Gaming Addiction Explained
Gaming addiction – also known as gaming disorder, video game addiction (VGA) and computer game addiction – is one of the most recent forms of addiction to have emerged, and significant debate still exists about the extent to which it should be considered a condition in its own right. However, regardless of its precise medical status, gaming addiction has caused incalculable pain to countless people in recent decades, and a growing number of people are now being treated for it in the UK and the wider world.
Diagnoses of gaming addiction identify the compulsive playing of video games to the extent to which such behaviour causes physical and/or mental harm, or other detrimental effects, to the gamer. Some individuals are unable to stop playing video games for extremely long periods, with potentially serious ramifications for their health – indeed, a number of fatalities have been associated with such extremely long periods of gaming; others may find themselves able to stop after a while, and indeed to punctuate their gaming with periods of work and/or academic activity, but nevertheless cannot get rid of their obsession with gaming and allow it to dominate their lives, possibly at the cost of previously treasured relationships, activities and ambitions.
Although, as noted, there is no medical unanimity regarding whether or not gaming addiction should be considered a distinct disorder, the neurochemical basis of behavioural addiction is increasingly well understood: changes in brain chemistry, in particular in the brain’s reward centres drive a compulsion to continue to play video games regardless of any negative impact that doing so may have.A broad range of health conditions, including some other serious mental health disorders, have been linked to gaming addiction.Meanwhile, a substantial body of anecdotal evidence now exists demonstrating the catastrophic impact gaming addiction can have upon a sufferer’s relationships, social life, world view, life prospects and general well-being.
Gaming addiction classified as disorder by WHO
Despite the aforementioned lack of agreement within the global medical community about the specific status of gaming addiction, in 2018 the World Health Organisation (WHO) classified “gaming disorder” under “Disorders Due to Addictive Behaviours” in its diagnostic manual International Classification of Diseases.
The WHO definition identifies “a pattern of persistent or recurrent gaming behaviour… which may be online (i.e., over the internet) or offline, manifested by: 1) impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2) increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3) continuation or escalation of gaming despite the occurrence of negative consequences.”
Types of Gaming Addiction
As the aforementioned WHO definition indicates, the type of gaming to which an individual might become addicted can involve either online or offline play; indeed, theoretically, any game or combination of games might prove addictive, and as is the case with any form of addiction each individual case is unique (though with some obvious commonalities). In practice, however, most video game addicts find their obsession focused upon online gaming (though it is important to note that this does not mean that offline gaming does not also form part of any given case of addiction).
Some video games include elements of gambling (whether with real-world or in-game currency) and thus playing them compulsively may, in reality, be an indication of gambling, rather than gaming, addiction. Similarly, certain adult-themed games feature pornographic content, the compulsive viewing of which may form part of a pornography addiction rather than a gaming addiction specifically, while in others still, it may be certain social-media-related elements which drive compulsive engagement, possibly betraying a social media addiction (currently an area of significant study).
The lines between such compulsions and gaming addiction per se may not be clear, and in any given case it may well be that multiple addictions are in play, or that these compulsions are symptomatic of a broader and more complex disorder. Treatment for anyone suffering from such a combination of compulsions would be of necessity more bespoke, but would likely contain elements of the treatment now typically provided to gaming addicts.
Stages of a Gaming Addiction
Once again, because there is no unanimity within the medical profession about how to categorise gaming addiction, no generally agreed list exists of the stages through which the condition develops. Furthermore, because each case is unique and may involve an entirely different game or games from another, any such list should only be considered as a rough guide to how the condition may manifest. Nevertheless, some key stages might be as follows:
- Initial exposure: an individual’s early experiences with video gaming, during which enjoyment of and perhaps a fascination with such games may develop very quickly.
- Deeper interest: gaming begins to take up a position of greater significance in the individual’s life, perhaps requiring growing investment in hardware, software and time. Other activities may begin to take on a diminished significance in consequence.
- Growing obsession: gaming begins to take up a central role in the individual’s life, with their thoughts becoming increasingly solely directed towards gaming and other activities and, now, relationships becoming increasingly neglected as the great majority of the individual’s free time is now taken up with gaming.
- Full-blown addiction: gaming becomes the individual’s dominant or even sole interest. All their free time is taken up with gaming, and all their energies are focused upon it, possibly at the cost of work or academic progress. Dietary and sleeping patterns are likely to be hugely affected by constant gaming, and the gamer may find themselves entirely dislocated from friends, family and the real world.
It is important to note that, despite many media scare stories, video gaming will not inevitably become an addiction in every case; gaming can be a harmless – indeed, healthy – part of a person’s life, an enjoyable way to relax and even a way to make friends and socialise virtually.
