Understanding Video Game Addiction

There are a reported 2.7 billion people who regularly play some form of video game, 34% of the global population. That’s more than there are fans of baseball, tennis, golf and basketball combined. For most of them, gaming is a harmless distraction. For others, a social activity where they make and meet friends from all over the world. For a relative few, however, gaming can quickly go from occasional late-night indulgence, to a full-blown obsession that takes over their lives. Witness the gamer who took his laptop to a wedding so he could indulge his Football Manager fantasies. Or the Las Vegas children reportedly suffering from Fortnite addiction. Some will scoff at such stories, dismissing them as lightweight or knee-jerk reactions to the latest craze sweeping the nation, but behind the attention-grabbing headlines, excessive gaming is a problem for many people and a genuine worry for parents. This undeniable fact raises a whole nest of questions: What constitutes “excessive gaming”? What is video game addiction? What can I do about it?

This article doesn’t have all the answers. It doesn’t even cover all the questions (although it tries), but we hope that after reading it, you’ll be able to better appreciate the issues and concerns around video gaming addiction. Whether it’s a real thing is probably as good a place to start as any…

Is video game addiction real?

When in 2018 the World Health Organization recognized “gaming disorder” as a form of behavioral addiction, it undoubtedly shifted the conversion on compulsive gaming towards one of acceptance. Prior to the vote that added the condition to the WHO’s International Classification of Diseases (ICD), much of the discussion around video game addiction was whether it should be recognized at all. We should stress that there are many that remain skeptical of the WHO’s ruling: 46% of scholars dispute that “pathological video game overuse constitutes a distinct mental disorder”, while the American Psychiatric Association deemed the classification premature, saying that further studies were needed. That said, there’s no denying that the conversation around gaming addiction has moved on – probably for the better.

Unfortunately, there’s no agreed definition of what video game addiction, or, rather, gaming disorder – the preferred term – actually is. The WHO defines the condition as “a pattern of gaming behavior” where increasing priority is “given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities… despite the occurrence of negative consequences.” Diagnosis thus requires a person’s behavior be such that there is “significant impairment in personal, family, social, educational, occupational or other important areas of functioning… evident for at least 12 months.” 

Behind the headlines

Leaving aside the issue of whether gaming addiction is a manifestation of underlying health issues (which seems to be where the scholarly contention lies), there’s no denying that excessive gaming can be damaging to personal relationships, finances, health and, in extreme cases, life itself. The case of three-month-old Kim Sa-rang, who in 2009 starved to death at home as her parents played games at a local cafe, is undoubtedly one of the most tragic outcomes to have been reported on. Such extreme instances are few and far between, thankfully, but they can’t help but inform attitudes about what for the vast majority of gamers (66% of the US population) classifies as a harmless waste of time.

Shocking reports of gamers that have taken their obsession to extremes can be counterproductive. They polarize opinion, painting video game addiction as black and white, when there are as many shades of gray as there are players of games. They enforce stereotypes that are, at best, lazy and unhelpful, and that can hinder any kind of legitimate definition or diagnosis. Better instead to seek out the stories of those gamers whose obsession with their game of choice might appear to tread the fine line between harmless – perhaps even beneficial – and deeply problematic. Such stories will provide a better reflection of how the positives of gaming can become negative; a better mirror in which to see ourselves and make appropriate changes before intervention becomes necessary.

As well as understanding the consequences that can accrue from excessive gaming, this article seeks to understand how a gaming disorder can develop. Personal circumstances are a huge factor, biology is understood to be too, as well the nature of the games themselves. Yes, games are part of the problem. Gaming Verdict is of course a gaming site and we love games, but even we recognise that far from being a benign influence, there are developers and publishers that are exacerbating the problem of video game addiction by manipulating gamers with microtransactions, loot box mechanics, and other psychological tricks to get people to play and pay more. The worst culprits (as well as many gamers, it should be noted) then insist those that fall foul of such methods simply take responsibility for their actions. Such attitudes can be just as destructive as the methods that incite them. Not helpful.

The moment in which a compulsion to game is such that it persistently and negatively affects day-to-day life, is when what was once a hobby can be seen as a problem. It might not be an immediate one for the afflicted gamer, perhaps not consciously, and those around them may not be aware of any issues, but step too far beyond that point without taking steps to acknowledge and deal with the issue and the realms of addiction will surely be poised on the horizon.

The biology of video game addiction 

As wondrous as the human body is, it’s not always on the side of long-term well-being. As well as all sorts of unpleasant byproducts, it creates dopamine. Dopamine is a neurotransmitter, a chemical substance created by neurons and passed from synapse to receptors in the cells of the brain. Synthesized around the body, it helps to regulate vasodilation, reduce kidney and pancreatic functions, as well as digestion. It’s useful stuff, but to most it is seen as the “pleasure chemical”; released as a reward by the brain in response to certain behaviors. It is commonly understood that the release of dopamine – or the anticipated release of dopamine – then reinforces that behavior to the point of addiction.

