Dale Dietrich
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Video Game-induced Nausea, Dizziness and Headaches

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nausea in video games

In the early days of console gaming, about 25% or so of all games made me nauseous, dizzy or gave me headaches to the point where I couldn’t play them. A prime example was Deus Ex: Invisible War. I enjoyed the game and wanted to continue playing it. But I couldn’t play for more than 15 minutes without becoming dizzy and nauseous. Ultimately, I had to abandon the game.

[Updated May 25, 2009. Added first person bobbing-while-walking factor.]

In the current (Xbox 360/PS3) console generation, the percentage of games that are unplayable due to nausea, headaches or dizziness has dropped dramatically to, perhaps, 5 to 10%.nausous gamer For example, I couldn’t play the otherwise enjoyable Laura Croft: Tomb Raider Legend for more than 15 minutes without feeling ill.

Below, I identify three four factors that cause me dizziness, headaches and nausea when playing video games.  I also list specific games that have made me sick.

I’d be interested in your thoughts – especially with respect to what might be behind the X-Factor discussed below.

Nausea Caused by Aggressive Camera Centering / Fighting

When a game gives me only partial control of the camera, especially when I need to fight the game for camera control, this makes me nauseous every time. Ironically, when a game takes total control of the camera from me, such as in God of War 2, I do not get nauseous.

resident evi 3l box artThe poster-child for this type of camera-control-fighting-induced nausea is the entire Resident Evil series. Not only does the game st0p you from moving your character wherever you wish (they are all ‘on rails’ games), the game aggressively fights the player for control of the camera by constantly pulling the camera back to the center every time the player looks hither or thither. Rumor has it that the forthcoming Resident Evil 5 might finally hand camera control to the player where it belongs. Surprisingly, this is controversial.  I won’t be playing RE5 unless this problem is finally fixed. [Spring 2009 Update: The reviews for RE5 were so bad, I’m not even going to bother trying it.]

Each of the recent Uncharted: Drake’s Fortune, Battlefield: Bad Company, Resistance Fall of Man, Grand Theft Auto IV (but only when driving) and Star Wars, Force Unleashed (but only while moving) games fought me over the camera somewhat. This resulted in mild dizziness. Happily the implementation of camera centering in each of these games wasn’t aggressive enough to cause me to abandon the games over the issue.

Nausea Caused by No Y-Axis Inversion Option

The first console-based video game I ever played was Pilot Wings, on the N-64. As a flying game, it naturally featured inverted Y-axis controls. A dozen years and a hundred or so games later, I have inverted the Y-axis on every console game I’ve played since.

If I can’t invert the y-axis I can’t play. Non-inverted game play makes me instantly nauseous. My brain is wired in such a way that when I pull the right stick back, my brain expects the camera to move up. When the camera goes the opposite way it is very disorienting.

silent hill homecoming cover artThere are very few games now-a-days that do not provide the inverted control option. Indeed, inverting the Y-axis is so common that the Xbox 360 can be set to automatically configure every game I play with the Y-axis inverted.

I was astonished to discover that Silent Hill: Homecoming does not allow players to invert the Y-axis for normal viewing (it does have a limited Y-inversion option for shooting when the gun is wielded).  As I wrote here, the game was unplayable. I had to abandon it.

Dizziness Caused by First Person Bobbing While Walking

I first wrote this post in October 2008. In late May 2009 I played F.E.A.R. 2 and remembered another cause of dizziness – the screen bobbing while a character walks. In F.E.A.R. 2 and several other first-person video games, the screen bobs up and down as the character moves. The bobbing, I gather, corresponds with the cadence of the character’s walk. This doesn’t make me dizzy or nauseous as quickly as the other factors discussed in this post, but I can usually only play a game that does this for an hour or so before becoming dizzy. The game is not unplayable, but it has to be taken in light doses.

Nausea Caused by the X-Factor – Possibly Frame Rate

laura croft tomb raider legends cover art Finally, there is a class of game that makes me seriously dizzy or nauseous even when I have full control over the camera and the Y-axis is properly inverted (see list below).

I’ve never fully understood, absent the camera/Y-axis issues, why some games make me dizzy and nauseous while others do not. I’ve always assumed it was a frame-rate issue. I’d be keen for any of you to suggest other possible causes.

Whatever the reason, such was recently the case with Mercenaries 2. The game gave me complete camera control and I had happily inverted the Y-axis but it still made me nauseous to play.

List of Games Causing Dizziness / Nausea

Below is a list of games that have made me seriously dizzy or nauseous. I also list the underlying game engine in parenthesis. Note how many games are built on versions of the Unreal and  id Tech engines. I intend to expand the list over time as I remember them:

PC:

  • Half Life 2 (Valve’s Source Engine): Enjoyed it so much I pushed through about 80% it. But, to this day, just the sounds of that game (the gravity gun in particular) make me woozy.

