadness or emptiness. Those feelings are almost always accompanied by a lack of motivation or a loss of interest, especially in things the person normally enjoys. Simply put, life stops being fun; things that are supposed to be fun aren’t for some reason, and things that aren’t supposed to make you sad do for some reason. Other common symptoms are a loss of self-worth, persistent negative self-talk (“I’m so stupid and worthless; why does anybody bother with me?”), inexplicable feelings of guilt, or a lack of hope for the future. Eventually these symptoms begin to interfere with a person’s normal day-to-day functioning. College students may begin skipping class because they can’t find the motivation to put on clothes. Employees may begin calling in sick to work, or may find themselves constantly second-guessing every decision they make, certain that they’re going to mess up and lose their jobs and disappoint everyone and face a miserable future. If that thought process sounds like hyperbole, please understand that it is exactly the thought process that depression tends to produce in people. Fighting those thoughts, every moment of every single day, with no idea whether you’re ever going to get better, is beyond exhausting.

According to the ADAA, “Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things.” One of my students with anxiety disorder has described to me in detail the way she instantly and vividly imagines all the horrible outcomes that may result from some situation, how she can’t stop obsessing over them, and how even when the situation is resolved in a happy manner, she remains convinced that something will go awfully wrong. Most people with anxiety disorder know their thoughts aren’t healthy, and also know that things never go as wrong as they fear, but their brains simply will not respond to the commands to stop worrying. Just imagine, if you don’t struggle with anxiety yourself, how absolutely crippling it would be to go through an entire day in freak-out mode and not be able to turn that switch off. Djan Sma adds: “One of the things that goes with the anxiety is having certain triggers. Until you’re able to step back and look at things in a calmer environment, you don’t really know what sets you off.” Identifying those triggers is an important step in beginning to fight back against the disease, but for a person who is just beginning to struggle with anxiety, suddenly having your brain tied in knots – with no idea why – is beyond terrifying. You feel out of control in your own body, with no clue what’s happening to you or how to fix it, scared to even talk about what’s happening because people might think you’re crazy.

If those lists of symptoms have made no sense to you, then you can easily see why there is still a stigma surrounding mental illness and why these conditions are so difficult to talk about. Nearly every person who struggles with depression has heard, “why are you sad? You should try harder to stop being sad.” Nearly everyone with anxiety has heard, “everything will be fine. Just stop worrying about it.” Let me be very explicit: depression is not sadness, and anxiety is not worry. Depression and anxiety are mental illnesses, and the whole point is that they cause the brain to respond in ways that are not normal. But those kinds of ignorant reactions from well-meaning people are precisely the reason why people with mental illness do not typically want to talk about it.

How does all this relate to EVE Online? My contention is that New Eden is the perfect place for a player to work through issues related to depression and anxiety, in a setting that has less pressure than real life but where the rewards for success are just as high. EVE is a place where there are always things you can do, but there is nothing you have to do.

Depression and anxiety are crippling for people because real life has no pause button. You have to wake up and go to work tomorrow even if you would rather crawl into a ball and sleep for six months, even if the thought of taking a shower fills you with dread because there are sixteen different ways you could die. When you come home, you have more responsibilities: food to make and a bedroom to clean and laundry to do. Life is really an incredible grind; the mere act of staying alive is extremely expensive and extremely labor-intensive. Nobody likes vacuuming the floor, but for a person with depression or anxiety, the thought of vacuuming (“I never do a good enough job, and the floor is just going to be filthy again tomorrow anyway, but I really should because if one of my friends comes over they’re going to be really disappointed in me”) is so utterly overwhelming that their brain simply refuses to send the go-signal. Yet the floor will not clean itself. Life grinds on. You have to go through the motions, hoping tomorrow will be better. Spoiler alert: it won’t be.

EVE, on the other hand, offers a meaningful sense of progression but without a sense of obligation, without “pressure to perform” as Djan phrased it. In-game, you can work on building your skills toward a goal, giving you a real sense that you’ve achieved something. You can watch your wallet grow, and you can buy and fit new ships to fill your space-garages. Although there’s no level-up in EVE, nothing like World of Warcraft’s visceral rush where your character is bathed in golden light, there is still a feeling of achievement.

The great thing is that you can make those achievements either by yourself or in a group. You can mine solo if you want to, or you can join one of your alliance’s mining fleets – the choice is yours. Unlike real life, where you have to go to work and smile at customers even if you would rather drown yourself in a bathtub, EVE requires no smiling, no communication at all apart from perhaps a “thanks for the fleet.” If you want to talk, you can. If you want to be quiet, you can. In this sense, EVE plays a crucial role in restoring a sense of agency to the player who feels out of control, at the mercy of his or her own mind. The choice is yours, unlike in real life, where your mental illness is something that happens to you and you are powerless to prevent it or make it go away.