However, it’s important to understand that the brain does not crave dopamine, nor are we all predisposed to addictive behavior (gaming or otherwise) due to an excess. Studies suggest that it is more likely that a genetic molecular switch is a prime suspect behind the development of many instances of behavioral and substance addictions, such as are associated with excessive video gaming, drug-taking, overeating, sexual activity, gambling, or shopping. Sadly, until GARS testing (Genetic Addiction Risk Score) becomes reliable and commonplace, we must rely on rather more prosaic methods of diagnoses.

Most games are designed to be addictive

Regardless of an individual’s ability to regulate their gaming behavior (genetically predisposed or otherwise), it’s an undeniable fact that many video games are structured in such a way as to reward continued and repetitive interaction. Early incarnations of video games offered the simple thrill of achieving a high score or reaching a new level. In the 1990s, massively-multiplayer online role-playing games (MMORPG) underscored the increasing social appeal of games, which, coupled with the concept of “grinding” progression and regular game updates, fueled a subscription model of gaming intended to keep gamers enthralled month after month. It was this success that led to the success of Blizzard’s World of Warcraft, which reached a peak of 12 million subscribers in 2010.

Methods of snaring gamers have become considerably more insidious since, with the twin concepts of “free-to-play” and live-service gaming now dominant. Such games (like Fortnite, Counter-Strike: GO, Smite, and others) are made available for free and promote microtransactions within the game itself. The idea is to tempt new players into claiming free items by completing a small transaction through an in-game store. By reinforcing the behavior with more free items (gifts for logging into the game at certain times are a favorite tactic), the idea is that unwary gamers – many of whom are left to their parents’ devices – become invested in the game through a series of small transactions. These, of course, add up over time. Mobile gamers are especially evolved in this area, by locking players away from certain areas of gameplay through the use of timers and other mechanics, which will often require some small investment to remove.

Loot boxes and gacha games are a more recent phenomenon. These feature a recognized compulsion loop that have draw direct comparisons with gambling and are a mechanics that are starting to be regulated as a result. It’s notable that even the most hardcore gaming apologist, one that would likely always dispute the existence of video game addiction, often finds it hard to defend the existence of loot box mechanics. Sadly, it’s the combined effect of all these purposefully-designed and intricately-layered progression and reward systems, to which many gamers have fallen foul. Some commentators have concluded, with some justification, that gaming has sold its soul. 

Loneliness, depression, and anxiety

A compulsion to excessively play video games is just as likely to result in serious consequences as any other kind of addiction. It can also be triggered by very similar conditions. A gamer might consider their time spent in Fortnite or League of Legends to be well spent and not at all excessive, but circumstances can often arise – through no fault of the gamer – that can cause the time spent in-game to reach unprecedented levels. A loss of work or school closure, say, in reaction to a global pandemic.

As social media appears to have contributed to making young people lonelier, it’s perhaps inevitable that we are seeing a rise in the number of under-18s turning to video games to perhaps deal with their problems. No matter our age, depression, anxiety, and loneliness (as well as stress, trauma, and heartbreak), will often tempt people toward the most accessible forms of escapism, of which videogames are undeniably the most immersive. That’s not to suggest escaping into a game of Call of Duty is a bad thing, or leads to compulsive behavior, but issues outside of a game can reduce the capacity to regulate time or money spent in-game.

Everyone struggles with issues that can lead them to overindulge in games. These include:

• Arguing at home – between parents or family members. In extreme cases there these types of arguments can lead to young people feeling unsafe 
• Limited social skills – if they are having trouble making friends they may turn to video games where the social rules are often easy to follow 
• Victims of bullying – video games give us the chance to play the hero and win. If we are being bullied then video games can be the only place where we can feel powerful and enabled 
• The stress of work or school – sometimes anxiety can paralyze us. This is a basic survival instinct known as ‘playing dead’. When our body is in this mode we may rely on games a little too much to lift us out of our gloom.

Video game addiction has a reputation for afflicting children in particular, many of whom will often react negatively when asked to stop. However, this may have as much to do with them playing age-inappropriate titles for long periods of time without any effective oversight (to give the parents – often understandably – a much-needed break). In such cases it’s for the parents to spot any issue before it develops and act more responsibly. 

Excessive gaming in adults is much easier to hide, especially if the adult doesn’t see that they may be developing a problem. The odd sleepless night or letting housework pile up for a day or two is rarely a problem, but if work days are being lost or family members neglected – children especially – it’s time to recognize the problem before someone else does.

