Simulator Sickness: Game Sickness, Dizziness, Vertigo, Nausea and Epilepsy

It’s been a while since I posted something apart from technology. But this subject was something that inspired me to post about it. Video gaming is a big industry now and people of all ages play them several hours in a day (including myself). If you’re a gamer you should be aware of this feeling when playing certain games and it is better that one knows more about it.

To start off, Vertigo may be a bigger word for this because typical dizziness from playing a game is not vertigo or at least a severe or permanent form of it. But it is definitely serious and you should always take caution and read a game’s manual where it shows warnings about physical health. So let’s define what we are talking about here:

What is this feeling? What are the Symptoms?

When you play an FPS (First Person Shooter) game and the camera moves fast enough to shake your head, that feeling is dizziness. But if that feeling prolongs and your eyes and the head cannot follow up to it, you’ll start feeling sick in the stomach, eyes with throbbing headaches and increased Blood Pressure. This is where you leave the game, and I advice you DO leave the game. However, this is not restricted to FPS games only. You can feel sick to many a games and real life situations and there are reasons to it, which I will list down in the following paragraph. Now, you must keep note here that the amount of pressure a game can put on your health varies to the patterns involved in triggering that feeling. Some games can just make you feel a little dizzy, some will make you feel sick with little nausea/headaches and others can be extreme like triggering epilepsy and vertigo. The symptoms can be as follows:

  • Varied Dizziness
  • Altered Vision
  • Light Headedness
  • Vision Displacement
  • Stomach sickness / An urge to Vomit
  • Eye or Nerve Twitching
  • Muscle Contraction or Aching

Reasons for this feeling?

When I was young, the first game I picked up to play on my old 286 system was Duke Nukem. I was 8 years old and I played that game for 10 minutes with a friend. That game made me sick and I vomited shortly after. My gaming career is too long to detail here but I can list down games that have made me sick over these years, and most of them are FPS games. I avoid playing FPS games or games with a dodgy camera, which is one of the reasons for this feeling. I must also say that this feeling has started to climb down in the recent years, not because of my age but because of the advance in technology and how the games are made.

The patterns in video games that trigger this feeling may differ from one person to the other and that is entirely on how a person perceives or processes the information in front of him. Let me explain this through an example:

One knows that when a pilot controls an aero plane, he pulls the control lever downwards to make the plane go upwards. Now when you play games that simulate flight behaviors, they give you the same controls. If you press down on your controller d-pad, the plane should go up. But if those controls do not respond the way,  your mind thinks they should, you will feel uncomfortable and might say that it is unrealistic. So whenever you play a game, the information you engulf with your eyes is readily processed by your brain and if your brain evaluates the information to be wrong or “not the way it wants it to be”, it will cause this feeling. Thus, this feeling can differ from one person to the other. Your brother can keep playing a game for hours and not feel dizzy but you might get sick looking at him play, in 5 minutes.

I have gone ahead and tried to figure out things that can cause this dizziness to happen. I will try to incorporate more factors into this later on.

Physical Reasons

This post has received so much attention from the community that I’ve decided to update it with my new found research. Some time ago, I was unable to play some games including the Uncharted series on the Playstation 3. A month ago, I picked up the game once again and started playing again. To my surprise, I did not feel any dizziness. I went on to play the whole series and I was really happy. I looked back and remembered what had changed:

Weak Eyesight

I wear eye glasses because I am a programmer and use the computer screen most of the time. It’s been such a long time that I forgot I may have lost a bit more of sight. I got my eyes checked a month or two ago and the doctor suggested me a different pair of Glasses. The new lenses were a shock, my eye sight had grown really weak. I was able play Uncharted and some other games that made me dizzy just fine after the change of lenses.

Tiredness or Screen Brightness

Another one of the reasons why you’d feel bad playing a game is because your eyes/body is really tired. It does not have the energy to cope up with a fast moving environment. Too much brightness on the screen or the display device itself can cause strain on your eyes. Please take rest and make sure you’re fresh before starting a game.

