Understanding video game addiction

After a decade of observations, the World Health Organization is adding gaming disorder to its list of recognized mental health condition starting in 2018. According to Daily Mail, the WHO draft defines gaming disorder as when gaming “takes precedence over other life interests... even when it leads to ‘negative consequences.’” In light of this recognition, I would like to go over some key points about the relationship between video games and personal health and well being.

Every once in awhile, there are news stories about how someone has played games until they died mid-game or have played so much they neglected responsibilities, sometimes to tragic consequences. There was a story, I remember, about how a couple in South Korea had neglected their baby to play games, resulting in the baby’s death. You don’t have to go far to find similar stories of people playing literally for days and dropping dead.

One of the first things that may pop into our minds when we see stories about people who game without sleeping or eating are the words “video game addiction.” The terminology immediately groups video games with things like drugs and alcohol, prompting worried parents to turn their heads whenever the words are mentioned. So the question is, are video games addictive?

First, we must understand what addiction is. Psychology Today defines addiction as “a condition that results when a person ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable but the continued use/act of which becomes compulsive and interferes with ordinary life responsibilities, such as work, relationships, or health.” Wikipedia and its string of citations define addiction as a “medical condition characterized by compulsive engagement in rewarding stimuli, despite adverse consequences.” Finally, there’s the American Society of Addiction Medicine and they say, “Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.” The key aspects from all the definitions of addiction we’ve looked at characterize addiction as a condition when a prolonged activity hinders normal, everyday function.

When people say video games aren’t addictive, they’re right in the sense that video games don’t act like drugs or alcohol where there is a tolerance build up resulting in a physiological change in brain chemistry. After all, playing video games over a long period of time does not lead to dependence in the way that chronic smokers or drug users face. Video game addiction is on the side of behavioral addictions, which are covered by impulse control disorders, so it isn’t in the same grouping as chemically addictive substances. It isn’t uncommon for behavioral addiction to also be labeled as a disorder, as the terms are rather interchangeable. The addictive facet of games comes from compulsion, a heavy engagement. As Extra Credits put it, games aren’t addictive; they’re compulsive. There isn’t a physiological demand that is being met with excessive gaming and there isn’t a euphoric high that can only be found with increasing amounts of game time either. The compulsive aspect of gaming comes from an intense, irresistible interest or attention that cannot be ignored.

However, just because games aren’t addictive from a physiological perspective doesn’t mean video game addiction or disorder isn’t a real condition. Video games are compulsive and that very compulsion can potentially develop into video game addiction. In truth, anything can be “addictive” in the sense that any deep compulsion can potentially develop into an addiction—video games are no different. Dr. Mark Griffiths, in a BBC article titled “Why anything can be addictive,” puts it very nicely: “In a nutshell, the fundamental difference between excessive enthusiasm and addiction is that healthy enthusiasms add to life whereas addiction takes away from it.”

It’s uncertain how many people may be affected by gaming disorder. The estimate given by the Daily Mail article gives a range from anywhere between 0.2% to, I kid you not, 20% of all gamers. The formal guidelines for a diagnosis haven’t been written yet, but I think gaming disorder is something you’d definitely know if you saw it. For example, it’s one thing to skip a college class to play a newly released video game, but it’s an entirely different matter when it becomes a recurring event and grades become negatively affected. It’s one thing to go home after work and play six hours of video games and another to just continuously play, not bothering to go to work.

So far we’ve mostly discussed gaming disorder in the context of older gamers with greater life responsibilities than kids. Where do kids fall in with our definition of video game addiction? What does “normal, everyday function” mean for kids? Are kids even diagnosable with gaming disorder? How should parenting style factor into a potential diagnosis? Is it fair to be diagnosing kids with gaming disorder when so much of their lives is out of their hands? There are still many questions that need answers to fully understand the scope of gaming disorder.

I can’t speak to what treatments work or don’t because there are so many stories out there about what’s effective or not. Everybody is different and one method may work for someone but not another. So let’s instead talk about a question that resides at the essence of gaming: Why do we play games? You might think that was a dramatic setup for such a mundane question, but gaming means different things to a variety of people and how people see gaming tells us something about themselves and the society we live in. Maybe we just play because it’s in good fun and we want to relax. Maybe it’s because games offer a challenge that we want to see ourselves overcome, to get to the next level or beat that boss monster that has us gnashing our teeth and swearing in frustration. Maybe we play because gaming offers a space with absolute rules and we know our roles and everything that comes with it. Perhaps we view gaming as a space for creative expression, a place where we can play within set rules and still be able to create and innovate. Games also offer a virtual space to hang out with old friends and make new ones. This list goes on and on, but in short, maybe games offer some people things they can’t find anywhere else.

When we look at gaming disorder, we can’t look at the video games alone as a sole cause. Demonizing video games as some harbinger of mental disease is counterproductive and acts as a distraction to the real underlying social issues that have created a space in which gaming disorder can exist. As a community of gamers, we need to begin to discuss why we play games in the first place, what is it about games that make them so compelling and interesting to play. We need to begin to look at what games offer that other mediums don’t. By bringing up discussion and exploring the heart of why we game, we can begin to better understand what people with gaming disorder go through on an internal level.

Merry Christmas, Happy Holidays. I wish you all the best for 2018.

I’ll see you in the next one.