Signs of video game addiction

One of the struggles of diagnosing a gaming problem is that it is often mistaken for laziness, disinterest, or teenage obsession. However, it has very similar symptoms to other behavioral addictions. If a number of the following signs or symptoms are recognized and appear to persist for a significant period of time, further investigation and diagnosis might be required: 

• Other hobbies become less appealing, this includes friendships and socializing. Activities often become neglected in order to spend more time playing video games 
• School and/or work performance drops. Deadlines are consistently missed, work is of reduced quality. Household chores are neglected 
• A loss of ability to limit how much time is spent gaming. Quite often it is difficult to keep track of how long you are spending gaming every day. 
• Personal hygiene and grooming activities are postponed or skipped to spend more time gaming. 
• When forced to stop gaming (even for just a short period of time) a spike of emotion is experienced. This is often anxiety, panic, anger, or irritation.
• Video games become an escape from situations at home, school, or work.
• Problems are experienced when trying to concentrate on things outside of video games.
• Lack of motivation to do anything but play video games.
• Sleeplessness, emotional outbursts, insomnia, loss of appetite and/or binge eating, both physical and psychological withdrawal – all when not gaming. 
• Putting yourself at financial risk in order to keep gaming – this could be through microtransactions and/or buying new releases.  

If you are worried that someone you know is suffering from problem gaming, the best thing you can do is put an arm around them to engage with them. When it’s appropriate, try to discuss your concerns about aspects of their behavior. If there are underlying issues that are contributing or exacerbating the negative behavior, try to address them with honesty and sensitivity. If appropriate, talk to family members or close friends. They may have spotted behavior that’s important to help move the situation forward. 

If you are concerned with your own gaming, or it’s having a prolonged negative effect on your life, finances, family or friends, reach out to someone you trust – even if they are someone you regularly game with that you’ve never met. They may have concerns that they’ve been itching to talk to you about, or you may be able to help them with issues they’ve been experiencing. If necessary, seek out a professional who can help you directly or put you in touch with a local service that can help you. No one should have to suffer in silence.

For your child 

Reprimanding anyone for overindulgent gaming is not going to be helpful, least of all for children who are otherwise encouraged to engage in fantasy play. Much better instead to set boundaries in terms of the game that they can play and for how long, by using timers and game blocking settings. If parents can actively take part in a game session, a much more responsible and sustainable attitude to gaming can be fostered.

If you as a parent or guardian feel you are being reasonable and responsible about your child’s gaming activity and they are continuing to display a number of the harmful effects mentioned above, particularly with persistent sleeplessness and behavioral issues, then you should take them to see their doctor or a child specialist.

Current research shows that CTB (cognitive behavioral therapy) is the most effective way to treat video game addiction in young people. CTB is a form of therapy that focuses on developing mindful coping mechanisms. These will help your children to change the way they see video games and give them healthier outlets for their stress. 

Treatment for problem gaming may reveal a deeper problem that led to your child seeking refuge in video games. This could be that they are experiencing bullying or they are unhappy with themselves in some way. Your child’s doctor will have further advice on who to deal with any issues that crop up during their investigations. 

For yourself

Spotting signs of addiction in your own behavior is very hard. Our brain often fights against accepting the truth and we often find ourselves in denial. You may have found this article because someone close to you is worried about you. 

Try asking yourself some of the following questions: 

• Am I spending too much money on video games? 
• Is my work and/or school performance suffering because of video games? 
• Are my relationships with friends and family being affected by my compulsion to play games? 
• Has my personal hygiene suffered? 
• Am I eating well and exercising? 
• Am I struggling to concentrate on things that aren’t video games? 

If your answer is yes to a number of the above questions then you may reach out to someone and seek help. 

You should not beat yourself up about gaming becoming a problem. Do not let your new revelation lead you into a spiral of self-pity. Don’t write yourself off and make positive changes. 

The most important thing to remember is that having a possible video game addiction doesn’t mean that you are a failure or lazy. It will likely have been caused by underlying problems you weren’t fully aware of, like anxiety and/or depression. 

If you are worried, the best thing you can do is to talk to your doctor. They might not understand gaming, but they will recommend types of therapy or treatment that they think will help you the most. There may be other areas of your mental health or concerns in your life that your doctor will be able to help you with. 

Treatments like CBT will give you practical tips on how to cope with your problem. While talking therapy will help you face up to any underlying issues that may be compelling you to game excessively. 

Most people won’t have to completely give up video games after developing a reliance on them. Millions of people play video games around the world every day and games can have a place in a healthy lifestyle if they are enjoyed appropriately and for the right reasons. With the right help and understanding, your treatment will help you to go back to playing video games for fun and not as a coping mechanism. 

When trying to prevent gaming from becoming a problem you need to ask yourself why you feel drawn to play video games to excess. If you have a surfeit of creative energy you find hard to direct elsewhere, or are persistently bored or lonely, it might be helpful to direct those energies into other activities. The broader your range of coping mechanisms, the less of a void gaming has to fill and the healthier your favorite pastime will become as a result.

