Escaping to Heal: The Psychological Benefits of Open-World Games Mental Health
- Yana Evans
- May 16
- 7 min read
Updated: May 25
In recent years, the perception of video games has shifted dramatically. Once dismissed as mere entertainment, they are now recognized for their potential therapeutic benefits. Open-world games, in particular, offer immersive experiences that can positively impact mental health, providing players with tools to manage stress, enhance emotional resilience, and improve cognitive functions.
Private note about this painting from an artist
I have vivid memories of the first lockdown during quarantine. I spent two weeks at home, playing The Witcher 3 non-stop. Despite the chaotic situation with the pandemic, those two weeks became a cherished oasis and created some of the best memories for me. Over the next three years, I faced many challenges, and whenever things got tough, I found myself reminiscing about those two weeks.
Towards the end of 2023, fate gave me a wonderful gift - Larian Studios' game Baldur's Gate 3 and the fascinating character of Astarion. It's hard to put into words the mix of emotions I experienced while immersing myself in this game. The joy and excitement were so overwhelming, especially amidst my own mental struggles, that it felt like a storm of energy was raging inside me, seeking an outlet. By chance, fate also led me to discover a stunning 3D fan art by a talented young artist, Nee Arts, which resonated deeply with my state of mind. It was as if the art, like my own longing, yearned to break free from the confines of computer graphics, seeking its own release in a piece of a transformative art.
After several months of work, the painting was finally ready. The fictional boy came to life, and I felt a sense of stability.
There were many challenges encountered while painting this picture, such as identifying and correcting anatomical errors, including twisted and broken collarbones, dislocated shoulders, and disproportionate arms. There was also amusement around how unnaturally tense the muscles appeared in this pose. Working with chiaroscuro presented its own challenge due to the complex but beautiful lighting. Without attempting to create an exact replica, the painting naturally reflected some of my own features onto the character's face, perhaps only understandable on a subconscious level.
I am grateful to all the people who contributed to creating the game, the character, and the overall atmosphere.
Cognitive Escapism and Stress Reduction: The Mental Health Benefits of Open-World Games
Picture this: it’s 2 a.m. You’re emotionally fried from a long day of managing life, your boss’s “urgent” emails, and the latest round of existential dread. You turn on your console. Five minutes later, you're no longer you. You're Geralt of Rivia, silver sword on your back, galloping across a foggy moor. The wind howls. A monster growls. Your heart slows. You’re free.
Welcome to cognitive escapism—a psychological safety net that, believe it or not, might just be saving your sanity.
What Is Cognitive Escapism?
In clinical terms, cognitive escapism is the act of mentally retreating into a different space—real or imagined—to distract, soothe, or recalibrate the mind under stress. It’s not denial. It’s not avoidance. It’s a smart, adaptive coping mechanism. And in the world of modern gaming, it’s an art form.
A 2024 study published in the Journal of Medical Internet Research, led by Dr. Matthias Hofer from the University of Zurich, took a deep dive into this phenomenon. Titled “Gaming as Mental Health Practice: The Role of Escapism in Stress Reduction and Well-being”, the study surveyed over 1,200 gamers. The result? Players who used games for escapism reported significantly higher levels of relaxation and well-being. Translation: the right game at the right time can act like emotional first aid.
Why Open-World Games Work Best For Mental Health
Let’s be real—if you’re going to escape, you want your new world to be a damn good one. That’s where open-world games come in.
Whether it’s the mythic Japan of Ghost of Tsushima, the morally tangled realms of Baldur’s Gate 3, or the sweeping Slavic fantasy of The Witcher 3, open-world games don’t just let you play—they let you become. These environments are expansive, immersive, and designed to make you forget your overdue rent or that awkward thing you said in a meeting six months ago.
Dr. Andrew Przybylski, Director of Research at the Oxford Internet Institute, has long championed the idea that games provide "a unique digital environment where stressors can be controlled, reinterpreted, or simply left behind." His 2020 study, “Video Game Play Is Positively Associated with Well-being”, shook the internet—and the old-school stigma—by showing that players who engaged in games like Animal Crossing or Plants vs. Zombies felt significantly less stress than non-gamers.
Imagine what happens when you swap cartoon plants for morally complex quests and beautifully rendered war-torn cities. You don’t just play. You process.
The Hero's Journey, but for Your Mental Health
There’s something primal about taking on a quest, right? It’s not just entertainment—it’s emotional transformation. Open-world games simulate what psychologist Joseph Campbell called “The Hero’s Journey”—you’re the outsider, the underdog, the one thrust into a world of chaos with only your wits, your will, and maybe a ridiculously large sword.
As you navigate monster-infested swamps or ancient tombs, your real-world stress begins to shift. You get to confront danger in a place where you have control, and that’s where the magic lies. In gaming, you can win. That feeling spills over. Studies from Dr. Isabela Granic at Radboud University show that video games help build emotional resilience, even in adolescents, by offering success through skill and perseverance (“The Benefits of Playing Video Games,” American Psychologist, 2014).
