Last time, I shared my thoughts on the Early release build of Darkest Dungeon, described as "a challenging gothic RPG about the stresses of dungeon crawling." As I was researching this game, I came across a fascinating article looking in-depth at how the game portrays mental illness in light of the Lovecraftian horror genre and other games that have come before. You see, in Darkest Dungeon, your heroes face two kinds of danger: physical danger, which results in a loss of health and eventually death, and mental danger, which results in increasing stress, leading to mental illness and possible madness. It is this second danger that the article focus on.
In most video games or RPGs that deal with horror, characters have a generic sanity trait that measures how much mental stress has accumulated based on their experience. Darkest Dungeon instead utilizes stress, which characters suffer from simple exploration, from debilitating monster attacks, falling victim to traps, encountering otherworldly horrors, and even from critical hits inflicted in combat. As this stress builds, eventually the hero reaches the breaking point, and usually immediately suffers some major bout of mental illness. This can lead to the character inflicting damage on herself, refusing healing, skipping their turn, and perhaps worse of all, criticizing or frightening your other heroes, which stresses them out and eventually leads them to the brink of insanity as well.
Thus managing stress becomes your most important task in the game. During quests, making camp and activating certain hero abilities are your primary means of reducing stress. And in between these quests, you gain access to services in town that can reduce a character's stress level, like meditation, binge drinking, prayer, or a night in the brothel. And negative quirks and injuries that remain can be treated in the sanitarium, but only one at a time. Of course, gaining access to any of these services cost money - money that could instead be used to recruit replacement heroes or outfit another venture into the darkness.
It's this mechanic that makes Darkest Dungeon stand out from other similar games, and for this alone it is well worth checking out.