Gaming and chronic illness: TBQ talks difficulty modes and the importance of patience

Headshot of a smiling Andruid.
By Andruid

Writer, roleplayer, storyteller, and nerd who tries to live by Bill & Ted wisdom, i.e. "Be excellent to each other." 

Table of Contents

    Welcome to the next installment of the Accessibility in Gaming Series! In Part 1, we briefly touched on the importance of mental health with Aaron, a partially sighted gamer. Aaron had thoughtful advice about what to do when a roleplaying game starts to ask too much of you. In today’s post, we’re going to take a closer look at gaming and chronic illness from the perspective of this week’s guest: TBQ.

    When you say gaming and illness, you mean gaming addiction, right?

    Actually, no!

    While gaming addiction is a recognized illness, it’s not the focus of today’s post. Instead, we’re going to hear the perspectives of TBQ – a gamer, TTRPGer, and writer who lives with chronic illness and isn’t afraid to talk about it candidly.

    I’m excited to share TBQ’s story, as she offers some pretty good advice applicable to many readers – whether you’re just a casual roleplayer or make your living creating games. (Or something in-between.) Let’s dive in!

    (UPDATE 5/29/22: If you’re interested in the topic of gaming addiction, check out this post on mental health and gaming.)

    Meet TBQ, a writer and roleplayer

    To kick things off, I asked TBQ to tell readers a little bit about herself – whatever she felt like sharing.

    “Hello! I’m The Brat Queen or TBQ for short,” TBQ said. “I’m a geeky, bisexual, cisgender woman (pronouns she/her) who is currently on disability because of my mental and physical illnesses. As far as my illnesses go, I have chronic migraines, generalized anxiety disorder, depression, and agoraphobia. These things affect my ability to work and play games, particularly when it comes to things like stress and concentration. I have a blog where I talk about pop culture, living with disability, and other topics.”

    As a writer, TBQ isn’t shy: she’s pretty vocal about her health and uses her writing to share her interests, experiences, and advice. One of the things I really like about her blog is that it’s very down-to-earth and approachable. Reading it, I feel like I’m not alone, regardless of what I might be dealing with at the time.

    To better understand what TBQ’s situation is like with respect to accessibility, I asked her to describe some of the challenges she faces, both as a gamer and as a writer.

    Memory and concentration

    One of the biggest challenges TBQ identified has to do with memory and concentration.

    “If you give me a multiple choice question, by the time I get to option D, I’ve forgotten what the question was,” she said. “My short term memory simply cannot retain chunks of information. This in turn makes it difficult for me to do things which require keeping track of many details at once. My anxiety then kicks in as it becomes stressful for me to try (and fail) to hang on to the information. I’ve had times of breaking down in doctor’s offices when they try to test my ability to remember a set of numbers.”

    Quote by TBQ on gaming and chronic illness, pulled from the body of the text.

    Gaming and chronic illness example: the ‘easy’ mini-game

    TBQ laid out a specific example of how her illnesses impact her ability to enjoy games – even ones that seem relatively easy or straightforward.

    “Things that are often considered simple tasks in a game are impossible for me,” she explained. “One video game I played had an ‘easy’ mini-game that involved cooking food. I couldn’t do it. The steps required you to remember the order, remember the ingredients, remember if you cooked the ingredients, remember who to give the food to, and I could not get past remembering the order. It was frustrating and depressing to realize I couldn’t do a so-called simple job even in the context of a video game, let alone in the real world.”

    Overall health and wellness

    But what about tasks that are less demanding and intensely in-the-moment? TBQ noted that for TTRPGs and writing, the bigger challenge tends to be her overall health.

    “Will I be in the middle of a four-day migraine and thus not able to play a regularly scheduled D&D session?” She asked. “Or, worse, will the headache hit right before the session starts?”

    At other times, it’s the meds themselves that make things more difficult for TBQ.

    “My medications knock me out on a regular basis, so it’s also always a question of if I will be able to stay awake and concentrate long enough to get things done,” she said. “In general, I can go for about two or three hours at a time before I need a break, so it’s always a challenge to try to hit that sweet spot of getting gaming or writing done when I’m able.”

    When it comes to gaming and chronic illness, what helps?

    Learning about TBQ’s experiences with gaming and chronic illness was really helpful for providing context and laying a foundation for further understanding. Next, I asked her what helps her get through a game, session, or a chunk of writing.

    Difficulty levels and story modes

    “With video games, the big thing I had to do is recognize that some games are not for me or people like me,” said TBQ. “For instance, I am never going to be able to play something like Elden Ring, where the difficulty is the point. And that’s fine! I’m not slamming anyone who enjoys games like that. The frustration for me comes when I’m playing games like Skyrim and people try to sneer about those who play on easy mode because to them that’s not ‘real’ gaming. Like ‘excuse me, but I’m the one who paid for this game, and I spent my money to be able to enjoy myself.'”

    I could definitely relate. I’ve been judged for playing games in easy/story mode, too. But the point is to have fun, not feel stressed out.

    “Being able to take my time to enjoy the world and the story is fun,” she said. “I’m going to play my way, you play yours. Neither one of us is ruining things for the other.”

