Experiencing nausea when gaming

Last week I wrote about my issues in gaming with dark mode, which seems to be the standard for video games. In this post, I would like to address another issue that stops me from playing a lot of games: dealing with nausea with gaming due to first person perspective, enclosed spaces, camera shake and related issues.

Some time in the past 10 years, I have lost my ability to play first person perspective video games. While I was still able to play Skyrim in early 2012 without any issues (on the XBOX), I have since not been able to play another first person game (on my PC), because whenever I tried, after a few minutes I became incredibly nauseous. This was the case with Portal and We Were Here Together, which is quite a shame, because both of these seem like really cool puzzle games.

Nausea when playing first person games is actually very common, and is often referred to as motion sickness or simulation sickness. If you google “nausea from first person games”, you’ll find plenty of posts on reddit on this topic, as well as a lot of articles with varying degrees of usefulness, such as one of Kotaku and on PCGamer. The latter recommends increasing the FOV, which has helped me for some games, because nausea is something I also experience in some third person games  depending on settings and other factors. Horizon: Zero Dawn (PC), for example, had the option to set the FOV to 70, 80, 90 or 100. To compare these settings, you can view this image in full size by clicking on it:

Needless to say, I played the game with the FOV of 100, which didn’t cause me any particular issues. Unfortunately for inexplicable reasons, a setting like this is absent from Horizon: Forbidden West (PS5). While this didn’t bother me too much playing the game, I sometimes did wish I was able to play with a higher FOV. Perhaps this also explains my love of isometric games – having starting my gaming career with games like Diablo I & II, isometric games still feel most natural to me.

I haven’t touched any first person games in a long time, probably also because they tend to not be the types of games I like to play anyway (I don’t really like shooters). However, as I already mentioned, third person is not even a guarantee for me that I will be able to play the game without issues. FOV obviously plays a big role, but so does ‘enclosed space‘, for lack of a better word. I noticed this in particular when I tried to play Witcher 3, as well as Assassin’s Creed: Origins. In Witcher 3, I had issues whenever the game took me into enclosed spaces, such as caves, houses, etc. Navigating my way through a house in this perpetually way-too-dark game also made me very nauseous. I was usually able to handle it by balancing indoor and outdoor time in the game, but at some point the game took me to a big town that was just all indoor all the time, or generally navigating around tight spaces, and that’s the point when I gave up on the game because I became too nauseous to really progress the story. Which is a shame, because people keep telling me how good it is. Give me wide open spaces, and I’ll happily ride around them for hundreds of hours – which no game did as beautifully as Red Dead Redemption 2.

Another issue I encountered when playing third person games is camera shake or handheld camera effect. I recently started playing God of War (2018), and for completely unfathomable reasons apparently the developers of this game thought it would be cool or artistic or whatever to have this game take place with constant camera shaking. Thankfully you can turn this off in the gameplay, but all of the cinematics still have this horrible shaking, and after trying to play the game for about 3 hours, I eventually gave up due to nausea. A quick google search confirmed that I’m not the only one, plenty of people complain about the camera shake in this game and its sequel, and it’s absolutely puzzling to me as to why camera shake¹ is not a bigger topic in the discussion of accessibility in games. People keep telling me to play this game because of how awesome it is, but alas, I just can’t.

Ironically, I do not seem to have any issues at all when playing VR games, which is where most people actually have issues with motion sickness. I haven’t played in VR very extensively, but I tried playing a little bit of some Resident Evil game, some Star Wars game, and the most excellent Rez Infinite, all of which I greatly enjoyed without issues. Similarly without issues, I have played both Assassin’s Creed escape games, Escape the Lost Pyramid and Beyond Medusa’s Gate, which were both roughly one-hour first person VR escape games. VR apparently makes it easier for my brain and stomach to not be confused, because my entire world is moving, whereas especially when gaming on my PC, the limited field of view turns my stomach upside down. VR has some other issues though, most notably that after about an hour, my whole head feels squished from wearing that heavy headpiece.

To summarize, I wish video games would offer more accessibility features that make games playable for people who are subject to simulation sickness. Being able to adjust your FOV should be a standard setting for any game, and just not having camera shake at all seems like the only logical option for me. However, the problem of enclosed spaces is probably not something that can easily be solved, depending on the game. I will just have to limit my choices and stick to isometric games and third person open world games that actually have lots of wide, open space.

I am far from the only one with these issues – research has found that women and older gamers prefer third person perspective (A Matter of Perspective: Female Gamers and Older Gamers Prefer Third-Person Perspective) and that women are much more likely to experience motion sickness from gaming (Beyond 50/50: Breaking Down The Percentage of Female Gamers by Genre; Sex differences in tolerance to visually-induced motion sickness). I’m not surprised that women prefer certain genres when it’s quite obvious that some of the more popular genres among men cause them such issues.