Creativity 

If you like to play video games because it makes you feel more creative, or it is the only thing that inspires you then you might try one of the following activities:

• Go for a run – novelist Haruki Murakami swears that he would not have written a single one of his books if he did not run every day 
• Teach yourself a new skill – learning something new will force your brain to build new pathways and wake up the already existing ones
• Play a TTRPG (table top role-playing game) – if you want to play the fantasy hero then there is no more social way to do this than to play in something like Dungeons & Dragons. You can play with your current friends or with new people online. As counterproductive as the latter option might appear, the fact that you can only play when your party is available will limit your time online.

Boredom 

If you are looking to play video games to cure your boredom, then try one of these alternatives: 

• Try improving a skill you already have – we all have that one skill that would make our lives easier if we were just a little bit better at it. Why not spend the time you would be gaming on this skill instead. 
• Start a new project – having something else to do that you can choose over video games is a great way to kill that craving. Make it something you will enjoy. Why not start writing a book, or maybe even design your own game. 
• Read – fiction or nonfiction, it’s your choice. Reading is a great way to develop your concentration levels and build your willpower back up. 

Loneliness 

Loneliness is one of the worst feelings in the world. We understand why it makes gaming so tempting. Let’s explore some other things we can do to relieve our loneliness. 

• Volunteer – not only will you be meeting a load of new people, but you’ll also be making the world a better place. And you’ll have a boatload of fun along the way.
• Set up a board game night – invite your friends, family, or people you want to be friends with along to a night full of fun and adventure with not a screen in sight. 
• Join a club – if you’re interested in learning something new, or want to get to know some people with similar interests to you. Clubs are a great way to spend your time

Set goals 

Once you understand why you are drawn to video games and have come up with some alternative ways to prevent you from leaning on them, you will want to set yourself some goals. 

Set yourself limits and stick to them. Limit yourself to only playing for a set time each day, as a reward, or only after you have finished all of your work. 

If you write your goals down you are more likely to succeed at them. Write your goals out on a piece of paper and stick them up somewhere where they will get in your way, so you have to look at them every day. You could even stick them on your game console. 

Create friction 

We develop bad habits because they are easier than the good habits. So, how do you break a bad habit? You make it harder to do than the good habits. 

To make video games less tempting you should try and put as much friction between you and playing them as possible, here are some idea to help you with that: 

• Unplug your PC or console after every use 
• Keep your controllers in a separate room
• If you game on your PC, make the most of blocking software. This can stop you from being able to open your games during certain times of the day 
• Ask someone in your house to look after your power cable for you, so you can only game if you collect it from them 

The more obstacles you put between you and the games, the less tempted you will be to play. 

Having a friend or family member with a possible video game addiction can be a difficult thing to have to deal with. It can be hard to see them suffering with the issues that might have caused them to turn to gaming as a coping mechanism. You’ll be glad to hear that there are things you can do, and something you should avoid doing that will make your loved one’s recovery easier. 

Things you shouldn’t do:

• Expect change overnight 
• Nag them 
• Criticize them 
• Make fun of or bring up their excessive gaming to upset them 
• Try to force your own ideas about recovery on them

Things that you can do to help: 

• Understand their doctors plan for their recovery, and help them to stick to it 
• When you see them relapsing, treat them with kindness. Remind them that recovery is never linear and that they are already in a better place than when they first started 
• Accept yourself that recovery from potential addiction is a slow process
• Learn as much about the addict mindset as you can. Empathize and try to think about why addicts make the choices they do 
• Praise them whenever they succeed (even if that success is just going a day without relying on games) 
• Help them celebrate their big wins, rewards are a lot more effective than punishment 
• Sometimes you will need to push them to make hard decisions, always do this with kindness and consideration and make sure they know that you are doing it for their own good 

Whether or not gaming addiction should be considered a medical condition, the causes and effects of excessive gaming are clearly a cause for concern and any problems surrounding them should always be taken seriously. They can be an indicator of deeper mental health issues, and can be a contributing factor to a whole host of physical conditions, from type 2 diabetes in children, repetitive strain injury, insomnia, and seizures. Then there are the unseen symptoms; heightened depression and anxiety, debt, falling behind at school, deteriorating relationships, and problems at work. 

If you believe you or someone you know is suffering from gaming issues then you should speak to a specialist healthcare professional. They will be able to offer help through various types of therapy or other treatments. 

If you do know someone who is suffering through an excessive gaming problem, the best thing you can do for them is to take them seriously. Many sufferers do not seek help because they do not believe it is a verifiable condition. Instead, they tell themselves they are lazy or a failure. Having someone take them seriously can be very liberating. 

With a mixture of therapy and practical coping mechanisms, it is possible to live a healthy and balanced life that includes video games.