Zoë experiences personal struggles with depression prior to the development of "Depression Quest". These experiences inform the game's themes and narrative.

The release of "Depression Quest" and the subsequent attention it receives lead Zoë to become a vocal advocate for mental health awareness. They share their own experiences and create spaces for open conversations about mental well-being.

The Gamergate controversy and the intense online harassment Zoë experiences have a significant impact on their mental health, exacerbating existing challenges and requiring ongoing support and self-care.