Hellblade: Senua’s Sacrifice is so good that it’s bad for my mental health

Posted on August 21, 2017

SPOILER ALERT: I will be talking about aspects from the first 3 hours of Hellblade. There may be mild spoilers abound in this article.

Hellblade: Senua’s Sacrifice is not fun. Hear me out. It’s not the kind of game that you get excited to play after a hard day at work. It’s not relaxing. Quite the opposite of relaxing to be honest. It raises my hackles, has me checking over my shoulder for voices that aren’t there, makes my heart race and my hands shake. I have to alt-tab to talk to friends or check Facebook just to get a brief escape from the game’s intensity.

Hellblade: Senua’s Sacrifice is so good that it’s literally bad for my mental health. It’s so effective in its techniques that it makes me incredibly hesitant to pick up and continue playing. It’s so powerful that the game aptly begins with this warning:

I’ve been following the development diaries from Ninja Theory ever since they announced the premise of Hellblade at Gamescom a couple of years ago, though I did struggle to look past such a cheesy title for a while. A Celtic woman on a quest to save her lover’s soul from Hellheim. Yes – strong female main character, count me in! Twist – she suffers from psychosis. Colour me… interested, but incredibly dubious.  

Many games have tried the mental illness route before but very few get the formula right. Most of the time they come across as poorly researched, patronising, glorified, romanticised, or a combination of the above. Especially when it comes to the more “extreme” ends of mental illness, such as psychosis. “Psychotic” is a bad word in common usage; I’m sure you’ve probably heard someone refer to someone else as “that psycho” or “they’re completely psychotic!”. However, “psychosis” is the clinical term for a range of symptoms usually associated with schizophrenia. The titular character, Senua, hears voices that aren’t there. Sometimes she sees things that aren’t real.

The video below is an excerpt from the 25 minute documentary included with the game, and it provides a little more context to what I will be talking about.

Full disclosure – I don’t suffer from psychosis. I have a number of mental health issues, some of which I’ll go into with you, but psychosis is not one of them. The only voice in my head is my own inner critic. That voice is loud, unbearable, and I have to fight to ignore it or keep it muffled. What unsettles me the most is that voice, my voice, is echoed by some of the voices that Senua hears.

I’ll quickly air my dirty laundry so that you have a better idea of where I’m coming from. I suffer from a combination of major depressive disorder, generalised anxiety disorder, post-traumatic stress disorder, and borderline personality disorder. Most of them are self-explanatory, except for the last one – BPD is not very well understood and is pretty stigmatised. It doesn’t mean that I’m on the border of having a personality disorder. I won’t go into all of the diagnostic criteria (that’s what Wikipedia is for), but I’ve heard it best defined as “the borderline between neurosis and psychosis”. I don’t suffer from outright psychosis, but some of my behaviours and symptoms echo it.

Upon booting up the game, it recommends that you play with headphones for a proper 3D binaural experience. I hook up my 7.1 surround sound headset, turn off the lights and my other monitors, and settle in for an experience. There is little faff. You start a new game and are immediately greeted by the most prominent voice whispering softly, almost calmingly, in your ear.

“Hello. Who are you? It doesn’t matter. Welcome. You’re safe with me. I’ll be right here, nice and close so that I can speak without alerting the others. Let me tell you about Senua, though her story has already come to an end.”

The screen pans forward, showing the back of a woman, paddling up a river with what appears to be a head covered in bandages strapped to her belt. This is when the other voices chime in, from all directions.

“It’s breathing, the head is breathing.”  

“He knows she’s getting closer.”  

“They’re watching.”

“They’re watching.”

They’re watching.

“They can feel you coming.”



Pause.  A couple of seconds of reprieve where the only other sound is the soft splash of an oar rowing through water.

“Oh, how rude of me. I never told you of the others. You hear them too, right? They’ve been around ever since the tragedy. Ah, that’s not quite true. Some are old, some are new. But they’ve changed. I think the darkness changed them, just like it changed her.”

The narrator continues, but so do the other voices. Fading in and out, filled with urgency. I alt-tab to mention my mounting anxiety to a friend, and reply to a message (that was, ironically, asking if anyone was playing this very game).

“What is she doing?”

There are bodies scattered around me. Some hanging, some pierced on spikes. All rotting.


“Can you see them?”

“Why isn’t she looking?”

A soft giggle, “why aren’t you looking?”

“Turn back.”

“Go back.”

“It’s not safe.”


I check the run time on my recording software. 3 minutes. I’d barely gotten through 3 minutes of the game and I was already incredibly uncomfortable.

