Stressed Out: An Examination of Mental Health in Darkest Dungeon

Stressed Out: An Examination of Mental Health in Darkest Dungeon

This article was submitted by Greg Lent.


In most games, the stress of combat is simply not explored.

If touched upon at all, it is in cutscenes. A character may rant about how much a dead friend is affecting them, but this only as a preamble to their striding into a building full of people and slaying them without a second thought. Player characters are usually portrayed as robots, able to sustain endless injuries, fight infinite foes, and experience unending trauma without lasting effect. Very rarely is there a mechanical implication to stress, loss, and fear, and when there is it is often gimmicky and quickly forgotten.



Darkest Dungeon is different.

Where many games pay lip service to the idea that exploring, fighting, and killing can have an effect on a person’s mind, it is usually only on a narrative level. Darkest Dungeon is one of the only games that attempts to explore these issues on a level beyond skin-deep. While nowhere near perfect, Darkest Dungeon’s mechanical examinations of mental health make them much more meaningful to players than any cutscene could hope to accomplish.

A fundamental aspect of Darkest Dungeon is stress management.

In this turn based combat game, each hero comes with two meters: the familiar, abstract health bar that can swing back and forth wildly, and a more rigid and difficult to cure stress bar. While the health bar is the more immediate concern, since the stress bar takes much longer to fill than the health bar does to deplete, Darkest Dungeon players quickly learn that putting off stress management will lead to later disaster.

While taking a massive amount of damage from a critical hit dangerous in its own right, the stress damage it conveys to the party is the silent killer. When given the choice between quickly taking out a big damage dealer or a subtle creature that uses spells to stress the party out, a skilled player will usually choose to eliminate the stress threat immediately and take the damage on the chin. When sitting down to rest by the campfire, buffs that remove stress often come first, with the various combat buffs available being a distant secondary priority.


Even after the adventure is over, stress has a lasting effect.

The health bar is transient; no matter how injured they were at the end of the last dungeon, a day of rest in town is enough to return a party to full hp. Stress, however, is another matter.



In Darkest Dungeon, the player takes on the role of a manager. There are tasks that need to be completed quickly, and not nearly enough resources to make everything happen at once. The player needs to prioritize: is it more important to give this stressed out hero a much needed vacation, or push them a little harder to get them on a mission that they will be perfect for? Is it worth 1500 gold to fund a hero’s rest or hospital trip, when that same gold could go toward a new sword or a backpack full of supplies? While it is often tempting to put off stress management in favor of more material concerns, this is usually a bad call. As in real life, pushing a person to work too hard can do more harm than good.


Maxing out a hero’s stress is mechanically very similar to real life burnout.

Reaching the breaking point will bring out the worst in a person; heroes so afflicted will gain temporary traits like irrational, sadistic, abusive, or paranoid. Just like working with someone who is overstressed can be counterproductive on the job, these heroes become a serious detriment to their adventuring party of four. They may shout insults when another hero misses an attack, incurring stress. Sometimes they will become fearful and hide behind their friends, or not be able to muster the ability to attack. Often they will become hopeless and morosely inform the party that they are all doomed. Occasionally they will refuse healing, or even inflict injury on themselves.


The hero’s concerning behavior and inactivity usually means that when one hero hits 100 stress, the rest of the party quickly follows suit. Between the reduced ability to deal with threats and the various ways that an afflicted hero can inflict stress on their friends, it won’t be long before the entire party is in the same boat. As more heroes become afflicted, the stress increase doubles, then triples, then quadruples, as hero after hero falls under the weight of hopelessness. Then, when a hero’s stress meter tops out for a second time, they suffer a heart attack, reducing their health bar to 0. Stress in Darkest Dungeon, like in life, is contagious. This domino effect is one of the primary ways that an adventure can devolve into a total party wipe.


The stress bar, however, is only one manifestation of mental health.

In Darkest Dungeon, each hero has their own particular personality and history that can have various mechanical effects on the game. These quirks come in positive and negative varieties, and are added and subtracted over the course of the hero’s adventures.

For example, a hero may come fresh off the stagecoach with compulsive behavior (not ideal for dungeons full of traps and dangerous objects), a hatred of the undead that causes them to attack skeletons more furiously, and a kleptomaniacal tendency to pocket loot for themselves. Then, after a disastrous trip to the ruins, they may fear returning, and so take increased stress damage there. However, they may also get some experience fighting in a bad situation, and so gain an increased chance to critically hit at low health.



These quirks cover a wide range of situations. They can be simple competences, like the ability to dodge attacks better or hit harder. They can be medical conditions, like a torn rotator leading to reduced melee damage, or anemia increasing their chance of being inflicted with bleeding. They can be personality quirks, like a specific fear or hatred, or the tendency to relax when not in combat (less speed on the first round of combat). Or, they can be real mental health conditions, like anxiety (increases all stress damage) or OCD (the hero sometimes can’t help but interact with objects, many of which are dangerous).


The way the game treats these mental health conditions is refreshing. Rather than being played for laughs or downplaying them as not “real” problems, these conditions are handled as frankly as a lasting shoulder injury. The condition has a detrimental effect on the hero, and to solve it the hero does what they would do with any other issue: go to the doctor with a sack of gold and get it sorted out.


While it is not entirely realistic to spend a week at the hospital to cure a longstanding case of anxiety or a trauma-induced phobia of skeletons, neither is it realistic for that same hospital stay to cure anemia. On a mechanical level, the game treats mental health issues as on an equal footing with any other affliction, which is extremely unusual in any media.


Darkest Dungeon, at its core, is a game about hope.

While early on it is easy to feel buried under the piling negative quirks and stress relief that need to be addressed, not to mention actually buying heroes new equipment now and then, throughout it all the mechanics of Darkest Dungeon encourage hope and persistence.

This seems counter to the surface design of the game, but it is true. The game presents itself as a tough as nails roguelike in which heroes will succumb to the horror of its challenges and die over and over. While it is true that heroes will die and quests will be lost, however, this is supplanted by the deep mechanical reality that there will always be another try.

Like it does to its heroes, Darkest Dungeon also attempts to stress the player out. At times a loss can be crushing; over the course of a hero’s life, the investment is immense. Heroes become important to the player as they outfit them with better and better equipment, train them to learn new abilities and use their skills to greater effect, and pay for their stress relief and hospital treatments. High level heroes represent an enormous investment, and the prospect of replacing four of them after a disastrous party wipe can be crushing.



However, there is always another chance.

In spite of the ease with which heroes can be suddenly killed, the game provides infinite opportunities. Even a player who loses every hero they possess will always find new heroes in the stagecoach, ready to be customized, trained, and shaped into new warriors. The money lost can be replaced in future dungeons, and the permanent upgrades to various town buildings mean that the next climb will be easier than the first.

Darkest Dungeon hits the player hard, gives them tough choices, and punishes mistakes heavily, but it always allows another try. Like other games that are good for mental health, the key message is that no matter how bad things seem, the solution is to hang in there, keep trying, and never give up. Heroes may succumb to the pressure and become afflicted, but a hero reaching 100 stress can, rarely, rise to the occasion and become virtuous instead, gaining power instead of affliction. As Darkest Dungeon attempts to wear you down, there is always the opportunity to rise to the occasion yourself.