For Some D&D Players, Tabletop Roleplaying Is More Than Dice and Magic – It's a ‘Sanity Saving' Mental Health Boost

How these Dungeons & Dragons fans are protecting their mental health by battling fictional demons.

Those familiar with tabletop roleplaying games like Dungeons and Dragons may see it as nothing more than a carefree game based on living out dreams of being a wizard, or collecting every set of dice under the sun.

But for some players, D&D goes beyond fun battles with make-believe dragons, becoming an invaluable mental health tool: one that allows them to fight or flee from their problems for a few hours, brings them closer to people they may never talk to otherwise, and can even serve as a lifeline during hard times.

While D&D on its own isn’t a replacement for psychotherapy with a licensed professional, it does provide a social, creative and emotional outlet that some players find invaluable for their mental health.

For Aabria Iyengar, a tabletop roleplay gamer who plays in and runs storylines on several popular D&D-based podcasts and live streams, books and movies are fun, but “there’s nothing quite like being inside the adventure.” 

Being inside the adventure is the goal of Dungeons & Dragons, which boils down to a fantasy-themed choose your own adventure story, with a group of players acting as the characters, and one “Dungeon Master” acting as the referee. One roll of the 20-sided dice can determine how a player’s decision impacts the story, and what happens as a result.

Iyengar started playing D&D in 2015 or 2016. Since then, the characters she’s created, for different games on livestreams and outside them, have helped her learn more about herself, and provided an outlet for connection and distraction in times when both things were hard to come by.

“I am an extrovert, so the idea of truly being away from people, for years at a time, was EXTREMELY bad for my mental health” during the pandemic, Iyengar explained. The murder of George Floyd, and the resulting protests “for the right to exist” as a Black woman, added extra frustration. 

Dungeons & Dragons gave her the “ability to have shared communal experiences… during one of the hardest mental things I’ve ever had to deal with.” That, for her, was “sanity saving.”

And as someone who first dove into the topic of mental health to learn best practices for her own ADHD, she’s learned to check in on “other people and where they’re at mentally” as they play their sessions, in the same way she checks on her own emotions and reactions to her brain processing the world differently. 

If a player is going through a rough time, she can choose whether to throw them a session of the game that leans more heavily on roleplaying their character and working through those issues, or she can choose to throw them a villain to battle until they get a win.

“There’s something very healing in sitting with people and going ‘We will work together,’” Iyengar said. Nevermind if the team-building exercise is fending off an imaginary goblin horde.

“D&D isn’t therapy, but it is therapeutic,” she said.

That’s the same distinction drawn by Dr. Megan Connell, a licensed and board certified clinical psychologist who practices in North Carolina. Her background is in music therapy, a form of applied therapy, which takes “a tool that’s not necessarily intended to be therapy and [teaches] therapeutic methods through that tool.”

“For those who play music, sometimes listening to music or playing music can be incredibly therapeutic,” Connell said. 

In the same way that music or art can be used as a therapy tool, Connell has found that she can use D&D to help her clients learn new skills and grow as people.

“There’s not a lot of research on tabletop roleplaying games in general” as therapeutic tools, she explained. “Not just Dungeons & Dragons, any of them.” She chalks that up to the Satanic Panic of the 1980s, which demonized D&D as leading to violence and satanic rituals.

But as she’s found while working on “Tabletop Roleplaying Therapy,” her upcoming book about the applications of D&D and similar games in therapy, the people who play such games report real benefits.

The skills used in most games like D&D – “telling stories, being social, being creative, practicing math, practicing reading – all of those things are really, really helpful” for someone struggling with their mental health, Connell said.

Research hasn’t definitely uncovered why, she said, but with all of those factors combined, D&D “really does seem to be an incredibly powerful tool.”

For Liam O’Brien, the collaborative storytelling that’s inherent to D&D is “just good soul building and good friend building.” He’s one of the founding stars of Critical Role, one of the most well-known D&D streaming shows out there. It has its own graphic novels, comic books, and Amazon Prime animated series voiced by the original cast, who are all professional voice actors. 

But for O’Brien, D&D is primarily “the most fun I’d had in years.”

He started playing when he was about 12 years old, then “put away childish things” in favor of his acting career – that is, until he played a game with the friends who now form Critical Role’s cast.

“I just didn’t remember how much fun it was,” O’ Brien said. Being in a room with other people, without phones or distractions, “is a good tonic for what ails you.” 

Like all good fiction, D&D can often “accidentally or intentionally [end up] circling the things that give you trouble or friction in life,” O’Brien said. Fortunately, the game allows players to “conquer that dragon in a way where you might not be able to in real life.”

