Migraine is not just a headache, it is a complex neurological disorder that affects about 15% of the adult population in the UK and 10% of children and young people. Some people have short, mild infrequent attacks, whilst others suffer frequent, long severe attacks. There are effective treatments and most people find a combination of treatment and lifestyle changes that limit the impact it has on their daily lives, however some, like me, have chronic migraine that does not respond to treatment. Trigger management is an important part of managing migraine attacks and some video games do contain common migraine triggers.
Making games accessible to people who suffer from migraine and other headache disorders is not usually a top priority when creating a game, but reducing possible triggers can make games more accessible to a wider audience and migraineur gamers will be eternally grateful for the effort. Reducing and ideally avoiding common triggers is the best way to include those who get migraines.
- Bright or flickering light: Using lighting effects in games is a trigger, particularly bright or flickering light. Bright torches wielded from a first person perspective in a very dark environment is a good example of a possible trigger. So are flashy combat special effects, like those used in Remember Me, enemies who shine bright lights straight at the player or bright white screens in between sequences, like the Halo series.
- Rapidly flashing sequences: Avoid flashing images, particularly bright rapidly flashing sequences. Game trailers are particularly prone to use these to try to capture the essence of the game without revealing too much detail.
- Visual effects: Most visual effects are common migraine triggers. Menus often contain needless triggers as they are animated to slide in and out, ripple or zoom. Provide a motion free version of the game menu.
- Glare: Excessive or uncontrolled brightness is a problem. Simulating glare in first and third person perspective games are triggers.
- Jitter and shake: Jitter and shaky cams are obvious triggers, but any sequences that contain uneven movement can be a trigger for both migraine and motion sickness.
- Motion sickness triggers: Many migraineurs also suffer from motion sickness and inducing motion sickness could act as a migraine trigger. Triggers do overlap, more information about minimizing motion sickness triggers in our article Dev Tips: Simulation sickness and video games.
For more information on making games universally accessible, have a look at Game Accessibility Guidelines.
- Have an ergonomic set-up. If your screen is too high, too low, too close or too far away, it could cause eye and neck strain which are both known contributors to headaches and migraine. Mobile gaming is even harder to get right as the position we usually hold our phones and tablets are not ergonomic. Find a good spot to game, set your gear up ergonomically and use it for those longer sessions.
- Take breaks and avoid marathon sessions.
- Reduce glare from the screen – make sure the lighting in the room matches the lighting on the screen, so when playing game sequences with a dark palette or night-time setting, play in a darker room and when playing game sequences set in bright sunlight or with a light palette, play in a well-lit room. Don’t overdo it either way though.
- Choose accessible games with as few triggers as possible.
- Take care of yourself: Lifestyle changes and adhering to treatment and medical advice can reduce migraine attacks overall and could reduce the impact video game related triggers have.
- Stop playing if a game gives you a migraine or if you really want to play it, be aware that it will probably cause a migraine and compensate for it accordingly.
- Be aware that complete avoidance isn’t always the way to go. Some triggers can become less severe with regular exposure and more severe with too little or too much exposure. Little and often is generally a good rule to follow unless you are happy to permanently give up gaming and other similar activities.