Further – and this is crucial – you are under no pressure to talk about your mental illness. If you’ve ever talked to people who are depressed or have anxiety, you will find that, more than anything, they simply want to be normal. They don’t want to talk about their problems; they want those problems to go away, and in EVE Online, if only for a few hours, they can fly just like everyone else, mine just like everyone else, and PvP just like everyone else, without needing to be defined by their condition. As Djan Sma told me, “one of the things that goes with the lack of pressure is that you’re free to contribute as much or as little as you want. When you become more comfortable with yourself, you find that you start to take on more roles at your own pace and find confidence in those roles.” Those phrases – “as much or as little as you want,” “at your own pace” – those are the language of agency, of feeling like you’re in control of how things are unfolding. This is a feeling that those with anxiety and depression simply do not experience very often in real life.

As Djan also pointed out in his story, although EVE is a place where players are not forced to talk about their condition, it can also be a sandbox where players can learn to talk about their condition, in their own way, on their own time, and in a non-judgmental environment. I don’t even want to think about how many people are hiding their depression or anxiety from their bosses, or even their spouses, for fear of how those people would react. Within EVE, though, nobody is going to think any less of you. You can practice opening up to those around you, figuring out how to describe your condition in a way that makes it sound less scary to those who don’t know, preparing answers to the stupid questions you’re going to get when you try and explain yourself to people who are clueless. Then, when you’re ready, you can take all of that to the real world and express your thoughts and feelings the way that best suits you. Knowing how to talk about your condition can help you achieve agency, can help you feel some power over it, and EVE is a great place to develop that talk.

One other thing Djan mentioned: in a corporation or alliance of any meaningful size, you’re absolutely guaranteed to find other people who have struggled with mental illness, or even who are struggling with it right now. For whatever reason, the first way mental illness tends to afflict people is with thoughts of, “I am completely alone in this. I’m a total weirdo and no one understands what I am going through.” Connecting with others, smashing that lie of solitude, is a huge first step in fighting back. Added to this, other people can share their coping strategies with you. Someone who’s figured out how to break the cycle of worry, someone who’s mastered the self-talk of encouragement and hope, can give you something extremely valuable. There are many places a person could make these kinds of connections, from support groups to a board game club to a church group to your own neighborhood, but for a person who is scared and dealing with a mental illness that is planting awful and unpredictable thoughts in their heads, the pseudo-anonymity of EVE, where you can reveal as much or as little about yourself as you want, is a really good place to begin.

Please understand me carefully. I am not saying that an online video game can or should take the place of professional help, whether counseling or medicine or both. Do not be one of the 37% who receive no treatment for anxiety or depression, because the truth is that you do not have to suffer alone. However, I do know how terrifying it can be to take that first step. I have personally seen a friend walk a student to the counselor’s office because the student was too scared to go alone. If you have read over the symptoms of anxiety or depression and you felt them resonating in your soul, but you can’t muster the courage to open the phone book and call a therapist, maybe you can start with EVE. Starting somewhere is better than not starting.

The Big Takeaway

So what conclusions are we supposed to draw from all this? The first and most important is that, if you’re battling depression or anxiety or any other mental illness, you are not alone. According to that New York Times article, you’re actually in the majority. Depression and anxiety are not weird, or rare, or a sign that you’re defective. The human body is a ludicrously complex system of organs and cells, and it’s a wonder that any part of it ever works right. Yet our brains can get sick just like the rest of our bodies can, and this is a perfectly normal part of the human experience.

Another big conclusion, and related to the first, is that you have friends in New Eden, and if you don’t, then you easily can. I can’t speak for any of the other large alliances, but I can say there’s a place for you in Goonswarm Federation. Whether you want to quietly mine in a system with twenty other people, saying nothing but taking comfort from the fact that your friends are nearby; or whether you want to do a Saturday Night Swarm with fifty drunk Goons and a Russian accordion player, you’ll find people who like you and want to be around you, mental issues and all. You don’t have to put up a front. You can be yourself in EVE in a way that, perhaps, you cannot in real life – your messed-up, imperfect, broken, real self.