    Patience from others – and yourself

    “For everything else, it’s patience,” said TQB. “Patience from my audience if I’m not turning around something like an episode analysis in what I consider a timely fashion (which I always judge so much more harshly than they do, my readers are so wonderful and understanding that way), patience from my fellow TTRPG players if I need to cancel last minute because my head is hurting, and patience for myself, which is the hardest of all.

    When you have chronic illness, self-care needs to be one of your highest priorities, and I still struggle with accepting that instead of telling myself I’m being lazy or a quitter if I’m not able to do something when I want to.”

    She added that, “For TTRPGs in particular, one thing that’s been especially helpful is that the people I play with also have chronic illness issues of their own. In any given session, any one of us might need to call out at the last minute due to health reasons, and, as we always joke with each other, we are certainly a group which more than understands that sometimes health just happens. Besides, all TTRPG players know that the biggest boss fight is the evil real world schedule, so in that regard we’re no different from any other D&D group.”

    Quote by TBQ on gaming and chronic illness, pulled from the body of the text.

    TBQ’s advice for game creators and fellow roleplayers

    TBQ was both kind and candid in sharing her perspectives on gaming and illness, including what makes life easier for her. My next question was about advice. Specifically, her advice for game creators and fellow roleplayers to help make games more accessible.

    Difficulty modes and alternative solutions

    First up: difficulty modes for video games. “Again, I know this doesn’t apply to all games,” she said, “but whenever possible including an easy or story mode is just as important as having the ultra death hard mode.”

    “Likewise, options for how to accomplish tasks differently in order to complete the game. It’s frustrating when a game which otherwise depends on roleplaying and combat suddenly throws a memory test puzzle at you. Or a quicktime event requiring fast hand/eye coordination, with no option for getting past that challenge otherwise,” she explained. “My limitations as a player in the real world shouldn’t be my character’s limitations.”

    Patience and understanding about chronic illness

    “For fellow RPers, patience and understanding are huge,” said TBQ. “I’ve already spoken about being understanding about scheduling. The other big one is understanding that I might need things to be repeated so I can write them down, or said again because I didn’t catch all of the information the first time.”

    “Also, teamwork is huge.” TBQ explained, “I was in one RPG where another player, knowing I had memory issues, would have her character step up to handle challenges I as a player couldn’t do while providing reasons in roleplay which made it plausible for why my character, who didn’t have my memory issues, couldn’t do it. That way I was able to roleplay the character I wanted to play without having to break immersion or force my character to have limitations that I didn’t want her to have.”

    TBQ added, “What I particularly appreciated about that was her kindness as a player paved the way for our characters to interact more and become good friends in the game. So it was a real win/win situation where her out-of-character desire to help created wonderful in-character moments and development which wouldn’t have happened otherwise.”

    Willingness to listen and collaborate

    “Finally, I’d say really listen when people tell you they can’t do something,” said TBQ. “I’ve had times where I’ve said I couldn’t do something in an RPG only to be told by the DM, ‘Oh, it’s easy!’ Sure, maybe for other people, but it’s not for me. So can we please brainstorm solutions to get around this obstacle? I’m happy to help work the problem, but I can’t do that if no one will listen.”

    I asked TBQ if there’s any advice she’d give her younger self – or maybe something she knows now that she wish she’d known sooner.

    “There’s no one way to play a game,” she answered. “If you’re having fun and nobody else is being hurt by it, that’s the right way for the game to be played. Whether it’s easy mode, god mode, or things like ignoring the main quests because all you want to do is pick flowers and talk to random NPCs it doesn’t matter. Do what makes your heart happy.”

    (Side note: I’m totally one of those people who wanders away from the main quest line to pick flowers and talk to random NPCs.)

    TBQ’s recommended games and resources

    Finally, I asked TBQ if she had any games or resources she’d recommend to fellow writers and roleplayers.

    Video games

    “I love anything where you can focus on story over death and difficulty,” she said. “Right now, I’m enjoying Skyrim’s anniversary edition because it added more housing, and housing is always endgame for me no matter what I play. I’m also looking forward to the new Monkey Island that will be coming out because the worst fate you can have in a LucasArts game is that you hit a mental wall because you can’t figure out something like how to upset a volcano god, not because you got killed over and over.”

    Tabletop RPGs

    “For TTRPGs and writing, a good organization system is huge,” said TBQ. “For TTRPGs, I use OneNote for each campaign that I’m in. I set up a notebook with tabs for my character’s information, background, features, and spell information if applicable, and also have a section where I take detailed notes of what goes on in each session.”

    “Yes, character sheets keep track of this information too,” she explained, “but I find it easier during a game to click on a clearly-labeled tab that says something like ‘First Level Spells’ with every spell written out than to rifle through papers or find the right line to click on an online sheet.”

    Again, do what works best for you!

    Writing

    “For writing, I use Notion, which allows me to keep track of everything I’m working on and cross-reference it to a calendar and any other tracking system I might need. It also lets me keep a library of references, resources, my income and expenses, and anything else related to my site.”

    TBQ added that both Notion and OneNote have a free tier. You can also find them in the app store for your mobile device.

    Thanks so much to TBQ for taking the time to share her perspectives on gaming and chronic illness. It was a pleasure interviewing her for this series. To learn more about her takes on pop culture and living with disability, visit her blog or drop by and say hello on Twitter, Instagram, or Facebook!

    Other posts in this series

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