Video Game-induced Nausea, Dizziness and Headaches

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%. 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.

The 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.

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.

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

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:

• 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:

• F.E.A.R. 2 – (Valve’s Source Engine): First person bobbing while walking issue
• 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:

(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.)

• The Darkness  (Starbreeze Engine)
• Resistance Fall of Man (Insomniac Engine): Caused only mild nausea. I was not nauseous when I played its sequel. I note that it’s sequel, Resistance 2, did not make me dizzy or nauseous.
• Uncharted: Drake’s Fortune (Naughty Dog Proprietary) – Best PS3 game yet!

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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