Djan Sma’s story formed the core of this article, but his was just one of many stories I encountered with the threads of anxiety and/or depression woven into them. I don’t know whether depression and anxiety are more common now than at any other point in history (although, with how complex and fast-moving and unpredictable our lives are, I would not be surprised) or whether we’ve simply gotten better at identifying and treating them. Whatever the case, though, mental illness is a common and normal part of the human experience. People in your corporation and alliance have struggled with mental illness in the past, and maybe they even are right now. We never know the stories of the people we talk to, unless those people choose to share with us. Yet you can share a valuable gift with players who are battling depression and anxiety. That gift may be a listening ear for those players who want to practice talking about their condition, who are using EVE to take those first terrifying steps toward healing. That gift may simply be creating a place where players with mental illness can be normal people for a while. That gift may even be challenging your own attitudes toward mental illness, realizing that these kinds of conditions are indeed normal and common, and understanding that one cannot simply will one’s way out of them, that they don’t make a person weak or weird or defective.

Ultimately there is nobody on Planet Earth, or any of the worlds of New Eden, who has it all together. We’re all works in progress, trying to figure out this crazy thing called life that didn’t come with an instruction manual or even a tutorial level, where there are no reloads or save points. None of us are in any position to finger-wag or pass judgment on anyone else’s struggles, because we have no clue what they’ve been through. Mental illness, having one’s own brain go haywire, is frightening enough. The least we can do, the absolute bare minimum of human decency, is to make things as easy as we can for those who are struggling.

Editor’s Note: If you’re depressed, suicidal, or need someone to talk to, please reach out to those around you or seek professional mental healthcare. There’s no shame in needing help.

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  • 9T9 Red Ballons

    I know the intention of the writer is good, but INN makes a mistake to publish it.

    Several things are problematic.
    – I see that the writers background is sports teacher. I hope that the readers will be aware that he is in no way qualified to make recommendations concerning treatment or “managing” a serious and widespread medical issue.
    – I have discussed this topic with an MD recently. His opinion was the opposite that was the writer is stating. EVE Online, as a harsh environment, and being a game that might have the tendency to isolate a person from real life (certainly someone suffering from depression or burnout) is *not* a solution, even not a valid palliative to the problem of depression.
    – Addiction to PC gaming is a real thing.Advising a person having depression problems to enter a virtual world with strong addictive potency (because of its social nature) is a bad advise.
    – Personal opinion here, but I would not advise playing a pc game with permaloss and social ramifications. Some social in eve are based on friendhip and camaraderie, but so many others are based on conflict… The simple fact of perma-losing a pixel spaceship can have an impact on someone suffering from depression.

    (sorry for the broken english, it’s my third language)

    May 2, 2018 at 1:35 pm
    • Bill Bones 9T9 Red Ballons

      Frankly, the author is taking an anecdote way too far. He thinks that EVE is good because it provides control over the experience (the player is master of his EVE experience) whereas EVE is fucking terrible precisely because it punishes without limits the lack of control over the experience that’s inherent to the system.

      EVE Online is the game of The Wizard and the Bonus Room. Nobody in his mind would recommend it to anyone with mental issues.

      May 2, 2018 at 8:29 pm
    • J Moravia 9T9 Red Ballons

      Thanks for commenting – and in your third language no less! I appreciate you taking the time to share your thoughts.

      I’m not just a sports coach. I’ve also had depression myself for more than a decade. I didn’t mention that in the article because my experience does not match that of the other players I’ve talked to – I can’t honestly say EVE has helped me in any way.

      That fact illustrates something the medical professional you talked to should have known: not every person responds the same way to the same kind of treatment. How many different types of antidepressant medications are on the market? A drug that helps you may do nothing for me. Counseling may help some feel better, while it may feel useless to others. Everyone is different.
      Unless that medical professional is capable of speaking for every single person with depression in the entire world, he or she is simply not qualified to say that EVE is “not a valid palliative,” especially since the very first comment on this article, which came through about an hour before yours, begins with the phrase, “I struggle with depression and playing eve helps.”

      I am not saying people SHOULD use the game as treatment for depression. I am not saying people OUGHT to feel better from playing it and making progress in it. (I am certainly not saying the game is free from issues that might be problematic for a person with depression, such as permaloss.) I am saying that some people – not all people – DO feel better when they play, and I set out to discover why. In that regard I stand by everything I said – especially the entire paragraph that I dedicated to the fact that the game does not take the place of getting professional help 🙂

      Thanks again for the thoughtful comment.

      Respectfully yours,

      May 2, 2018 at 9:38 pm
  • General Thade

    I struggle with depression and playing eve helps. I look forward to getting on during the week and its good to have people to talk too, but addiction to computer games is an real addiction. It releases dopamine. I have found that going outside and doing something helps a lot more than sitting on a computer. I have had to force myself to get off the PC in the past. I have had even withdraws ( not like drugs, just thinking about it and getting super depressed just because you cant get on it) so in most ways this article should support getting outside to the gaming community more than playing more games. Even if your fat, disabled, or hate doing stuff, going outside and just sitting down and looking around helps a ton.

