Can video games depict serious illness? Yes, and they should

‘Hyper Light Drifter’ proves that video games have the insight and guile to represent our sickness

My friend Ali of the brilliant horror video games podcast Zero Brightness turned me onto a game the other day. It’s called Hyper Light Drifter and I’ve been playing it obsessively ever since. It’s not an especially new game – it debuted on PC, Xbox One and PS4 in 2016, Nintendo Switch in 2018 and iOS in 2019.

It’s a game built on systems even older; it’s hard not to recall 1991’s The Legend Of Zelda: A Link To The Past when you’re exploring the games’ 2D, pixel art map. Or a game even older, 1985’s Atari-made, top-down, fantasy-themed hack and slash, Gauntlet. Fittingly, creator Alx Preston has described the game as his tribute to the SNES.

The SNES, a wonderful machine, is a great reference point. Hyper Light Drifter has some of the most unique in-game art I’ve seen in yonks; bright, garish, neon colours paint the picture of a ruined world – which could either be somewhere in the distant past, or somewhere in the far future – strewn with the corpses of failed civilisations, and strange tribes of creatures walking its forests, mountains and underground lairs.

There’s another lick to it, though, that has exacerbated my obsession with the game. That is the physical well being of Hyper Line Drifter’s protagonist – presumably, the titular ‘Drifter’.


Hyper Light Drifter
Hyper Light Drifter. Credit: Heart Machine

As you make your way through the game, your character will suddenly stop, keel over and begin to cough up blood. At other times they will collapse, then wake up, woozy, somewhere else on the map. There’s also a blob of nasty, black goo that stalks you throughout the game. It transpires that the game’s creator was born with congenital heart disease and has spent his life in and out of hospital with digestive and immune system issues relating to the condition.

Preston told The Guardian upon the game’s release; “The main character in Hyper Light Drifter ‘suffers from a deadly illness, one he is desperately seeking a cure for. It haunts him, endlessly. That’s something I’m keenly familiar with…”

I’m interested in the representation of illness within the medium I love so much. I’ve had Obsessive Compulsive Disorder (OCD) all my life. It makes life much more complicated – more traumatic – than I would have liked it to have been. And, I’ve never seen my condition depicted within a video game. I’m not even convinced a depiction would work – OCD is both widely misrepresented as a condition solely concerning cleanliness and symmetry, and one where many of the obsessions and compulsions that make up a sufferer’s existence are internal and unseen. I’ve had the condition so long now that a war can be raging inside my head, and nobody other than people who know me very well would know. How do you depict that on screen?

Hyper Light Drifter
Hyper Light Drifter. Credit: Heart Machine

I don’t have a congenital heart defect, so this is all supposition, but I do think that Preston has most likely captured the condition very well in his game, without never explicitly saying that the ‘Drifter’ shares the same illness as he. In this vagueness, the ‘Drifter’ becomes an avatar for many serious medical conditions. It made me think that maybe one day I might see OCD depicted accurately in game. Sure, you might not be able to show what the disorder looks like, but Hyper Light Drifter shows that you can depict the relentless, unpredictable grind – the fear that you’re on borrowed time, that the worst thing that can happen to a person might happen at any given time – of being seriously ill.

Games don’t have the greatest history of depicting illness, and when they have – unsurprisingly – they’ve come from within the ever-progressive indie sector. I’m thinking of 2016’s That Dragon Cancer, 2017’s What Remains Of Edith Finch – extremely poignant in depicting the tsunami of chaos unleashed upon a family when mental illness is concerned – and, while I objected to its depiction of psychosis as a ‘superpower’, the evocative Hellblade: Senua’s Sacrifice. I’m excited about the sequel, Senua’s Saga: Hellblade II, which is being touted for release this year. If they can tilt the balance more towards fear, confusion and suffering than being gifted, then I think it could be a really important, era defining game. We’ll see.

We often say that representation is important, and it is, hugely, especially within a medium like games, one with such reach and such influence. But we don’t say that representation is thrilling, anywhere nearly enough. Illnesses like OCD or a congenital heart disease are frightening and isolating. Within this, seeing yourself accurately depicted within culture is an experience that nigh on transcendent. I hope I get to experience that when I’m playing a game someday.


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