“Can you see them? They’re going to do that to you.”

“They’re watching. Can you feel them watching her?”

“You think you can overcome the darkness.Make sense of it. And once relief settles in, it strikes out of nowhere, throwing you helplessly back into the maelstrom. Drowning the mind in fear, deeper, deeper, dragging you down so far into the void that maybe this time, there is no coming back. With every battle the darkness grows stronger. Every victory bringing her closer to defeat. Unfair isn’t it?”

When one of the voices in Senua’s head whispers this in my ear, my heart drops and I blink back tears. It is unfair. How many times has my voice said that in the back of my head? We’re supposed to keep our chins up, keep fighting the good fight, search for the light at the end of the tunnel. What happens when that light isn’t there? I’ve been fighting all of this for over half of my life. Next year will mark 18 years since I was first diagnosed with depression. This year is the eighth year that I’ve been seeing my psychiatrist every 2 – 8 weeks. When is it my time to break through and begin to shine?

I digress – this is about Senua, not me… actually, no. This is about me and Senua. And these damned voices.

Continuing play, I realise how little the game holds your hand. Nothing is overly difficult here but the lack of UI, lack of tutorials, lack of on-screen prompts, and even the inability to save your game manually is isolating. I think it’s important to note that even these subtle omissions create that feeling of being alone in an unknown and scary world. No-one is there to help or save you from the horrors ahead.

I push my tolerance a little harder and make it further into the game, whispers continuing in my ears.  I fight some ghastly shades of viking warriors long gone and one voice warns me with an abrupt “Evade!”, so I do. It saved my life. “Don’t let them surround you.” But they do, and the voices get louder and more desperate. Then I fall. Senua lets out a bloodcurdling scream that drags on, assaulting my eardrums with utter agony. She’s on her knees, clutching at her hand. Here the developers introduce the Rot mechanic. Rot begins to take over Senua, starting at her hand. Each time you die, the Rot climbs further up her arm until it eventually reaches her head. If it reaches her head… game over. And the game tells you that it’s not your traditional game over either – that your save gets deleted. This is the first of many battles against minions of Hellheim, and I have already failed Senua once.

Not only do I have to deal with the whispers in my ears terrorising me and Senua’s tortured screams when she falls, but now there’s a “bad end” mechanic? My anxiety jumps through the roof. See, I have this weird fear of dying in video games. I freely admit to cheating my way through games so that I never see that dreaded “Game Over” screen. I just want to make sure I don’t die through any failure of my own. I don’t know where it comes from. Perhaps my perfectionism, fear of failure, and the exceedingly high expectations I have for myself carry over into my gaming habits too. It’s one of the reasons I’ve never been able to embrace games like Dark Souls and Bloodborne, where failure is a featured mechanic. All this said, there have been little to no reports of anyone managing to hit this point.

I take another break and ring my mum. I tell her with excitement about writing my first feature for Checkpoint, and go into some of the details of the game. “…why would you put yourself through that?” She’s so confused. As is my girlfriend. They both know that I handle stress and anxiety poorly, so why put myself in a position where I risk elevating my symptoms? Because the game is good. I want to journey with Senua. I want to journey with those people that helped inspire and create such an accurate depiction of what someone that suffers from psychosis goes through. My girlfriend tries to reason with me. “Please, at least try playing it during the day, with the speakers and not your headphones.” And even though I know she’s right, I also know it would weaken the experience.

I have to forcibly will myself to keep playing, but it can be hard to work up the motivation. Nothing about Hellblade is enjoyable, but it’s absolutely captivating.

I think that this game is a very important piece of work. It was researched with such empathy, as is proved in the 25 minute documentary included with purchase. As I said, I don’t suffer from psychosis but I do have my own personal issues. This was incredibly eye-opening to what those with psychosis might go through on a daily basis. The fact that this was designed in conjunction with people that have lived experience is such an important part of Hellblade. This could prove a vital avenue to expose those who are not mentally ill to what sufferers go through. For those of you that are interested in the game and do have mental health issues – remember your self care. Take frequent breaks, watch silly videos, talk to loved ones. Don’t let my struggles put you off playing this. Support it. Play it. Show the industry that this type of game is not only financially viable, but also well-received and worthy of the time and effort.

Honestly, I am dreading going back to the game.  Not because it is bad, poorly designed, or tropey. I could ‘cheat’ and play without headphones, but that really does ruin the intensity of the experience. But I will finish it. It deserves that justice. I want to go on this journey with Senua, and with myself. We will get through this darkness. Together.