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Hellblade Portrays Mental Illness in a Sincere, Meaningful Way

A respectful approach to an important topic.

It’s not often that you see mental illness really represented in video games. I mean really, properly represented. It’s brought up, or used as a plot point, but seldom do you see it as the main crux or driving force behind a game’s story. However, that’s exactly what Hellblade: Senua’s Sacrifice does, it uses its main character’s mental illness to explore the depths of her personality and motivations, as well as help shed light on a topic that video games can and should talk about more.

Senua is a young viking warrior that suffers from severe psychosis, a condition which causes her to constantly hear voices and see horrible visions. The really unique thing about the game is how it plays with your perceptions, dropping you right into the shoes of Senua, and trying to emulate how difficult it is to deal with psychosis for those who really do suffer from it. The main objective of Senua’s quest is to travel through Hel and save the soul of her beloved Dillion. From the outset it’s clear that something is not quite right with her journey, and Hellblade weaves a complex, multi-layered story that takes time and thought to unpack.


Senua is basically building a gauntlet of horrors for herself to face down, trapped within the confines and dangers of her own mind. From the very beginning you know that a mysterious force known as “The Darkness,” is hunting you, and you constantly have to battle fearsome dark warriors that spawn out of thin air. Through this darkness the game builds a terrifying antagonist, which as it turns out is Senua’s own mind. The Darkness is representative of the constant struggle that those with psychosis experience to stay in control of their own mind. It almost seems like Hellblade’s combat feels so visceral and gritty because Ninja Theory wants it to feel like a true battle each time Senua grapples to retain her sanity. The game throws hordes of enemies at you all of which are stronger than Senua generally, a reminder that the game (Senua’s mind) is really the one in control, not you.

At the same time, Hellblade uses some really brilliant gameplay design to emulate her illness in a more realistic way than we’ve probably ever seen in gaming. From the very first seconds of the experience you have multiple voices whispering in your ear, comforting you, scolding you, making suggestions, and more. Ninja Theory suggests that you play Hellblade with headphones, as it definitely makes the experience that much more immersive and unsettling. The sound design on display in Hellblade is absolutely incredible, with headphones on it’s completely unnerving to have voices whispering in your ear incessantly. At the same time sound in general has been amplified, making thunder strikes chill you to the bone. Hellblade makes you feel hyper sensitive to sound, like you’re listening to something through a filter of some kind.

Even better, however, Hellblade uses its voices to play with your perceptions. The voices will help you in battle, saying things like watch out behind you or dodge, helping you stay aware in battle despite the claustrophobic close up camera. This is in direct contrast to certain story moments when the voices will scream not to do things like open a door, making you pause to wonder if you’re really choosing the right thing. Across the 8-10 hour experience it takes a while to get used to the voices, but when you finally get to a section they aren’t there, it feels even more unnerving. A challenging puzzle later on in the game even has you navigating through a pitch black building, relying on nothing but your hearing and touch through the controller rumble. It’s terrifying, stifling even, but a great example of the true darkness that Senua can fall into at times because of her fractured mind. Through smart audio choices like this, Hellblade manages to build a convincing representation of psychosis, supported of course by the visuals.

One of the more striking parts of Hellblade is when Senua turns directly to the camera during cutscenes, addressing the player almost like another being or character. As she travels deeper and deeper through Hel, new visions and horrors reveal even deeper parts of Senua’s person. The intense fire segments on the way to Surtr show the guilt that she feels for the impact she’s made on others, the illusions on the way to Valravn shows her insecurity and lack of knowing who she is. Even smaller touches like the way that the light from torches smears when you look at them, show the state Senua’s mind is in.

Another gameplay element also ties directly into Senua’s mind, when you pull the right trigger to focus. This mechanic is used to solve many puzzles in the game and continue on your journey, representative of Senua actually focusing her mind and trying to concentrate on getting through the ordeal. It’s impressive how well Ninja Theory has managed to blend actual gameplay representing psychosis and story.

Through all of these small and large touches one thing rings true throughout Hellblade, you never fully know what’s real and what isn’t. Senua has certainly created her own personal Hel, designed to appeal to her specific fears, and through these fears you learn more about the tortured past she’s had. Others, including her own father, shunned and mistreated her because of this “darkness” that she held. Even by today’s standards oftentimes those with mental illness are seen as different or unnatural by some, let alone how it would have been in Senua’s time period. By playing as Senua we get to see things from her perspective, see how scared she was during her childhood, how full of life she became with Dillion, and how the horrors others inflicted on her in the past still haunt her to this very day.

hellblade, story, ending

There are hints of mythological powers in Hellblade, although we’re lead to believe most everything is in Senua’s head. Still, we can’t be sure, and that in and of itself is the most indicative part of the game’s representation of psychosis. Mental illnesses cause immense confusion, blurring the lines of what’s reality and what’s not to those that suffer from them. The story in Hellblade doesn’t really come together until late in the game, with many things still being left to player interpretation.

This is hell for Senua, trapped within her own mind, with the player along for the ride. It’s chilling, confusing, disorienting, and terrifying, as the game constantly reminds us that the greatest battles are fought within your own mind. Yet for that, the experience the game gives us is only the briefest look into how psychosis works, the very bare minimum of what those of us that don’t have it can experience.

Ninja Theory clearly had a lot of passion for this project and wanted to provide an accurate representation of psychosis, something that they spent hours researching and meeting with professional on. For any problems or gameplay issues Hellblade has, the developers absolutely have to be commended for using an interactive experience to try and accurately represent an illness, and make players truly think about something. In the end, we need more games like Hellblade that send an affecting message with relatable characters that can really make us think about important topics.

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