When Video Games Literally Make You Sick

I never had a problem playing video games growing up. They were always accessible to me. But in my young adult years, along with various diagnoses came a whole host of barriers that prevented me from doing the things that I loved. Pain and fatigue meant that I could no longer comfortably play big open world games for 12 hours at a time, migraines would prevent me from even being able to look at screens, and certain games would make me physically ill after just minutes of play.

A late 80s baby, I missed the hype of the original DOOM games, but got sucked into the buzz for the 2016 reboot. I was so pumped about becoming a buff space marine fighting demonic forces and punching monsters in the face. It was unapologetically metal, and I was so eager to finally experience the ridiculousness and be a part of the excitement. An hour into streaming it, I knew I had made a terrible mistake. I wanted to entertain and keep my viewers engaged so I kept pushing, despite my intense discomfort. Maybe it would subside after my eyes got used to the movement? Another hour later, I had to call it a day. I felt so nauseous that I could barely stand, and all I could do for the rest of the night was to lay down in a dark room staying very, very still. I was so embarrassed.

Motion sickness in flight and driving simulators became apparent in the late 90s, affecting up to 80% of users, and this pattern continued as games developed over the years.

Motion sickness affects a huge number of players, but it’s something that we don’t often hear about. Having to put down a game because you can no longer play without vomiting can be seen as shameful. The toxic ‘git gud’ culture in gaming tells you that anyone unable to finish games for any reason is weak — you’re not a real gamer because you didn’t try hard enough to push past those barriers. But those barriers are present for so many of us, and unfortunately no amount of trying to push past them will stop us from throwing our guts up. Believe me, I’ve tried.

Motion sickness in flight and driving simulators became apparent in the late 90s, affecting up to 80% of users, and this pattern continued as games developed over the years. One recent study found that more than half of all participants suffered from motion sickness after just an hour of play (Chang et al, 2012). But why is this happening?

The most popular theory of motion sickness suggests that it occurs due to a sensory conflict in the brain — your eyes are telling you that you are running, driving or flying when you are sitting still on your sofa. Another theory suggests that this sensory mismatch leads the body to believe that it might have ingested something poisonous, and the nausea and vomiting is the body’s way of trying to get rid of that perceived toxin. Most of the research since the 1970s has focussed on motion sickness in moving vehicles, but more recent studies have looked at its presence/appearance/effects in virtual environments.

Video games tend to differ from typical motion sickness triggers such as travel sickness in that players are generally in control of the motion. Anecdotally, we know that drivers are less likely to become motion sick than their passengers because they are in control of the vehicle. It’s also been shown that active gaming produces less visually induced motion sickness than passive gaming, which is where someone watches another person play a game (Keshavarz and Hecht, 2012). Is there something here that can help us alleviate motion sickness for players?

Like most accessibility issues, I don’t believe that the players should bear the full weight of this responsibility.

Well, like most accessibility issues, I don’t believe that the players should bear the full weight of this responsibility. Sure, you could play something else, but that’s no good if you’ve just dropped $60 on something you can’t play. This also ignores the impact of being shut out of social gaming, or being able to join in discussions with other fans online. Sure, you could try various motion sickness remedies like medication, ginger tea or those weird little wristbands, but wouldn’t it be better if the game was accessible in the first place?

Including a wealth of visual options in games are a great start, such as giving the player the ability to modify the frame rate, the field of view, the camera sensitivity, or the level of motion blur. But what about those moments where the player is not in control of the camera? You know the ones I mean. When you trigger a special kill during combat, and the camera whips round, zooming in for a close up shot of the action. The surprise screen shake when you land a mighty punch, or an enemy roars. The dizzying wobble of a character that’s had a bit too much to drink. If motion sickness is more likely to occur when a person is not in control of their situation, we need to give the control back to players. By reducing the frequency of removing control from the player, developers can make games more accessible to people who struggle with motion sickness, that will ultimately benefit people with other health conditions and disabilities. These options don’t need to be removed completely, but giving players the opportunity to turn them off can be the difference between playable and unplayable. That satisfies the gamers who want the full effects of camera-grabbing moments and cinematics, without also closing the door to a large part of your audience.

Being unable to access a game is not a character flaw, and disabled and unwell gamers are not lesser because of it.

Unfortunately, many studios are still lagging behind in this well-known, relatively clear cut area of accessibility. Their lack of attention to motion sickness also reinforces the idea that we are a secondary issue, or maybe less important than the gaming experience.  It’s time the community stopped making us feel ashamed for not being able to finish a game because it makes us physically unwell. Being unable to access a game is not a character flaw, and disabled and unwell gamers are not lesser because of it.

And it’s also time that developers step up to the plate, and provide those options to make their games more widely playable. Players just want to be able to enjoy their $60 game without keeling over, and that shouldn’t be too much of an ask.