For example, during the first campaign Critical Role streamed, O’Brien’s half-elf rogue character died and ended up making a bargain with a god of death to be resurrected for just long enough to save the world. When the heroes defeated the major villain, his character “died” again, for good, getting whisked away to act as that god’s champion for all eternity.

In the real world, “surreally close” in time to that arc in the show, O’Brien’s mother died.

“I was really struggling behind the scenes,” he said. But his character’s story was “one of accepting a fate that he fell into,” and that helped O’Brien process the same problem.

According to Connell, the empathy involved in acting as another character and understanding why they react and feel the way they do in real time like O’Brien did, may be one of the reasons tabletop roleplay games can provide such mental health benefits.

Research on reading fiction, Connell said, shows that people who do so score higher on measures of empathy – the ability to understand the emotions of another person and why they feel that way, even if you don’t feel the same. That skill is “one of the most important things” for connecting with other people, which is also important for emotional growth.

Connell believes that creating a D&D character, and identifying strongly with their actions and feelings during a story arc, can facilitate the same kind of emotional growth.

In her groups, she sees her clients work through uncomfortable fictional situations as their characters, and learn real-world skills as a result. Roleplaying a character in “potentially highly emotional events, arguing and having disagreements” with other characters has been powerful for those players to learn what to do when they work through future interpersonal problems, Connell said.

She’s seen clients in her D&D therapy group for young women, who often have trouble saying “no” and being assertive in real life, say “My character would know what to do” before standing up for themselves in the real world.

“It’s this fascinating thing,” she said. “The skills are still in that person, but they almost can’t access them” without filtering the experience through a character.

That idea is close to the founding principle behind Game to Grow, a nonprofit based in Seattle. 

“The fundamental belief of Game to Grow is that games have the power to improve people’s lives,” said Adam Davis, one of the organization’s co-founders. He and co-founder Adam Johns created the group to help children and teens who may have trouble reaching out and connecting with others, be that because of diagnosed anxiety or depression, or just because they don’t fit in, Davis explained.

They don’t just use D&D to help the kids they serve, and they’re not out to replace therapy with tabletop roleplay. But Davis has seen the difference the games can make.

“If you remember middle school, it probably sucked,” Davis said, and part of that is because, for a lot of kids, there aren’t many rewarding social experiences.

But “in a game like D&D, no character can do everything by themselves,” and that makes kids who might not have a solid friend group realize that their presence is important, and their absence is noticed.

Davis spoke recently to the parents of a child who joined a Game to Grow program because they were feeling lonely and had a hard time forming their own social community. 

But recently, that same kid “was at a sleepaway camp – which is already kind of a big deal – and sent a picture to Mom in the mail of her child running a game of D&D.” 

In the photo, the child was surrounded by other kids, who were “all looking to them,” Davis said. That kind of change is what his organization, and the games they use, are all about.

Taliesin Jaffe, another founding star of Critical Role, has been similarly impacted. 

For him, the game stretches the same muscles as the drama, theater and acting he grew up surrounded by as a child actor – with less pressure attached.

“I changed schools quite a bit, and was, due to my upbringing, not well socialized to other children,” Jaffe said. Playing D&D was how he made friends when he settled in high school.

In his teens and adulthood, as he battled “moderate to intense mental health issues” including depression, creating new worlds and characters got him out of the house and out of his own head when his mental health worsened.

“Especially for those times that you’re not feeling up to socializing, it affords a much healthier version of light socializing,” Jaffe said.

When playing D&D, he explained, “you’re not there to talk about your problems, you’re not there to ignore your problems. You’re there to have easier problems. Like an ogre attack.”

Rather than avoiding people entirely when his depression made it difficult to want to see others, showing up for a regularly scheduled campaign meant seeing friends “without having to go into your own s—,” he laughed. “Which is great at 16!”

And, like it did for O’Brien, it’s helped Jaffe work through grief.

“I found out about a close relative’s death in the middle of a game,” Jaffe said. It turned out to be a surprisingly effective way to deal with the news. 

“As these things go, I don’t think it could have happened in a better environment. Already detached, surrounded by friends.” 

But it’s not just about stretching “the muscle of socialization,” as he puts it. “I feel confident in saying that there are games of D&D that practically saved my life.”

Davis believes, at the end of the day, the impact of the game and the good it does people’s brains comes down to the community built by and between people, something that many felt they lost during the pandemic.

The specific structure of modern tabletop roleplaying games, with written handbooks full of rules for calculating a character’s power or strength or charisma, might be a new way of building a story together. But in other ways, those games are “ancestral.” 

People have played board games and even used 20-sided dice for millenia, to say nothing of the long traditions behind oral storytelling. In the end, the ideas behind tabletop roleplaying games, and the human camaraderie behind them, aren’t new at all.

“Getting together in a circle to tell a story by rolling bones? It’s in our DNA.”