Jittery Frame Rate or Lag

It turns out that whenever a game runs in a jittery manner and without consistent frame rates, it can induce this horrible feeling. For example, playing a fast game like Far Cry or Counter Strike requires that you have a firm control over your view and keep moving fast. This also requires that the camera be updated and moved as fast as possible. Now, if the game suddenly slows down due to graphical reasons or network issues, you’ll start feeling irritated and might get dizzy.

Also, if a game is supposed to run at 30 FPS (frames per second) and it slows down on various intervals, you can start feeling the effects of that too. I have also noticed that most of the games that run on 30 FPS and 50 FPS induce mild nausea while playing. This somehow does and does not mean that games that run on 50Hz can behave the same. This is because the induction of this feeling is not entirely dependent on the game or the game platform itself. Your environment and your TV play a big role in this.

Uncontrollable Camera or Insanely Fast movement

This can be easily explained that whenever a person moves too fast or takes circles, he’ll get dizzy. This is because the eyes cannot follow the motion fast enough and a feeling of confusion will cause you to get sick. In games, games like Tomb Raider and Counter Strike can have a very fast mouse scrolling rate, which can leave you vomiting on the floor. While playing games like Quake Arena, the characters move insanely fast and the camera is totally out of control. This can cause nausea very quickly.

Camera Centering

Again, it seems that Camera plays a big role in the creation of this phenomena. This is of course true since the game is seen through it :). Many games have a procedure built into the programming of the Camera that it tries to re center itself every once in a while or due to an object blocking the viewing angle. If this happens frequently or if it is badly handled by the programmer, you’ll instantly get sick.

Patterns (Light Strobes, Blood, Gore)

It is not always that you feel sick by moving or changing the camera angle. Certain points in a game can make you feel sick. I have heard people complaining about the water in Tomb Raider and Halo as well as COD4 that it makes them feel sick. This is also true to real life objects like Cliffs and high places. People who have issues with Motion Sickness can easily fall victim to those patterns in games.

Violent games like Quake and Gears of War have extreme Blood and Gore content. This can also lead to nausea and sickness. Some people are allergic to blood and objects alike. So this is also a contender in that.

Certain light patterns in games, for example in poker or card games can lead to light headedness and mild dizziness.

Camera Inversion

This may be one of the biggest reasons behind game sickness and nausea after other reasons attached with the camera, I explained earlier. Many games have a controllable camera but not all of them give the user complete control over it. This means that whenever the player wants, he/she can adjust the camera viewing angle as he/she sees fit in a 360 degree manner. The reason why this can cause dizziness is because of the following reasons:

  • The speed and accuracy at which the camera moves when controlled by the player
  • The direction of the camera when moved to as opposed to the directions given by the mouse or an analog stick. For example, if the user moves the control right and the camera moves left or if the user moves the control down and the camera moves up. This is called camera inversion.

Many games give the user an option to invert the axis of the camera according to their controls but many of them don’t. This can be frustrating and certain people get sick very easily with how the camera controls respond to their actions.

Too much information on the Screen

Ok, this is another one I’ve seen people complaining about. Some people cannot digest the amount of information being updated rapidly on the screen. This means that there mind is not catching up to the pace of the information being fed to the eyes.  This can too lead you to sickness.

Cramped/Dark Scenes

Recently, I’ve found out that I felt dizzy when playing Resident Evil 6. This was triggered by dark and cramped spaces all over the game. It put a lot of pressure on my eyes to make out what was going on. Other times, when looking for ammo or inventory, the lead character would need to go into cramped places and the camera behaved strangely to fit inside that space.

Ok enough Reasons, Are there any Solutions to this?

Oh yeah, I almost forgot, the reason I wrote this post was to help people find some solutions to this issue. Firstly, I must tell you that these solutions are really not that effective for playing and that if a game makes you feel dizzy, stop playing it. The world will not end if you don’t play that game. Gift it to a friend if he can play it easily. You’re better off with good health than some enjoyment with a game. OK?

Now i am going to divide this into two sections. First, if a game makes you sick, how do you correct it to play it. Second, if you are already sick, what do you do help to yourself.

Section 1: Make sure you’re healthy

– If you a history of epilepsy, drowsiness or game sickness; consult a doctor.
– If you wear glasses, get your eye sight checked. You should get your sight checked regardless :).
– Make sure you’re not tired. Do not play if you’re physically worn out. This makes things worse.

