Video Game-induced Nausea, Dizziness and Headaches

October 13, 2008 at 7:00 pm - by Dale Dietrich

In the early days of console gaming, about 25% (maybe more) of 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.

[Nov 8, 2008 Update: In an attempt to isolate exactly what the ‘X-Factor is that makes me dizzy/nauseous, I updated this post to add a list of games that have made me nauseous.]

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%. 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 factors that cause me dizziness, headaches and nausea when playing video games. 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 Centring / 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.

The picture 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. Rumour 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.

Each of the recent Battlefield: Bad Company, 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 make 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.

There 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.

So, I was astonished to discover that Silent Hill: Homecoming game 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.

Nausea Caused by the X-Factor – Possibly Frame Rate

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.

Below is a list of games that 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 now just the sounds of that game (the gravity gun in particular) make me woozy.

Original Xbox:

Brothers in Arms: Earned Blood (Unreal Engine 2)
Brute Force (?): Finished it anyways given how hyped it was – didn’t really enjoy it much
Deus Ex: Invisible War (heavily modified Unreal Engine 2)
Doom 3 (id Tech 4): Finished the game anyway – holding my cookies the whole way)
Psi-Ops (Unreal Engine 2)
Return to Castle Wolvenstein (id Tech 3): Finished it anyway but wasn’t that good.
TimeSplitters: Future Perfect (??)
Unreal Championship (Unreal Engine 2): Couldn’t play for more than 5 minutes at a time.

Xbox 360:

Half-Life 2 – Episodes 1 and 2 (Valve’s Source Engine)
King Kong (Ubisoft’s Jade engine): Bad game – pushed through just for the easy achievements
Laura Croft: Tomb Raider Legend (Crystal Dynamics Proprietary): I enjoyed it so much I pushed through about 40% of it before I had to stop because I couldn’t take it any more.
Mercenaries 2 (EA proprietary)
Perfect Dark Zero (Havok’s HyrdaCore): Thank goodness the game was horrible – I didn’t miss much
Quake 4 (id Tech 4): Abysmal game.
Prey (modified id Tech 4): Also pushed through about 75% despite extreme dizziness.

PS3:

The Darkness (Starbreeze Engine)

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 ways to go.

Related Posts:

Silent Hill Homecoming is Unplayble – No Y-Axis Inversion (October 13, 2008)
Mercenaries 2: World in Flames – Abandoned Due to Nausea (October 13, 2008)

Tags: camera, dizziness, dizzy, inversion, nausea, video games

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10 comments

1 Dave Zatz { 10.17.08 at 2:02 pm }: Could be pixels, could also be something like the screen door effect but without consciously seeing it though your eyes are trying to make sense of all the pixels. I’d keep an eye out for game resolution and tv resolution. I bet it’s less of an issue at higher resolutions and/or further from the TV.
2 Dale Dietrich { 10.17.08 at 3:52 pm }: The TV resolution has been a constant. I’ve been using the same Plasma HDTV now for 3.5 years. It doesn’t seem to be wholly resolution because I can get it from higher and lower quality resolution. The only “CONCRETE” thing I can point to is the second I look at a game that has the x-factor, I can instantly feel a weird sensation in my head. I can play, for example, Halo for 10 hours straight without getting any feeling of sickness, yet for the games that do make me sick, I’m feeling it instantly, and consistently for the specific games.
3 jim l { 10.22.08 at 5:06 pm }: I’m in the same boat. I can play Halo 3 for hours on end but 2 minutes with Half life 2 and I’m ready to collapse, making the totally unplayable. Fable 1&2 both make me queezy and now Farcry 2 is making me sick. It seems as though you’re right and it could be a frame rate issue. I just can understand why Halo will not make me the slightest bit queezy but Half Life 2 with it’s nightmarish source engine absolutely kills me
4 Tim { 11.07.08 at 6:11 pm }: at Jim:
to me half-life2 source engine is better than RL, it’s so smooth and never gets me dizzy, i love it so much just for this reason…
but farcry2 is so annoying to play, i can hardly hit anything, the same with bioshock and some other games… since i don’t have that good of a computer i have to tune down the settings and that usually fixes it, when i set the resolution to 800×600 or something low it’s easier for me, the textures seem more robust so i guess that’s a plus.
5 celefb { 11.09.08 at 1:39 pm }: This is my story! For the past 2 days I have been in a sheer living hell. I gave my 9 year old son his adderall yesterday morning. About 20 minutes later he came upstairs white as a ghost, sweating, dizzy, nautious and passed out cold. He was pretty sick all day long too. I thought for sure I must have givin him my medication by mistake as they are the same color and size, but a slightly different shape. I called the pharmacy and they said he’d be sick for a few days but it wasn’t life threatening or a need to go to a dr. But I still felt worse than anything.

