Developing a chronic illness in 2018 fundamentally changed how I play games, which also changed which games I can play. This past spring I've started to take what I learned as a player to modify my design approach so I am creating games people like me can actually play.
This is not, to be clear, "how to design games while coping with a chronic illness," but more about how I have changed my own views on "good" game design as a result.
Being sick has drastically changed my relationship with time in several ways.
One, I have less time. Some of that time goes to taking care of my health (medical appointments, physical therapy, sleeping more.) Some goes to the symptoms, when fatigue or brain fog makes me unproductive. Some goes to the fact certain activities take longer, either because I'm slower or because I need to pace myself to get them completed. All of this compounds, because now I have less time, which means more basic responsibilities to get done, and everything takes longer.
Two, my time is unpredictable. I can feel 100% normal for weeks, then get functionally debilitated for an entire week. I can have 2 good days followed by 2 bad days. I never know exactly how severe the bad days will be, or how complete the rest will need to be.
These two factors create the third factor: time is a constant battle of priorities. Nearly every moment of every day is filled with a mental competitive bracket to decide which task gets prioritized next. This balancing means a portion of my mental energy is always occupied. That leaves less energy and space for processing other things, which primarily causes an issue when it comes to novel tasks. If it's something I've done a million times, I go through on auto-pilot. But if it involves learning or creating something new? I may not have the mental time for it.
My physical, mental, and emotional energy are more limited by being sick. This concept has been described before through the spoon analogy. In addition to the daily tasks that require energy, managing my illness takes additional energy.
As I described above, my mental energy is consumed with juggling priorities. Mental and emotional goes into maintaining my mental health. Change is difficult; developing a chronic illness led to change in every area of my life: work, relationships, identity, expectations for the future. My symptoms decrease my physical energy, but my treatment plan requires sustained physical activity of ~1 hour every day. In the short term, physical activity wipes me out, but in the long term, if I miss more than 1 day, I can fall back a week in my treatment progress.
Playing Games Differently
The change to my relationship with time and my energy meant I have to play games differently in several ways:
I know a lot of people who would find these game elements helpful. Maybe they have a busy or unpredictable schedule. Maybe they have a stressful job. I just know for myself, these factors have become, in many ways, necessary for me to participate.
Designing Games Differently: A Case Study
Right now I am working on two main design projects: Crossing Worlds and Tides of Gold.
Crossing Worlds is an evolution on Karma in the Dark, which I started designing years before I got sick. Karma requires significant world building, is designed for campaign length play, has many interlocking rule systems, and plays best when following the character development of set PCs and the same team. It requires a 2-4 hour zero session just to get started, and while that leads to huge player investment, it makes it painful when you need to cancel a campaign a few sessions later. It also changed significant aspects of the Forged in the Dark system, requiring a bigger learning curve, and the mechanics are designed to mimic an oppressive, unequal world, leading to either fast character elimination or needing a slower, strategic approach to play. Before I got sick, I enjoyed this game system immensely; I haven't really enjoyed it since being sick.
Tides of Gold, in contrast, was 90% designed and playtested while sick. I developed it in concentrated stages to compensate for my own limits, and that iterative development over the year means a lot of my experiences as a player with chronic illness shaped my development priorities. Character creation and crew creation, especially if you use premades, takes less than 30 minutes. Game mechanics were designed for fast play, so you can get through multiple phases in a 3-hour session, so even a one-shot can give you the feeling of a complete adventure. I designed the world with layers of detail: you get the general world setting in a 1-page, primarily visual timeline; there are one-sentence summaries of groups in character creation; and then you can read a few pages of more detailed information about the cultures further back in the book. I also created port maps with notable PCs and landmarks to provide inspiration for building up the cities as you need it. As one of the final steps, I created tools for procedural generation of points of interest and people; in my most recent session, I generated an adventure and multiple NPCs in 10 minutes.
If I were healthy, I would probably tell you I enjoy the Karma approach to games more. I like campaign narrative, interlocking rule systems, getting invested in creating a world and story together, and playing with the same group over months or years.
As someone with chronic illness, I will always pick Tides of Gold over Karma in the Dark. It is easy, snappy, and requires no time outside of a game session.
As I continue working on Crossing Worlds, I want to incorporate some of the Tides of Gold style into the game. I am focusing on a few specific design techniques:
1. Think in layers and clearly separate them.
I think of this as layers of complexity.
Layer 1 for Tides is "make characters, go on adventures with the core roll mechanics." You can play the game with this simple core and enjoy it.
Layer 2 is, "there are different phases and you can choose which to engage with." Someone can get deeper into the ship mechanics with an odyssey phase or downtime at sea, or not. Someone can learn the trade game to advance their crew's wealth, but it really only comes up if you choose to do a trade phase.