Causes and Risk Factors of Gaming Addiction
As with addiction generally, there is no universal “recipe” for gaming addiction: medical authorities agree that addiction can result from both genetic and environmental factors, and even displaying a combination of many well-known risk factors for addiction does not automatically mean that a given individual will become addicted.
However, as our understanding of the condition grows, certain risk factors, in particular, have been highlighted as contributing to higher rates of video game addiction. These include:
- low self-esteem
- a feeling of having been neglected
- using computer games to manage moods
- having an aggressive personality
- a pessimistic outlook on life
- having been subjected to authoritarian parenting
- social anxiety
- a lack of empathy
- gender (many more men than women appear to be affected, though this certainly does not mean that women cannot suffer from the condition)
It is important to note that as the computer gaming industry has grown, and both hardware and software have become vastly more sophisticated, so too has gaming companies’ understanding of the elements of a game that drive repetitive behaviour of the kind likely to lead to addiction. Many game developers – especially those producing games which demand or, at the very least, are made significantly easier by financial expenditure (including micro-transactions) – have invested a great deal of effort into maximising their software’s ability to keep players coming back for more, and the psychology behind such mechanisms can be fiendishly impressive (and often indiscernible by the player).
While no mainstream developer would be willing to admit publicly that they aim to make addicts out of their players – just as the gambling industry proclaims that its aim is to offer “fun” to gamblers – the proof of the pudding is most definitely in the eating, and there is little doubt that one of the primary causes of gaming addiction is this increased sophistication of developers’ ability to drive repeated – if not constant – engagement.
How Gaming Affects the Brain
As with any behavioural addiction, gaming addiction is a disorder of the brain’s reward system. High levels of an addictive stimulus – in this case, video gaming – experienced over time initiate the production of increasingly large quantities of dopamine in the brain, which stimulates receptors (especially in the parts of the brain known as the amygdala and the ventral tegmental area) which in turn drive the impulse to repeat the behaviour in question.
Up to a point, the more frequently this is repeated, the more easily dopamine production is stimulated; after a while, however, the brain develops a tolerance to high levels of dopamine, and thus the individual in question feels compulsion to engage in the addictive behaviour – in other words, to play video games – more and more often in order to feel the same level of satisfaction and pleasure which was initially experienced.
Moreover, once this tolerance has developed, stopping the addictive behaviour will result in unpleasant sensations (and even withdrawal symptoms) – driving cravings – until enough time has passed that the brain chemistry has normalised and the addiction has been quashed – though cravings to resume the addictive behaviour may recur for months or even years after the last instance of engaging in it.
Signs & Symptoms of Gaming Addiction
Many addictions drive the addict to secretive and solitary behaviour, and potentially into isolation, and gaming addiction is especially damaging in this regard due to the typically solitary nature of most gaming. As a result, many of the symptoms of gaming addiction may be invisible or remain concealed for quite some time, as the addict withdraws from social circles and even important relationships. Nevertheless, there are a number of signs which can indicate the development of an addiction to external observers.
- Restlessness: the addict may find it impossible to remain still and calm for any length of time whilst not gaming; fidgeting, pacing, constantly getting up and down, and being unable to participate in any task for more than a few minutes may all indicate frustration at not being able to game.
- Irritability: an addict may be quick to lose their temper and/or to snap at others if they are kept away from gaming for a protracted period – or if they are in a bad mood from a recent unsuccessful gaming bout.
- Preoccupation with thoughts of previous or next gaming activity: gaming may entirely capture the addict’s thought processes, leaving them unable to think about anything else and possibly visibly distracted from important activities.
- Lying about the amount of time spent playing: many gaming addicts feel shame at the amount of time they spend feeding their addictions, and/or recognise that in many people’s eyes they are engaging in an unhealthy activity, and so deceive others about how long they actually spend gaming.
- Isolation from others to spend more time gaming: as noted above, withdrawing from social circles and previously enjoyed activities is a very common sign that something is wrong.
Physical symptoms of video game addiction
- Fatigue: many people play computer games for very long periods of time – indeed, as noted above gaming-related fatigue has been a factor in numerous deaths in recent years – and often sacrifice sleep for the sake of continuing to play. This is especially common amongst those who work or attend college or university and who are therefore unable to play during working hours.
- Migraines: prolonged gaming has been known to spark off migraines even in those who have previously not suffered from them.
- Carpal tunnel syndrome: repeated, very protracted bouts of gaming using manual controls such as drawing pads, keyboards or mice can lead to the wrist condition known as carpal tunnel syndrome, causing pain and tingling in the fingers and hands.
- Poor personal hygiene: some gamers allow their levels of hygiene to slip significantly as a result of their protracted gaming – and/or because their isolation leaves them feeling that they do not need to make any effort in this regard. Some e-sports competitions have been obliged to post notices warning that gamers exhibiting poor levels of hygiene will be disqualified and removed from the venue.
