Video games have come a long way in the last 50 years – from the very basic graphics and gameplay of “Pong” in the early 1970s to the ultra-realistic and life-like depictions that we see in today’s titles, ranging from athletic competitions to war-like simulations.
The Brain’s Response
It is easy to see the appeal of video games, which provide entertainment, and can simultaneously provide an escape from reality and a feeling of connection. However, this popular means of entertainment may be dangerous for some. The World Health Organization (WHO) recently announced “gaming disorder” as a new mental health condition included in the 11th edition of its International Classification of Diseases. Another leading resource in healthcare, the American Psychological Association’s (APA) DSM-5, lists “Internet Gaming Disorder” as a “condition for further study.” This means that more research is required to make it an official diagnosis. Though there is still research to be done, it is clear that there is a case for gaming as an addictive disorder.
Similar to other process/behavioral addictions – like food, sex or gambling – gaming does not require the ingestion of a psychoactive substance like heroin, cocaine or alcohol.
“As with many enjoyable activities, there can be a brain chemical response that will begin carving out a neural pathway, which can drive compulsive behaviors and lead to addiction” (Kaneajakala, pg. 34).
Dopamine is the neurotransmitter that is most heavily involved in the addiction process within the brain. Activities leading to spikes of dopamine – like sex, gambling, even exercise and, yes, gaming – can affect the brain in a very similar way to drugs or alcohol. Positive, dopamine-releasing experiences (like winning a game or beating a level) may create a triggering response and a reward pattern. This can lead to a tolerance affect for gaming – not unlike the alcoholic or addict needing more and more of the drug of choice in order to achieve the desired effect. In fact, many of the signs and symptoms of a gaming disorder could look very much like addiction to a psychoactive substance:
- Obsessive thoughts about gaming, followed by compulsions to play
- Continued play despite negative consequences (to employment, health, mental health, relationships)
- Changes in attitude and habits
The most significant checkbox in looking at a potential disorder is “functional impairment.” Does the chemical or activity affect the person’s ability to function as they normally do? Does it affect the way that he/she would normally live their life? There is a term of “functioning alcoholic/addict” which is often used to describe people who are able to maintain their daily lives, while abusing a substance. The same could be said for a chronic gamer who is able to maintain while spending copious amount of time gaming. However, if the person has truly developed an addiction, this type of lifestyle is not usually managed for long. Not everyone who uses (or plays) on a consistent basis will develop a problem. Addiction is a complicated, biological-psychological-social disease that affects roughly 10 percent of the population (in regards to psychoactive substances), and likely less than that for gaming.
So what do we do about it? Treatment for a gaming addiction can be similar to treatment for substances. Given that the same areas of the brain are affected, cognitive-behavioral therapy (CBT) is most often the best method of approach. As a social worker and substance abuse counselor in the clinical setting, I see CBT as “changing the way you think, in order to change the way you behave.” CBT is about creating new thought-behavior patterns. It also “helps individuals to identify what the gaming reflex accomplishes for them (avoidance of responsibilities, etc.) and to work through those challenges, replacing the behavioral response of gaming with a constructive activity that solves the problem. Also, family therapy, anger management, and stress reduction techniques are useful in treating adult video game addiction” (Kaneajakala, pg. 35).
Another view on the matter could come from licensed psychologist Anthony Bean who suggests that excessive gaming is used “more as a coping mechanism for either anxiety or depression” and “when anxiety and depression is dealt with, the gaming goes down significantly” (Scutti). Though I can see some validity in this sentiment, it is important to remember that drugs and alcohol are also used as coping mechanisms. However, at some point, those types of coping mechanisms like drugs and alcohol, or perhaps gaming, are likely to fail us and lead to negative consequences. At that point, the user or gamer must make the decision to change, which is often a difficult task to be tackled alone without help. While it is up for debate whether gaming addiction can be considered an “official” disorder, it is clear that functional impairment is quite possible when consuming this form of entertainment.
If you or a loved one start to notice signs of a gaming addiction, please educate yourself and reach out for help. Addiction carries a stigma that keeps a lot of people sick and in pain; let’s work together to turn that around. It may save relationships, jobs, marriages or even lives.
Cody Beaton is director of the Addictions Treatment Center at Prairie View. His treatment areas are alcohol and drug treatment and individual and family therapy.
“Adults not immune to issues with video gaming” by Benjamin Kaneajakala in Addiction Professional Magazine
“WHO classifies ‘gaming disorder’ as mental health condition” by Susan Scutti, CNN Online