Original Xbox:

Xbox 360:

PS3:

(Note, the numbers are fewer here because,  if given a choice, I play the 360 version of a game. Each platform is an equal opportunity nausea causer.)

Conclusion

Thankfully, better graphics, higher frame rates and the abandonment of nausea-inducing camera controller techniques is making gamer illness increasingly a thing of the past. Unfortunately, as the recent games Silent Hill: Homecoming and Mercenaries 2: World in Flames have shown, we still have a way to go.

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  • http://www.daleisphere.com Dale Dietrich

    Alister, the game you are referring to is/was Prey. It’s on my list above and it made me very sick too! I never tried Fable 2 as I didn’t much like Fable 1 – not my kind of game. Head bob is definitely a killer for me. Funny how you say “just thinking about it is sickening”. The same is true for me. I just think of the game Prey and I instantly remember how it felt playing it and I start feeling it. :) I do think herz and res can have an affect on gaming. I’m certainly feeling less nauseous since I moved to a high-def plasma screen from the old CRT I used to have.

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  • http://www.daleisphere.com Dale Dietrich

    Ha! Far Cry made me sick too. I’m not a PC gamer, though that is one game I did play on the PC for as long as I could stand it, which wasn’t long. nnIt uses the Crytek CryENGINE. I should add this to the list above when I get a chance.

  • http://www.daleisphere.com Dale Dietrich

    Your camera nausea is the exact opposite of mine Nivesh. The more control I have over the camera, the faster I can move it to where I want it to go, the less nausea I feel. The more the game controls the camera or limits my ability to move it the sicker I feel.nnThere is no game I could ever play and get used-to-it as you suggest by playing in short bursts. No amount of starting or stopping or short interval play ever cured me. A game that makes me sick always makes me sick.nnDarkness, hunger or fatigue have never made me nauseous. But, playing at the end of the day can get me very ‘riled up’ so that when I try to sleep after and I’m still buzzing from the game it can take a very long time to ‘calm down’ and fall asleep. A glass of wine helps! :)

  • http://www.daleisphere.com Dale Dietrich

    Sarah, I wouldn’t avoid a game just because it makes others nauseous. There are lots of games that make others nauseous that don’t bother me at all. The important thing is to find what common denominators specifically make you sick and avoid those games.n

  • George Helyar

    I just got this from watching a YouTube video of someone playing through Duke Nukem Forever.nnnI believe the frame rate issue is actually a mild form of epilepsy.nnThe worst game I ever got it on was Dog’s Life where you have weird colours, tunnel vision, low to the ground camera, massive side to side head bob, etc.

    • Anonymous

      Just found this, while searching for my son, who has been getting headaches and throwing up after playing his xbox, he is 9 years old, nomatter what game he plays after an hour or so he is nausea, sleepy, cant stand the light or noise, andcomplains of headaches, he threw up before, so for his own health im gona have to stop him playing his games, incase it gets worse, his twin brother is absolutely fine though.

      • http://pulse.yahoo.com/_SXOUJHR2FSH3K7Y6DQ2EPKW3YY Michael

        I stumbled on this page while googling “video game nausea”, though in my case it’s from a road cycling simulator/trainer.u00a0 I’m aware I have vertigo, just didn’t think the two were related, and they can be.u00a0 This may help you:u00a0 http://www.youtube.com/watch?v=ZqokxZRbJfwu00a0 when it works, it’s magical.

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  • Jerry Ku

    The third Deus Ex game came out (Human Revolution) and I get really sick from playing it. Stupid head bob!

  • Mary Doyle

    hi I just came across this while looking for the default camera controls for tomb raider underworld. I don’t understand the x & y axis things but a friend was playing my game on Xbox and since then well I’m in a whirl. I was diagnosed with vertigo in 1984 I was 16 then and had always had travel sickness. I was put on a medication called STEMITAL it controls the middle ear this is where vertigo comes from but I know that your eyes can cause it too- when your playing a game on a PC or a console your eyes are doing all the work because you are concentrating so much, if you feel dizzy then stop the reflexes of your eyes are on overdrive, this can lead to a full blown vertigo attack the solution is bed rest use at least 2 pillows don’t lie flat out it will only make it worse lie on your side not your back. you will also notice that you are slightly photo sensitive (the light effects you) don’t drive, drink,play PC or console games or watch TV programmes that have flashing images, remember vertigo is of the family of epilepsy and migraine – see your doctor get some motion sickness tablets. also once the initial attack has gone does not mean it has gone a vertigo attack can last from 1 to 8 weeks if not treated.