Gaming Addiction and Depression
Depression and similar disorders have been identified as both a potential cause of and the potential consequence of, gaming addiction. Depression can leave an individual feeling apathetic and hopeless about the future, thus reducing the apparent importance of any long-term work or academic aspirations and increasing the appeal of effectively inconsequential but immediately gratifying activities such as computer gaming.
The often solitary and effectively meaningless nature of computer gaming makes it even more dangerous in this regard, and various vicious cycles can develop as an affected individual’s self-worth can become ever more diminished by loneliness, fatigue, obesity, poor hygiene, an inability to communicate successfully with others, lessened employment or career prospects, guilt and shame, and even a poor performance within a game or games.
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Gaming Addiction and Substance Abuse
It is by no means uncommon for an individual to suffer from more than one addiction – or even more than one type of addiction – at once, and many behavioural addictions are often found to cooccur with substance abuse disorders. This condition of cooccurrence – sometimes called dual diagnosis or dual disorder – typically requires specialised treatment of a more complex kind than that provided to individuals suffering from only one addiction.
Partly because video game addiction is a comparatively new phenomenon, and partly because of the aforementioned lack of unanimity regarding its diagnostic status, the extent to which those suffering from gaming addiction may be especially susceptible to substance abuse disorders has not yet been particularly well established.
Some research suggests that many gamers – even those identifying as problem gamers – may actually be less likely to develop substance abuse disorders as their brain’s reward centres are already being stimulated in a similar way to how they would be under the influence of drugs. On the other hand, it is clear that in certain cases gaming addiction has developed subsequent to the establishment of addiction to drink and/or drugs, and similarly that in other cases, it has pre-existed.
Some of the common consequences of gaming addiction – including isolation, depression and diminished self-worth – are strong risk factors for substance abuse disorders. The lethargy and sedimentary lifestyle which is often associated with heavy cannabis use (and some opiate use) may also be conducive to the development of gaming addiction as affected individuals may opt for the playing of video games over other more energy-intensive activities.
On the other hand, some gamers may turn to drugs – especially stimulants such as cocaine – to give them what they believe will be a performance-enhancing edge, and/or help them stay awake for longer periods during protracted gaming bouts.
Short-Term Impacts of Gaming Addiction
Compared with some other addictions – especially substance abuse disorders – the short-term impact of gaming addiction can be comparatively negligible (though that is not to say non-existent). Many of the more serious risks and consequences can take some time to develop.
Perhaps the greatest risk in the short term is associated with games which require real money to be spent (above and beyond any initial purchase price). Games featuring microtransactions – especially certain mobile games – can quickly result in bills totalling hundreds, thousands, or even tens of thousands of pounds if the gamer is unable to control their spending, and a growing number of people have been left financially ruined by the dependency upon such cash hungry-games.
It is comparatively rare for serious health disorders to develop in the short term as a result of a gaming addiction but in certain cases, if affected individuals move very rapidly into extreme addiction, a lack of sleep and/or correct hydration and nutrition can have catastrophic consequences even after only a very short time of the addiction progressing. Similarly, if serious addiction develops this rapidly, job loss or expulsion from academic institutions as a result of non-attendance may take place similarly quickly.
Long-Term Impacts of Gaming Addiction
Over the long term, gaming addiction can be very destructive in numerous ways. Withdrawal from social life and neglect of important relationships can cause permanent ruptures with loved ones and friends, leading to lifelong regret (as well as, potentially, permanent obligations as a result of divorce). The collapse of employment or academic situations can, obviously, also have permanent ramifications for life prospects, as can financial collapse as mentioned above.
Psychologically, as well as any damage caused by the loss of important relationships, isolation can cause profound loneliness, depression and a loss of self-worth (perhaps manifesting in issues such as poor hygiene mentioned earlier). Interacting with others may become increasingly difficult, leading to a vicious circle of increasingly entrenched solitude. The essential meaningless of gaming can lead to existential angst and the consolidation of a sense of purposelessness which, again, can contribute to depression and even suicidal ideation. Although no firm evidence exists to prove the connection, there have also been links proposed between compulsive video gaming and acts of violence, including murders.
A lack of exercise and a typically poor diet contributes to obesity in many gaming addicts, with consequences for health including cardiovascular and respiratory problems, diabetes, and a range of other conditions related to poor fitness. Prolonged periods without sleep can cause permanent neurological damage as well as various mental health disorders including psychosis, and can even result in death. As mentioned above, carpal tunnel syndrome and repetitive strain injury, along with various other musculoskeletal and neural problems, can result from the repetitive motions associated with gaming.
Treatment for Gaming Addiction
Although video game addiction is only immersed comparatively recently (and despite the lack of diagnostic clarity discussed previously), there are now numerous facilities throughout the UK treating the condition, with an increasingly high level of expertise. While treatment methods and models may vary significantly from one facility or organisation to the next, treatment tends to be grounded in therapy in a similar way to that provided for other behavioural addictions and substance abuse disorders.
