Until last winter, I hadn’t played video games since my parents let me combine allowance and birthday money to buy an original Nintendo Entertainment System, the old 8-bit home video game console with two buttons and a gray flip-top lid. Back then, I could take or leave Mario and his green-trousered brother, but I would have traded my allowance for uninterrupted time to lose myself in Tetris.
The premise of the game was simple: arrange geometric pieces known as Tetriminos as they descend onto the screen. Completed lines disappeared. My mantra? Always build with Tetris, the point-maximizing simultaneous clearance of four lines at once, in mind. The game soothed me, especially on the heels of a breakup or the appearance of an especially egregious chin zit.
Lying in bed at night, I used to stare at the dark shapes in my bedroom, mentally nudging a dresser or nightstand left or right to fit, Tetris-style, with adjacent shapes. When I got bored at school, my eyes drifted to rectangular door frames and exit signs, all begging to be resituated, squeezed together, gapless to their counterparts, and dissolved. Tchaikovsky's “Dance of the Sugar Plum Fairies,” one of the game’s blissfully audio-compressed theme songs, played in a loop in my mind.
When I graduated high school, I left the Nintendo behind, stowed in my parents’ family room next to VHS tapes of Full House. The only time I played Tetris after high school was on airplanes. And even then, only when the game was preinstalled into the seatback in front of me. Nothing like Tetris to distract from stress-inducing turbulence. Apart from flights, I didn’t play.
When the pandemic and an onslaught of worry and anxiety hit, I doomscrolled, tossed and turned, and shouted at my kids more often than I should have. Much as I wanted to, I couldn’t get a grip on my emotions. I tried organizing closets to distract myself. Eventually, there were no more shirts to arrange by color, no more too-small hoodies to load into the donation tub. I needed another outlet.
Sometime before Christmas, while browsing for a new game to add to my kids’ Nintendo Switch games library of one (Mario Kart), I stumbled upon Tetris 99. Instantly, I craved the game of my youth.
“When we’re seeking ways to soothe ourselves, we often use a version of something that has worked in the past, even the distant past,” says Dana Dorfman, a New York–based psychotherapist, regarding my intuition to pick up the game after all those years. “It’s like music from old times—it can almost capture our feelings,” she says.
The day the tiny Tetris 99 cartridge arrived, I curled up on the floor in our hall closet so my kids wouldn’t find me for a few minutes and fell right back into my old rhythm of block flipping and stacking.
According to Dorfman, when emotions are dysregulated, doing something deliberately that gives you a sense of control, something you can master, gives you confidence. "The game allows you to organize pieces that, like in life, are coming at you faster and upside down, in such a way that they’ll literally leave the screen. It’s like a microcosm of what you’re trying to do in life, except you’re doing it on the screen in a more concrete and tangible way,” she says.
It turns out using a popular video game to feel better isn’t a novel concept. Researchers are investigating whether commercially available video games like Tetris can act as a sort of therapy.
Michelle Colder Carras, associated with the Johns Hopkins Bloomberg School of Public Health, is a gamer and a scientist specializing in commercial games and online gaming communities, and their role in supporting mental health. Her research suggests that commercial, off-the-shelf video games have potential applications in preventive and therapeutic medicine.
“For people who have anxiety, or feel constantly hypervigilant about potential threats in life, game playing can help distract from the way their mind normally works,” Colder Carras says. But no matter whether a person is pre-wired for anxiety, there is also value in simply taking a temporary break from the stresses of everyday life.
I am an overthinker. I forecast worst-case scenarios on the regular and end up irritable and short with my family more often than I should. But even in moments where the only thing “wrong” is the volume of the tiny voices around me while I’m trying to finish a paragraph or start dinner, a short tryst with Tetris is a reprieve.
Vasileios Stavropoulos, senior lecturer of Clinical Psychology at Victoria University in Melbourne, attributes that feeling of reprieve to flow, or the state of being completely absorbed by a concurrently challenging and pleasing activity. It’s akin to the flow state experienced by painters, dancers, and athletes who are in the zone. “Tetris is based on the well-known flow recipe of progressively higher challenges and rewards,” he says.
In Tetris 99, several modes of play are online and multiplayer. But competition has never been my thing. Nor did I desire social interaction. So I chose Marathon mode, designed for one player and available in 150- or 999-line play.
The purist in me eventually got over the existence of preview lines on the grid known as “ghost pieces.” I preferred to think about how the pieces would land, rather than be shown. It was almost as if the uncertainty embedded in Tetris was a safe way to practice living in a shifting and unpredictable world.
A 2021 review of 28 studies related to commercial off-the-shelf video games found evidence of the benefits of these games for reducing stress and anxiety. And not only in healthy individuals, but also in patients with depression, anxiety, PTSD, and other conditions. “There is this idea that games must be designed by psychologists with the aim of modifying behavior in some way to be helpful,” says Federica Pallavicini, research fellow at the University of Milano-Bicocca in Milan and the first author on the review. “But I believe in the potential of commercial video games for our mental health. They are easy to access, simple, and they can be played by millions of people.”
What makes a video game beneficial for our mental health? When we are stressed or anxious, we have limited cognitive resources. “Casual video games like Tetris, Angry Birds, and Pac-Man have low cognitive demand,” says Pallavicini. “We can play for five to 10 minutes, as a distraction, and feel better.” Other genres, including exergames that focus on moving the body like Just Dance, Wii Fit, and Xbox Kinect games can help with relaxation.
This year, as in my childhood, I still got the same rush when pieces started falling quickly—which happens as the game progresses. In other words, the less control I had, the more I let the pieces—ahem—fall where they may, the greater the chaos that ensued. But here’s the thing: In Tetris, the falling pieces didn’t give me the sweats. My stomach didn’t turn the way it did when I was feeling anxious about the world reopening, kids back in school wearing masks, the variants. Tetris provided a reliable way for me to get out of my head. After a game, I had fewer arguments with my family. I felt less agitated.
“Often, our response is to hold on tighter when we’re trying to work through something,” says Dorfman, “But it’s in the release, when we’re having fun, that the growth happens.”
Would I still prefer a few hours of silence with a book in a soft chair to another game of Tetris? Most days, yes. But let’s be honest, for the foreseeable future, my kids are little and my mind is rarely quiet. What I have now is a lot of chaos, a lot of love, and one solidly built line at a time. On a good day, four.
Here are some tips from the experts on using games for anxiety and stress reduction:
Experiment. Try games you loved as a kid or that interest you now. If you’re not sure, check out Steam reviews and see what other people are saying about which games help mitigate anxiety.Set an intention. When you set an intention, just like you might at the start of a day or workout, the mental benefits can be greater. Try simply thinking to yourself, “I’m playing for 10 minutes to mentally reset.”Reflect on the experience as you play. Colder Carras says, “As you’re playing, keep reflecting on your experience. You might think ‘Gosh, this is kind of silly, but I’m enjoying myself,’ or you might think ‘I’ve been playing too long,’ and all of those things are important and can encourage healthy use and promote self-regulation.”Enjoy yourself. Have fun flying solo or find your people online in places like the Geek Therapy Community on Facebook.
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