Competitive Hearthstone can have a profound impact on a player's mental health.

DocPwn will be competing in the upcoming Hearthstone World Championships, but he hasn't played the game consistently in months. Neither has Fr0zen. At face value, it seems like a risky move, but both have come to realize the toll that playing Hearthstone upwards of ten hours per day takes.

Just like in sports, esports pros don't always take the best care of themselves mentally. Without the physical limitations that come with traditional sports, players are able to train away for hours on end. League of Legends has been at the forefront of this issue as player salaries increase, physical trainers are hired, and mental health is promoted. Teams and better organization by Riot Games has allowed this to happen, but Hearthstone is an infant in comparison and is starting to experience growing pains. Playing remotely and without many teams to back them, many Hearthstone pros are left to fend for themselves. While the game may not require the same twitchy reactions, Hearthstone is mentally draining and some players are finally starting to emphasize the importance of proper health.

At the HCT Summer Championships in Burbank, California we sat down with DocPwn whom we had last spoken to following the Winter Championship in the Bahamas. We wondered what he had been up to since then considering he had already qualified for Worlds. The answer? Not a whole lot of Hearthstone.

"I played the Spring Playoffs. . . [but] I didn't even play for the whole summer," says DocPwn. "I was traveling and doing stuff so I didn't have much time to put into Hearthstone. I didn't want to have to tryhard at the end of the month so I decided to quit Hearthstone for basically three to four months.

"I was still playing here and there, a couple times with my friends and stuff, but not nearly as much as I was before. I took a big break and when the new expansion came out I started playing a bit, but just a little because the points didn't matter for me. It doesn't matter for anyone who's already qualified. I'm just playing for fun right now when I have time, but I'm not investing a lot into it."

He isn't worried about getting out of practice, especially given the nature of Hearthstone's periodic expansion releases calling it "kind of irrelevant."

"Everything is going to change, right? I think that people are over-practicing right now. I'm talking about people that are already qualified. I mean, people are playing because they like the game right? It's fine. I like the game too. I'm going to practice in the last couple of months before the World Championship. I'll be playing every day that's for sure, but for now, I feel like taking a break is better for my mental health. Not to sound too crazy about it."

Unless you're lucky like DocPwn and qualify at the first event of the year, professional Hearthstone requires an exorbitant amount of time. Each and every month players have to grind ladders, open cups, and play across multiple servers for their best chance at making it to the world stage. It's incredibly draining and the risk to reward ratio is huge. It's a tremendous task to have consistent finishes and that means that income is usually pretty sporadic for most players. All of this takes a big toll mentally.

DocPwn shares his story with us, explaining how he's trying to educate other players about the importance of mental health.

"Most of the players, if not all the players, are really feeling the pressure and they're telling us about it. It shows. For the majority of them it's not positive pressure," DocPwn explains. "That's because they're working too much on their gameplay and not enough on their emotions. That's really hard to do but if you want to be good on stage, you need to learn how to control your emotions. It's something that high-level players don't often do. I've been telling Jayce [Dr. Jikinini] about it and telling him he needs to meditate.

"It's not a joke," DocPwn says lightly, but sternly. "Everybody has their way of letting out pressure or repurposing it into a positive influence. Of course, I was feeling the pressure up there [in March] everyone is going to feel the stress."

There isn't a player out there that can deny the weight that is put on you when you've finally earned your chance at qualifying for an event you've spent all year working towards. DocPwn points out that this is where mental health comes into the picture.

"There are players that perform under pressure and there are players that crumble under pressure.

"What's the difference between the two?

"They're both equally good most of the time. It's just that when it comes down to a real game and there are fans and media, they lose their mind or they lose their [flow]."

Mental training is incredibly important if players don't want to let the opportunity slip away. Grinding at Hearthstone is taxing and a loss at this stage can oftentimes make things worse. 

Even though the Winter Championship was DocPwn's first major Hearthstone appearance he was ready for the occasion. This was in large part, he explains, due to his time playing chess as a child.

"I played a lot of chess when I was younger and it was on big stages like this. When I was young, as young as 11 or 12 years old, I was on a big stage so I learned to deal with the pressure. I had coaches and we worked out things you could say to yourself or how to meditate before the game. What would you do two days before the game? What would you eat? There's a lot of things to be done that people don't think about and that's why people make mistakes on the bigger stage. Not that I'm not making mistakes, but for these guys I feel - and because they're younger, they're 20, 21 years old - they're not as experienced in their minds and their body.

"Maybe in a couple of years they will think about it and say, 'Why, why did I do that? Why didn't I go see a psychologist?' Go see a psychologist for God's sake! Who cares? Go get yourself fixed! It's true! You're not mentally healed. That's a normal human being stressed behavior that you're having on the stage. That's just normal, but you need to be up there. There are things to be done and everybody is feeling the pressure out there. . .and people that are more affected by it should work on it."

DocPwn isn't the only player taking this into account either. His fellow competitor and runner-up at the Winter Championship Fr0zen has also stepped back from Hearthstone. Fr0zen has turned to Poker with the help of a coach who has helped him work on meditation, more frequent breaks, and better decision making.

We spoke with Blizzard's Matt Wyble who's been involved with Hearthstone's HCT efforts from the beginning about esports' trend towards better player health. Despite the lack of organizations with formal health care, he cites the player's themselves as a resource to take advantage of that is unique to Hearthstone.

"One thing that's been awesome that helps is our players have been really supportive of each other. For an individual game, the amount that people are willing to collaborate and support each other amongst that community, even way outside of what anyone would ever see on social media or Twitch or whatever has been really impressive in this regard."

That said, Wyble isn't afraid to admit that the game does require a ton of effort that might be somewhat wearing on players. We asked him what the team is doing to help relieve some of that from the system.

"I think for us, part of that is making sure we're creating the way players interact with the game [that is healthy] - things like generating points - that we're taking a pretty hard look at that. It's one of the things we're doing right now. It's no secret that there's a lot of things about the cup system that are not ideal that we want to fix as an example.

"At the same time, players want to practice a lot to continue to improve their skills and that's something we have a little bit less ability to directly influence. But its something we take quite seriously."

The HCT offseason isn't that far away. The World Championship is coming up in January and the process itself will start all over once the Year of the Mammoth concludes. There will undoubtedly be changes in store. Though he wasn't able to share specifics, Wyble continued to emphasize that there will be changes and improvements across the board.

It's been a tough year for Hearthstone as multiple organizations have disbanded including Fr0zen's former Team Luminosity. It seems there just isn't enough consistent income in the current schedule to justify teams in the scene. That said, in our talks with Fr0zen he said he "heard Blizzard is going to do something about it."

As to mental health, we're hopeful that whatever Blizzard has in store will help the situation. With most players being so young and so much on the line there's a lot more at risk than just money.