    May 2, 2018 at 2:24 pm
  • Bill Bones

    “People who had positive experiences” it’s called the “survivorship bias”. A lonely guy who killed himself over a gank would never be heard of by lack of someone to tell his story… you’d only hear the story of the guy who logged in on the verge of suicide and talked to a buddy and spilled the beans and got support.

    May 2, 2018 at 8:34 pm
    • GrimScythe Bill Bones

      And that fact didn’t even cross my mind but you are absolutely right.

      May 3, 2018 at 7:59 am
  • Lekly

    What makes Eve so great for many players, struggling or not, isn’t necessarily the game mechanics but the community and connections they develop.

    Eve isn’t a cure. Eve isn’t therapy. Eve isn’t a guarantee. Eve IS a possibility though. It has the possibility to help people.

    If someone only sees the topic from a binary point of view they will end up invalidating some group of people. This isn’t an article to be ‘right’ or ‘wrong’ about, it’s a statement on a way that Eve can affect people’s lives.

    May 3, 2018 at 2:03 am
  • Susurrus Synaesthesia

    As a medical doctor specialized in psychiatry, I have strong reservations about recommending video games as a potential treatment for ‘anxiety or depression’.

    That being said, I am glad this article is here because it serves an important purpose. It helps to de-stigmatize mental illness and helps people get help. Additionally, any kind of positive social interaction is generally good for people feeling sad and isolated, and if playing EVE helps you and does not negatively impact your life in terms of social, occupational or IADL/ADL-type functioning, I’m not going encourage anyone to stop. I repeat, if it helps you, and ONLY helps you, I’d never tell you to stop. Plus, the game’s fun – I like getting alpha’d off the field of each major supercap escalation as much as the next guy. By the same token, I wouldn’t encourage any of my patients to start EVE online as a treatment because my treatment recommendations are guided by evidence, not anecdote, and there simply isn’t any research evidence for video games as lasting treatment of mood or anxiety disorders. However, if you’d like my spur-of-the-moment opinion on why I made the first statement in this post, keep reading.

    I’d give you several citations to primary source research on what proven treatments are (hint, not EVE online), but I’m post 24-hour call and pretty damn tired. In brief, I can tell you the research indicates that physical exercise (!!!) and real-life interpersonal connections provide significantly more emotional stability and improvement for depressed persons than virtual (i.e. not in person), not specifically therapeutic, relationships. If you’re looking for a ready hypothesis as to why, it is fairly simple: video games, like TV and books, offer an escape from your emotional distress. It’s part of why we engage in them – it gives us a break. The current empirically most effective treatment of Major Depressive Disorder (a.k.a MDD. Note, not ‘depression’ as this is an inexact and often colloquial description of feeling dysphoric/sad) is aimed at the underlying reason for the emotional distress/depressed mood via psychotherapy, social interventions AND concomitant psychotropic medications (I’m not going to discuss psychopharmacology right now). If you’ll accept an analogy: playing EVE is like taking a vacation when the problem is that you hate your job. Psychodynamic psychotherapy is like learning the unconscious reasons why you hate your job (hint: it’s your mother, jk, maybe). Cognitive Behavioral Therapy is a process of retraining the underlying maladaptive thought patterns that are your reaction to your job and cause you to hate it. Mindfulness therapy is like… et cetera. Therapeutic techniques are designed to address the underlying problem, not escape from it.

    Mental illness is a huge problem in the world and one I’m passionate about – if you want to ask me about a mental health topic, try to find me in the broadcastforreps channel in EVE under the user name you see listed here. I’m on there from time to time.

    – Dr. Sus

    May 3, 2018 at 7:55 pm
  • I’m of two minds about EVE on this count. On the one hand, I love having a group of people I can relax and gatecamp with. On the other hand, I find it very easy to become invested in or distracted by EVE goals. When I get in the habit of logging in to EVE a lot, I start neglecting real life stuff because the EVE stuff (whether it’s making space money, or trying to make sure every ship that goes through any gate or rats in any anom in a hostile region gets ganked) starts to feel like it’s of equal or greater importance than real life stuff. The more time I invest in the game, the more attached I become to the outcomes.

    Luckily, for every few weeks where I have time to get into the habit of playing EVE regularly, there are a few weeks when I’ll be too busy to touch the game at all. Also luckily, I enjoy my work enough that having to stop EVE doesn’t make me feel resentful. At times in my life when I’ve been both depressed (often) and hated my work, it was very tempting to just stay home and play the game 23.75/7. EVE’s a pretty complete, engaging, challenging universe box. The only way to avoid getting sucked into it is to have a real-life thing you enjoy doing just as much.

    May 5, 2018 at 6:57 am