Set in a dark fantasy world inspired by Norse mythology and Celtic culture, the game follows Senua, a Pict warrior who must make her way to Helheim by defeating otherworldly entities and facing their challenges, in order to rescue the soul of her dead lover from the goddess Hela.

Self-described as an "independent AAA game", Hellblade: Senua's Sacrifice was created by a team of approximately twenty developers led by writer and director Tameem Antoniades.

The game's narrative serves as a metaphor for the character's struggle with psychosis, as Senua, who suffers from the condition but believes it to be a curse, is haunted by an entity known as the "Darkness", voices in her head known as "Furies", and memories from her past.

Hellblade: Senua's Sacrifice received positive reviews from critics, who praised it as a work of art and applauded its uncommon choice of revolving around psychosis, the quality and uniqueness of its approach of the condition, and its story and main character.

[2] Several areas feature their own exclusive mechanics or trials, such as reaching a safe zone in time before Senua dies, or using the focus ability to modify the structure of her surroundings.

[5] Set in the late 8th century, the game starts with Senua (Melina Juergens), a Pict warrior from Orkney arriving at the secret entrance to Helheim in a quest to save the soul of her dead lover, Dillion (Oliver Walker), from the goddess Hela.

[6] Senua believes she suffers from a curse that causes her to hear the voices of spirits, referred to as "Furies", in her head, the most notable of which is the Narrator (Chipo Chung), who is aware of the player's presence and often breaks the fourth wall by talking to them directly.

She carries Dillion's severed head to use it as a vessel for his soul and is guided by her memories of the stories of Druth (Nicholas Boulton), a former slave of the Norsemen well-versed in their legends, now deceased, who became her friend and mentor during a year-long self-imposed exile.

She then follows visions of Druth and a man-shaped light she believes to be Dillion to a great tree, where she undergoes four trials that test her body, spirit, and mind and is rewarded with the legendary sword Gramr, a weapon powerful enough to kill Hela.

As the game progresses, Senua's backstory is unveiled in nonlinear order through her hallucinations, revealing that her mother, the healer Galena (Ellie Piercy), suffered the same curse she did but thought of it as a gift.

When she returned a year later after seemingly conquering the Darkness, she found the surviving villagers killed by Norsemen raiders, who had sacrificed Dillion in a blood eagle to their gods.

[14][15] Hellblade: Senua's Psychosis, a short documentary film included with the game, details the concept behind its story and inspirations, notably the team's study of mental illness.

The character of Druth was based on both a real Irish Celt named Findan who was enslaved by the Norsemen in the 8th century, but eventually escaped and became a monk, and the Celtic tale of "a mad sinner who flees battle into exile and takes on a beastly nature, growing feathers on his body".

Senua's voice acting and motion capturing were performed by German freelance photographer and video editor Melina Juergens, who had not done either of those things prior to Hellblade.

[22] She was used by the team as a stand-in for Senua for several months while they perfected their motion capture techniques, and they eventually came to the conclusion that she could play the character in the finalized game to save the cost of hiring a professional actress.

[31][32] While the game was playable through backwards compatibility on the Xbox Series X/S, an enhanced version with improved visuals and ray tracing support was released through a free optimization patch on 9 August 2021.

In a positive review, Leif Johnson of PC Gamer praised Hellblade: Senua's Sacrifice for its themes, presentation and story, but complained that the "inspiration doesn't carry over to the actual fights.

Among them was Game Informer's Joe Juba, who found Hellblade to be "undeniably memorable, telling a compelling tale that explores subject matter many consider taboo".

"[6] Michael Briers of PlayStationLifeStyle, stated that "by working closely with neuroscientists and those unfortunate few who have been diagnosed as psychotic, Hellblade carefully avoids those cheap, half-assed tropes that render a character insane and, therefore, woefully one-dimensional.

Not only does it act as a disservice to those who suffer from mental illness, this practice of painting in broad strokes only minimizes the room for nuance, but Senua's Sacrifice boldly cuts through the white noise".

[21] Leif Johnson of PC Gamer praised the gripping depiction of a character suffering from psychosis, stating "Ninja Theory uses haunted eyes to full effect in long, moody closeups peppering the narrative.

"[2] Mollie L Patterson of Electronic Gaming Monthly declared that "while I can't speak to that side of things from personal experience, I can tell you that I was legitimately affected by [Senua's] condition at times.

Playing a good portion of the game with headphones on, quiet moments were often broken by the never-ending chatter of those other selves conflicting in their thoughts, with some wanting to help their host in her quest, and others constantly telling Senua (and you) that she was wrong in her choices, that she was destined to failure, or that it was all hopeless.

Shoemaker stated "Hellblade's single most powerful trick is a near-constant stream of voices in Senua's head, recorded with a spatial audio technique so they feel like they're all around you, nagging at you, undermining your decisions and your confidence.

Hellblade's robust bag of psychological tricks and the sheer fact of Senua's distressing reality result in the game's uncommon ability to capture the feelings of worthlessness, lack of control, of being misunderstood and shunned, the strange mix of hope and despair that can accompany a debilitating mental illness.

However, several media outlets later found out that the rot stops spreading after a certain number of deaths, and cannot progress further before a certain point in the game, ultimately making it impossible for it to reach Senua's head.

[61][45] Antoniades said that the permadeath mechanic was a bluff: while the rot will spread on Senua's body over repeated deaths, it will never fully reach her head; the wording they chose to describe this was meant to convey part of the fear associated with mental illness and psychosis directly to the player.

"[62] Reid McCarter of PC Gamer strongly defended Ninja Theory's move, calling it "great game design and a modern expression of unreliable narration".

He stated "As the story progresses, the nature of the corruption becomes clearer as the player comes to understand a correlation between Senua's backstory and psychology and the way they perceive the game's dangers.

From the makers of Heavenly Sword, Enslaved: Odyssey to the West, and DmC: Devil May Cry, comes a warrior’s brutal journey into myth and madness[93] Senua's Saga: Hellblade II was announced during The Game Awards 2019.