Section 2: Making them play Right

Play in a well lit environment

You should always play in a well lit room, which does not put pressure on your eyes while playing. This will reduce the amount of light falling on your eyes and the concentration you require to view the screen.

Frame Rate / Screen Refresh Control

Ok, most games do not let you control the frame rate they run at. But some of them do. This depends on what platform you are playing the game at. For example, if you are running the game on a PC, you can tweak your Card’s and game’s graphical options to make it run more smoothly. Good Developers like EA and Capcom keep that option in there, so you can give it a try. You can also change your VGA to run at a higher Refresh Rate to help this out.

If you are playing on a TV using a console, you can try shifting from a 50Hz mode to a 60Hz mode and see if that helps you. You can also notice that if you run a game in Progressive mode, you’re less likely to feel dizzy. Of course, you require a better quality TV for that to work.

Axis Inversion

Many recent games feature that option in Camera Control Settings. Many gamers including myself prefer that the camera moves to where I move my Mouse or Analog Stick. So if you find an Axis Inversion option in your game, try flipping that and you’re less likely to feel dizzy. For example, I always invert the Y Axis to play Metal Gear Solid 4 or else I can’t play it :).

Camera Sensitivity / Mouse Scroll Smoothing

Many games have a shitty camera and that is because the programmers did a bad job programming it. If you find an option to control the sensitivity of how fast the camera moves to your controls, try adjusting that and it might help. I could never play Killzone 1 because of its awful camera and lowering the camera sensitivity helped me enjoy that game for hours.

CRT versus LCD / Old versus Modern

Ok, this is a definite must. If you have a big screen TV at your home, whether it is a CRT or an LCD, you should try to sit as far away as possible from your screen. Also, I must tell you here that monitors and televisions capable of low input lag are less likely to induce you with this sickness. So this is a highly recommended change. CRTs are known to have low input lag but they’re out of the trend now. If you can, try to get hold of a LCD/Plasma TV/Monitor with low lag.

Viewing Angle

This may not be a big one but the angle at which you view the game screen does matter a lot. You should not look straight or under your TV screen. Make sure that you are a bit above the screen and the TV/monitor screen is a bit tilt adjustable to help with that.

Section 3: Ok, I am about to vomit, what do I do now?

I don’t want to sound ironic but whenever a certain photographic pattern makes you dizzy, this could be bad for you. So immediately stop viewing it or you can worsen your situation to an extent of triggering Epilepsy or worse.  You can search around the internet and see for yourself, the cases people have posted.

Lie Down and Close your Eyes

Lying down straight or on your couch and closing your eyes will help you relax instantly. You can also try putting your elbow bent over your eyes to help with the pain in the eyes.

Wash your Face

If you feel that you are heating up and the feeling is uncontrollable. Go wash your face twice or thrice. Drink some water and then lie down again. Do not drink milk or any Soda. This will only worsen your situation. If you feel like vomiting, you possibly won’t, but you may. It will help.

Go to Sleep

Just go to sleep, period. Sleeping for about 2-5 hours will eventually help you with this feeling. This has always solved it for me and I am pretty sure it will help you too.

What if it persists?

This is bad. If this feeling persists even after sleeping and you feel the same after one or two days and you change how you want to eat, then you should immediately consult a doctor. There is no fighting it, you should be careful with your health.

So, that was the longest post I ever wrote but I am happy that I put all the information I have ever known about this feeling in this post. Please feel free to contribute your experiences. I did not add any games that make me feel sick because it can vary from one person to the other.

Thank you and enjoy your games. Take care of your health and try not to over do it. I would like to mention Hideo Kojima and Metal Gear Solid 4 here because it was the first game that included content during it’s loading that advised the player to take  a nap either if it is too late in the night or if he has been playing for too long.

Update 1: I found this  detailed technical article on Simulator Sickness over at loonygames. If you want to know the technical history of this subject, head over to that link.

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This entry was posted on Monday, March 23rd, 2009 at 12:27 am

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Tags: camera, dizziness, dizzy, epilepsy, health, inversion, nausea, sick, vertigo

Posted in: Misc, Video Games