When it comes to depicting violence and its consequences, video games aren't that great.

Oh, sure, video games feature loads upon loads of violence, many would argue excessively so. People are sawed in half in Gears of War, Kratos rips off the heads of enemies without breaking a sweat, and every Call of Duty protagonist shoots and kills hundreds of carbon copy enemies with pinpoint accuracy. Video games are filled with violence.

Why games fail in portraying violence is in their depiction of what comes after all the shooting, the head ripping, and chainsawing is finished.

To make my point, let's take, I don't know, Nathan Drake for an example. The star of the Uncharted series is a good looking, wise cracking, artifact seeking hero in the same vein of beloved film hero Indiana Jones. By all accounts he's an all-around decent fellow, a character we all root for to come out on top in the end of each of his treasure hunting quests.

Over the course of his three games (four counting the PSP title) Nathan Drake has killed thousands of people by his own hand, whether with fists or guns. THOUSANDS.

Maybe to the average gamer is who used to killing wave after wave of enemies this doesn't seem like an impressive number.

So let's put this in perspective. Not even Genghis Khan, the legendary ruler of the Mongol empire who conquered much of Asia by the sword, achieved such a feat. Alexander the Great? He's got nothing on Nathan's record. Some of the worst serial killers in the history of mankind struggle to kill 100 people, let alone thousands. Often these same serial killers are clinically insane and mentally unstable. The list goes on and on.

You may have heard of a disorder increasingly being diagnosed among soldiers - PTSD, or post-traumatic stress disorder. It's serious business. People who have lived through traumatizing events, such as war, rape, or any other event that could cause physiological trauma, simply reach a point where their mind can no longer cope with the horrible acts they've committed or the terrible events they've witnessed or suffered through. Victims of PTST often are plagued by nightmares or flashbacks of the traumatizing event or events of their past, find they have increased aggressive behavior and sometimes enter a red-alert state known as hypervigilance, whose bodily function is to identify possible threats. In war, this is helpful, but in civilian life it is dangerous to both the person suffering from PTSD, as it causes anxiety and can lead to exhaustion, but as well as those nearby. Suicide rates for United States soldiers are at an all-time high after returning from war - many of these soldiers suffer from PTSD.

If all of this is true, that men who kill others by the hundreds most likely as a result have some kind mental condition, and that soldiers who have lived through life threatening situations and seen first-hand the horrors of war and death are plagued by the many symptoms of PTSD, then my question is this:

What the hell is Nathan Drake like on the inside?

By all accounts, Drake should be just about as messed up mentally as a human being can be. He's killed thousands of human beings and lived through countless near death scenarios, including but not limited to: nearly falling out of a cargo plane, drowning, almost being beaten to death by a Yeti, narrowly escaping being run over by a large truck, almost impaled on wall spikes, hanging on to dear life when climbing just about every climbable surface type in the world, barely managing to escape a swarm of thousands upon thousands of spiders - this list literally could go on forever.

And yet, Drake keeps on trucking, without hardly even an acknowledgement of the absurd amount of death defying moments he's survived (those spiders would give me nightmares for years) or the equally absurd number of lives he's taken in pursuit of buried treasure. Drake might be a mentally anguished hero who uses humor to hide the effects a lifetime of adventure and violence have had on his body and mind. Or he might be a crazed killer who takes joy in gunning down bad guys. We don't know, because nobody bothers to take it into account.

Many might argue I'm making a moot point, that this is different - it's a video game after all, it's often in self-defense, or often you are a soldier in a warzone. This is all true, and relevant to a point. But the fact of the matter is this:  a life of violence, death, and murder comes with a heavy price. Long after the physical strains of battle have healed, long after the fatigue of battle fades and the wounds scab over leaving scars, the mind remembers.

You wouldn't know it playing most video games. Depictions of violent acts in games have reached almost photorealistic levels, but a meniscal number of these same games really truly acknowledge what is happening on screen. Characters don't even stop to think about the acts they've committed. They don't suffer from physiological trauma or anxiety, despite having killed thousands of human beings.

However, times are changing. While there will always be action romps that are more focused on shooting first and asking questions later, some games are finally beginning to recognize the absurdity of having game protagonists that kill and maim with reckless abandon but yet are fully intact mentally and emotionally at the conclusion of the game.

The developers of the most recent Tomb Raider game at least acknowledge that killing a human being isn't easy.  When a young, scared Lara Croft takes a human life for the first time, it's gruesome, terrifying and emotional.  Lara can barely believe what she's done, saying "Oh God," as she kneels over the corpse of a man who just seconds before tried to sexually assault her.

Of course, 30 minutes later Lara is clearing out entire rooms of baddies without feeling or remorse. Baby steps.

The only game I'm aware of to seriously tackle the issue is the brilliant (and vastly underrated) Spec Ops: The Line. It's a beautifully pieced together decent into madness, a shooter that actually acknowledges the on screen carnage rather than just accepting the shooter status quo of having the player gun down waves upon waves of enemies without a second thought.

Players step into the boots of Captain Walker. He and his three man squad are on a seemingly self-explanatory mission - discover what happened to the U.S. soldiers who were sent to a sandstorm ravaged Dubai to help with evacuations. Upon arrival it quickly becomes apparent that things are not as they are supposed to be. As you fight your way through armed refugees struggling to survive  and renegade U.S. army soldiers attempting to bring order to the now demolished metropolis, the game taunts you asking if "you feel like a hero yet?" or if making you question if all the bloodshed is worth it or not.

By the end, Walker is a broken shell of a man. He is increasingly violent and aggressive to enemies and teammates in both his language and actions. He suffers from near constant hallucinations, his mind attempting to cope with the horrors and atrocities of war. He even contemplates suicide. He's a man who has committed terrible acts, both intentional and unintentional, all in the name of playing the war hero. After killing hundreds of armed soldiers, struggling to survive in a desert wasteland and witnessing first-hand the horrific effects of chemical warfare, we have a character who actually does suffer from PTSD. The man needs help, and thanks to the games numerous endings, the player gets to decide if he actually takes steps towards rebuilding his life or if he truly is broken by the events of the game.

Not all games are going for realism or want players to think critically about their on screen actions. Fun, light hearted action romps are popular in both movies and games and will continue to be popular. You don't see John Mclane suffering any negative side effects from being a badass action hero over the course of five Die Hard films, and if he did, well, many fans would view it as out of character. Same goes for Nathan Drake. He isn't a real person, and the whole point of the game is to be a summer, action movie blockbuster. There are, however, films that deal with and look at the issue which take on war and death much more seriously.

But there are few games that do so. Despite almost every video game involving violence of some kind, and the most popular games on the market being first-person shooters, games largely ignore addressing the ramifications of violence, death, and war beyond physical destruction. If video games want to become more realistic and want to be taken more seriously as a storytelling medium on par with or even surpassing film, game developers are going to have to actually think about the ramifications gameplay has on story or else suffer a disconnect between the narrative and gameplay.

A self-proclaimed "realistic" game simply sweeping the consequences of a life of violence and death under the rug kicks me out of the experience and shatters the veil of disbelief which allows to me to accept whatever is happening on screen. It leads me to wonder if some of my favorite video game characters aren't actually the great heroes they seem to be. They might instead just be psychopaths.