Layer 3 is, "you can discover optimal strategies." You can start adding situational modifiers to action rolls, but only if you want. You can pay attention to the dynamic market aspect of trade along with your ship's speed and plot out scores to steal and sell cargo that will make the most profit.
This layer structure also applies to the world building.
Layer 1 is captured by the introduction timeline, one-sentence culture descriptions in character creation, the world map, and the tools to procedurally generate points of interest. You need minutes or less to understand and engage with these touchstones.
Layer 2 is captured by the port maps. There are 9 ports with a map, city summary paragraph, notable NPCs, notable visual cues, and important landmarks. You can review a port when it becomes relevant, grab inspiration from what's provided, and develop your own details in play. This also includes the Bestiary, which provides short summaries of different marine life you might encounter while sailing.
Layer 3 is the chapter providing some history, cultural details, and names for each heritage in the game. It takes some time to read and covers more complexity than you need to play, but can also provide additional background to fill in the world and your character's story.
2. Provide flexible structure
Structure and limitations make both processing information and thinking creatively easier. For example, if gameplay is organized into different phases, players only need to think about tasks and rules for that phase. For creativity, it is easier to generate ideas when given prompts or limitations than when facing the blank page of "you can do anything."
I have begun experimenting with gameplay structure in many different ways in my monthly game experiments. I've experimented with player turns, with set number of scenes, with phase systems like scores/downtime, with clear play cues for how to start and when to end a scene, etc. This is the area I am currently exploring the most in my design. It requires a balance to work well: enough structure to organize play, but not so much it becomes another layer of rules you need to memorize.
I approach world design and GM tools with inspirational structure in mind. For example, the procedural generation tools for Tides can generate a reputation, physical trait, and motivation for an NPC. Those details act as prompts for the creative details you add yourself, or decide in play. For faction goals in Crossing Worlds, like in Karma, you pick a goal theme from a few options based on the faction's power level. A low level faction, for example, can have goals related to gaining new allies or increasing their influence; the high level factions have goals related to consuming or destroying less powerful factions. There is still a ton of space for the GM to decide the specifics of the goal, but the structure provides a direction.
3. Every session should feel significant
To adapt to the unpredictability of schedules and campaign length, I want each session you play to make an impact. If you can only play 1 session, I want that 1 session to feel like a meaningful adventure. If you have to end a campaign early, I want tools to support wrapping up the campaign on short notice, or tools to wrap up each session in a fitting way.
This doesn't mean throwing out all slow-burn dynamics or longer term advancement systems. In Tides, if you play longer you can build up your wealth, develop a fleet of ships, and bribe your way into controlling the trade marketplace. But the wealth advancement system isn't necessary to enjoy the game. (This gets back to the idea of layers).
In practical terms, this means limiting the amount of time needed for paperwork/house keeping and zero-session dynamics. It also means speeding up the core gameplay (i.e. not long planning phases, or battles that require hours to finish) or giving more control to players over the speed of that gameplay. This is something I tried to explore with Tides: you can discuss modifiers and bonuses and strategy for an action roll, or you can literally describe what you do, roll immediately, and move onto the outcome. The narrative control of consequences given to the GM also means you can slow down and focus on a blow-by-blow account of a challenge, or sum up the entire end of an operation with one roll.
4. Provide a ready-to-play setting and characters
For the foreseeable future, I want to design games with enough built in setting that you can begin to play in it immediately. For the sake of time, energy, and unpredictable scheduling, I want the creative/generative focus to be tied to actually playing the game, not preparing to play the game.
This isn't to say games which require worldbuilding are "bad", there are many cool systems out there and it does create a sense of investment, but for me it's no longer practically possible.
And why design a game I won't ever play?
This lesson falls into context after all the others, however. Games which come with encyclopedic settings, if not broken out into layers of complexity, are just as paralyzing as games with no setting. My goal is to create enough setting for you to jump into playing, and tools to generate additional content as needed.
It's worth noting, as a designer with a chronic illness, that designing this type of game is much harder. Writing up a setting, creating procedural generation tools, organizing gameplay into layers of complexity, requires all of the time and energy that I lack. This slower pace to design is frustrating. I have to continually remind myself that the investment now means a game in the future I will be excited and able to play.
I don't want to take up space in this post to discuss strategies for managing this tension, but I do want to acknowledge it.
I'm known for going on tangents. The only consistent thing in my life is that I spend most of it creating things: novels, games, graphics. I love taking apart how art and games work, then reconstructing my own version from the pieces. I'm also enough of a layout perfectionist to adore eraser shields.