Cognitive behavioural therapy (CBT) is at the core of many offerings, but other models such as motivational therapy (MT), motivational interviewing, art therapy, fitness therapy and many others are all available, often in combination with each other; the precise composition of a treatment plan would typically be determined after an assessment of each individual by the relevant facility staff.
Self-assessment tests for gaming addiction and their efficacy
Various tests are now available online purporting to allow for self-diagnosis of gaming addiction. The calibre and reliability of such tests vary hugely, while some may be of deeply dubious origin (for example, existing to capture data for nefarious purposes). If you are concerned that you or someone close to you may be suffering from an addiction to gaming, it is always recommended that you discuss this with your GP or an addiction specialist, who will be able to conduct or recommend a reliable and confidential assessment. Self-assessment online is not regulated and may not provide any useful data, regardless of the legitimacy of the assessment provider itself.
Drugs for video game addiction
There is no “magic bullet” pharmaceutical cure for video game addiction: as mentioned above, treatment consists of a wide variety of approaches almost universally founded upon psychotherapy. While research is ongoing into pharmaceutical approaches, any such cure will still be years off, if it is ever developed at all. However, some of the side-effects of gaming addiction – especially physical health conditions which may have developed – can be treated with medication. Always consult your GP before taking any such medication.
Prevention for Gaming Addiction
As with any addiction, behavioural or otherwise, the only way anyone can be absolutely certain of not developing a gaming addiction is never to play video games at all. However, such complete abstinence in those who have not developed an addiction may be overcautious: as mentioned earlier, as part of a balanced life gaming can be a harmless recreation providing a great deal of enjoyment and a good (and cost-effective) way of relaxing. Indeed, some studies show that some games enjoyed in moderation can actually be beneficial in terms of their impact upon problem-solving
skills, coordination and even general knowledge.For those who would like to participate in video gaming, but wish to take some steps to prevent the possibility of addiction developing, some safeguards can be put in place:
- Limit the length of any given gaming session (for example, be firm about not playing for any longer than two hours at a time).
- Do not play every day, nor more than, say, two days in succession.
- Do not play after a given time every night (that time will depend on your individual circumstances, but try to leave at least one hour between finishing gaming and going to bed).
- Do not take your gaming equipment on any holiday you may take; if you game on your phone or other mobile devices which need to accompany you on holiday, don’t give in to the temptation to start gaming whilst away.
- Be receptive to any concerns voiced by anyone close to you about the amount of time you spend gaming, and always prioritise important relationships over gaming.
- If you notice any of the signs and symptoms mentioned above, and/or have tried to stop gaming or even cut down on the amount of time you spend gaming and have failed, contact an addiction specialist immediately.
Gaming Addiction Facts/Statistics
In 2018, the UK’s video gaming industry exceeded – for the first time – the value of its music and video industry combined.
As far back as 2008, a study showed that over 7% of people playing online games describe themselves as “dependent”. Meanwhile, a 2016 survey conducted by researchers from the University of Oxford showed that 1% of people feel “significant distress” if they are unable to play online games at will. In every relevant study conducted, boys have shown to be significantly more susceptible than girls to video gaming addiction.
The most addictive gaming format, according to various studies is the MMORPG (massively-multiplayer online role-playing game) genre; as many as 44% of players of World of Warcraft, the most popular MMORPG in the world, self-described as “addicted”, and searches for “world of warcraft addiction” in Google produce around 30 million results.
Online game Fortnite – which now has over 200 million players globally – was cited in over 200 divorces in the UK in 2018.
Ready to Get Help?
It is a truism that no addict can be helped until and unless they’re prepared to acknowledge their addiction and to ask for assistance in overcoming it. If you have been struggling with a gaming addiction, help is out there if you are ready to request it. Addiction can cause great shame and guilt – but don’t let these emotions get in the way of your path back to happiness and fulfilment. As with any addiction, your gaming addiction need not be a terminal condition if you are prepared to take back control of yourself and your future.
Get help today
A range of high-quality facilities across the UK are now providing treatment to gaming addicts, and countless individuals are now in recovery and enjoying lives, which previously they could not imagine could ever be theirs. If you’re prepared to ask for help, do not let another day go by in which addiction dominates your life and continues to cause you pain: get in touch today with your GP or an addiction specialist to discuss your situation and what treatment options might be available to you.
Take Control of Your Life – get Started on the Road to Recovery
Anyone who has laboured with addiction knows the damage it can do to one’s self-esteem and sense of self-control. Draw a line under that damage today and begin the process of healing, and taking back control of your own life; do not let gaming addiction determine the course of your future, regardless of the impact it has had on your past. Help is out there: reach out for it today.
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