This morning he felt much better. He was acting like his normal crazy self. So I gave him his medicine but made him inspect it first. He said yes, that’s it and took it. 20 min. later he was back up here with the same symptoms and passed out on the couch.

Now I knew I had given him the correct medicine this time for 100%.

Long crazy scary story short….both times I gave him his meds he was playing Call Of Duty 4 on a new XBOX 360 that his older sister brought over 3 days ago. The first day he was fine because he was playing Madden. But both times he got sick he was playing call of duty. That has to be what is going on. The video game! I was about to bring him to the E.R. not knowing if the meds were fake (I’ve seen that on TV before about pharmacies getting bad meds).
6 Dale Dietrich { 11.09.08 at 8:28 pm }: Wow celefb,

That sounds way more serious than what I experience. You read on video game boxes that video games can sometimes cause seizures and such. Sounds like you should get your son in for some tests if he passes out from video games. It’s never been THAT bad for me.

…Dale
7 Sarah { 11.10.08 at 3:15 am }: Hi all, I don’t play alot of video games as a rule but got completely hooked on Guild wars. Once I’d got my head around the game and could play without stopping, I was merrily playing for several hours at a time. I played every day without too much of a problem for about a week. I just got a slight headache and sore eyes, understandable I suppose. Then, after a heavy night of playing Guild with many mssions completed, I woke with a mild headache feeling a bit irritable and tired. I was regretting spending so much time on the game. I went off to work but within and hour or two of being there I experienced the most intense attack of vertigo. I was unable to stand up so I lay on the floor while a sensation of very fast spinning over took my whole body. I felt like I was falling and spinning all at the same time. Thank God for my colleagues who stayed with me, holding my hand and talking to me through it. After a couple of minutes it stopped, I did not feel particularly sick, just absolutely terrified! It took me three days to really get over the shock but in fact, I felt mildly ‘off balance’ for about four months. I noticed that even short periods of playing this game gave me weird sensations in my head, mild ‘falling over’ sensations. I also get a little motion sick.
Now, I limit any play of this game and Guitar Hero (my other favourite) to 30-45mins at the most. I had a brain scan and balance testing because I felt there was something seriously wrong with me, like a brain tumour of something.
I think we should all be careful of potential ’side effects’ when playing these very sophisticated and fast paced games. I am so greatful that I wasn’t crossing the road or driving at the time I suffered this attack. The consequences are unthinkable.

Don’t get me wrong, I am not against gaming I’m just sharing my experience. Our brain and the various mechanisms that these games affect are undoubtedly very powerful and can fool our whole body into experiencing every sensation of movement and action. I think that it would be helpful for the game producers to give gamers a little warning about this as well as the epilepsy one.
Thanks for reading…all the best!
Sarah.
8 Tay { 11.12.08 at 3:49 am }: well i’ve been trying to play Call of Duty 4…but after 15 mins of playing i dont know why, but i get nausea. and the thing is that i was enjoying the game. the thing is that this only happens when i play this game… i don’t understand it because i wanna keep playing but when this happens i have to stop.

what can i do to enjoy this game without getting nausea?
Help
9 Dale Dietrich { 11.12.08 at 6:44 pm }: Tay, I don’t think there is an answer.

Some games make some people sick/naseous and others don’t. I personally get dizzy/nauseous playing many games (as you can see above) but I had no problems with Call of Duty 4.

You might see if you can change your Xbox 360’s video settings. I know that higher frame rates make me less dizzy. But your video settings are probably already optimized for your TV. You could also try playing the PC version (or its demo) and/or a PS3 version if possible to see if the issue you are having is console specific or unique to this game.

Wish I could help more. One of the reasons I posted this post is in hopes of starting this kind of a discussion so that people can figure out what specifically makes them dizzy/nauseous. In my case it seems to be the Unreal and id Tech engines almost always make me sick.

…Dale
10 William { 11.18.08 at 3:40 pm }: While playing Psi-Ops and Dark Messiah of Might and Magic on my PC I’ve begun to feel sick and dizzy so I stopped playing, as a rule, games like that go into my storage box never to be played again:-{