Escaping Isn’t Avoiding—It’s Alchemy
Contrary to outdated beliefs, escapism isn’t about running away. It’s about rebalancing. When your brain is drowning in cortisol (that pesky stress hormone), retreating into a lush digital world is like throwing it a life vest—and a mojito.
Gaming allows players to reset their nervous systems, not by numbing out, but by immersing in. That’s an important distinction. Open-world games don’t distract; they engage. They give you puzzles to solve, stories to unpack, landscapes to explore—while your subconscious quietly tidies the emotional mess you've carried all day.
Escape to Reclaim
So next time someone says you’re wasting time riding across Skellige or sneaking through Templar territory, hit them with some science. You’re not hiding from your problems—you’re digesting them, pixel by pixel.
In the end, escaping into a game world isn’t giving up on the real one. It’s taking a detour through imagination to come back stronger, steadier, and maybe a little more badass.
So saddle up, hero. Your therapy awaits in the next quest marker.
Enhancing Cognitive Functions in ADHD
There’s something oddly magical about slaying a griffin in The Witcher 3 or parkouring across Renaissance rooftops in Assassin’s Creed. For most, it’s immersive escapism. But for people with ADHD? It might be brain training in disguise.
Attention Deficit Hyperactivity Disorder often comes with a cocktail of cognitive challenges—poor working memory, impulsivity, and distractibility being the main villains. But research is now pointing to an unlikely hero: video games.
Take EndeavorRx, for example—a literal FDA-approved video game developed by Akili Interactive and studied in clinical trials led by Dr. Scott Kollins at Duke University. Published in The Lancet Digital Health, the 2020 study showed that kids who played this game five days a week for just one month showed marked improvements in attention—comparable to low-dose medication. It’s not Hogwarts—it’s neuroscience.
But what if you’re more into open-world epics than prescription-grade pixels?
A systematic review in JMIR Serious Games (Van Ameringen et al., 2020) examined game-based ADHD interventions and found that well-designed video games—especially those that engage working memory, problem-solving, and sustained attention—can boost executive functions while decreasing core ADHD symptoms. The key? Motivation. If the brain is bored, it’s gone. But if it's captivated—say, by the political chessboard of Baldur’s Gate 3 or the cinematic stealth of Ghost of Tsushima—attention sticks.
These games aren’t just visually stunning; they demand constant multitasking, decision-making, and strategic planning. You're tracking quests, analyzing risks, toggling between maps, inventories, and moral choices—all while hyperfocusing for hours. For ADHD minds, that’s not distraction. That’s therapy with a controller.
So next time someone says gaming is a waste of time, just whisper, “It’s executive function development, actually,” and ride off on your digital horse.
Building Emotional Resilience in Borderline and Bipolar Disorders
Let’s face it—real life doesn’t come with checkpoints, dialogue trees, or save/load options before a big decision. But in the world of The Witcher 3 or Baldur’s Gate 3, you can choose your path, fail with flair, and try again. For individuals navigating the emotional storms of Borderline Personality Disorder (BPD) or Bipolar Disorder, this isn’t just fantasy—it’s powerful practice.
Open-world games thrive on narrative complexity and moral ambiguity. You’re not just fighting monsters—you’re deciding the fate of entire villages, choosing who to trust, and dealing with the emotional fallout. For players with BPD, known for intense emotional sensitivity and struggles with identity, this becomes a sandbox for emotional regulation.
A 2017 study by Dr. Laura Frey at the University of Louisville, published in Current Psychiatry Reports, highlighted how structured emotional engagement—such as in role-playing and storytelling environments—can help individuals with BPD build affect tolerance and practice decision-making in non-threatening scenarios. That’s therapist speak for: virtual drama helps prepare for real drama.
Similarly, for those with Bipolar Disorder—where moods can swing from mania to despair—games offer a way to externalize inner turmoil. A 2021 study in JMIR Mental Health (Vigo et al.) found that interactive digital tools, especially those with narrative and goal-driven structures, support mood stabilization and cognitive flexibility.
Games like Ghost of Tsushima let players move through grief, honor, and redemption. In Assassin’s Creed, your actions ripple through time and consequence. This gives players a structured yet expressive space to explore emotions, reflect on outcomes, and develop resilience—one choice, one quest at a time.
So if someone questions your 80-hour playthrough, tell them it’s not escape. It’s exposure therapy—plus better armor.
In the end...
The immersive nature of open-world games offers more than just entertainment; it provides a platform for mental health support and psychological growth. By facilitating cognitive escapism, enhancing emotional regulation, and fostering social connections, open-world games and mental health become increasingly linked in discussions of therapeutic tools. As research continues to uncover the healing potential of gaming, it's clear that these virtual worlds can yield profound real-world benefits for mental health.
And hey, if you’re feeling overwhelmed or stuck in your own storyline—please don’t hesitate to reach out. Talk to your doctor, a therapist, or call a local mental health support line. There’s no shame in asking for help. Even the strongest heroes need healers.
