Experts have defined video game addiction as a problematic or pathological use of video games1 that results in social and/or emotional problems.2 Further, despite these problems, the gamer is unable to control this excessive use.2 Accordingly, one essentially prioritizes video game play to the extent that essential life roles and responsibilities become compromised.
Treatment is highly recommended to alleviate symptoms, which may include Cognitive Behavioral Therapy (CBT) and lifestyle changes, alongside support from family and friends.
When Gaming Becomes an Addiction
When engaged with in moderation, video game play can prove quite healthy. Experts contend, “While one widely held view maintains that playing video games is intellectually lazy, such play actually may strengthen a range of cognitive skills such as spatial navigation, reasoning, memory and perception.”5
Consider how today’s games require memorization, skills training, spatial logic, and other intellectual ability. Further, players may engage in online play, which allows for an added social component.
The path toward problematic gaming does vary from one individual to the next. For some it may become a problem upon picking up the controller for the first time. For others, it may be a slow progression. But in either case, a key indicator is when video game play takes up significantly more time than anything else.
When asked to stop, the individual becomes significantly distressed. Further, that individual often thinks about video game play while not actively playing. This mimics what one experiences during withdrawal.
Signs of Video Game Addiction: What to Watch For
Video game play crosses the line into addiction when it proves detrimental to one’s life roles and responsibilities. On May 25, 2018, the World Health Organization (WHO) officially accepted “gaming disorder” as a diagnosable medical condition.6
Although the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published in 2013 does not officially recognize this diagnosis,7 criteria for such an addiction that mimics those of others in the manual would be as follows:
Repetitive use of Internet-based games, often with other players, that leads to significant issues with functioning.
Five of the following criteria must be met within one year:
- Preoccupation or obsession with Internet games.
- Withdrawal symptoms when not playing internet games.
- A build-up of tolerance—more time needs to be spent playing the games.
- The person has tried to stop or curb playing Internet games but has failed to do so.
- The person has had a loss of interest in other life activities, such as hobbies.
- A person has had continued overuse of Internet games even with the knowledge of how much they impact a person’s life.
- The person lied to others about his or her Internet game usage.
- The person uses Internet games to relieve anxiety or guilt—it’s a way to escape.
- The person has lost or put at risk an opportunity or relationship because of Internet games.8
Although the symptoms for teens and adults are similar, the presentation does vary. For instance, teens may become combative toward parents and guardians when homework, extracurricular activities, chores, or other familial and social obligations interfere with play.
If unchecked, video games may become the center of the teen’s world—finding ways to engage in play regardless of the medium. Today, video games are no longer restricted to arcades and game consoles. They are available on smartphones, tablets, smart TVs, computers, et cetera. For many children and adolescents, smart devices are a right—not a privilege.
For adults, problematic game play may crossover from childhood and adolescence. It may also begin as an escape from everyday life. Now that one’s parents or guardians can no longer restrict use, one may play as much as one wants perhaps after work or on the weekends. It may also serve as a coping skill for stress, loneliness, substance use, et cetera. As the problem grows in severity, one may begin missing work.
Why Is Video Game Addiction Controversial?
Experts are split as to whether video game addiction is real or not.6 On the one hand, it does meet the criteria for addictive disorders in the DSM-5.7 Also, there is not enough evidence weighing in on whether lasting brain chemistry changes in the same way as with other addictions.6 Accordingly, there is still further inquiry to be explored.
Given that the DSM-5 has not included video game addiction as a diagnosable mental health disorder, clinicians have been unable to diagnose it for billable purposes. Consequently, actual cases may not be diagnosed as they should. This also skews research interested in current frequency and prevalence rates.
Health Risks and Concerns of Video Game Addiction
With any addiction comes health risks and concerns. Although these risks and concerns may stem from game play either directly or indirectly, they should be noted and taken into consideration. The higher the number and severity of risks and concerns present, the more significant the problem.
Health risks and concerns associated with video game addiction include but are not limited to the following:
- Lack of social engagement
- Problems concentrating
- Poor hygiene
- Lack of adequate sleep
- Failure to complete school, familial, and/or work-related obligations
- Anxiety, irritability, anger, and agitation as well as other emotional disturbance
- Loss of appetite
- Inability to respond rationally
- Reduced physical exercise9
Should these risks and concerns be present, it is an appropriate time to seek treatment.
Causes & Triggers of Video Game Addiction
Human beings thrive on stimulation, and video games provide a high amount of just that. Video games have numerous storylines, a learning curve, immediate feedback, and infinite possibilities. Each time one plays, anything can essentially happen.
As far as addiction is concerned, generally, the more positively reinforcing something is, the higher the addiction potential. Video games activate the same reward pathway in the brain as the substances we associate with diagnosable substance use disorders.10
Causes and triggers of video game addiction include but are not limited to:
- Addictive personality
- Desire to escape reality
- Increased amount of time spent playing
- Coping with trauma, significant stress, and/or a diagnosable mental health or substance use disorder
While video game play does provide temporary comfort to the player, it further exacerbates one’s problems.
Treatment of Video Game Addiction
For many with a video game addiction, treatment may involve therapy and/or lifestyle changes, such as setting limits for time spent on devices.
For those concerned that video game play has become problematic or is at the point of addiction, therapy is highly recommended. Therapy addresses the problematic behavior by seeking to explore its origin, reasons for use, symptoms, and means of enacting change. It should be noted that if there is any other mental health or substance use disorder present, that should also be treated to reduce the likelihood of relapse.
Common Types of Therapies
Cognitive Behavioral Therapy (CBT) is a leading therapeutic approach toward treating video game addiction.11 Through this approach, the therapist helps the individual replace thoughts about gaming to facilitate behavioral change. Upon changing one’s thoughts about gaming, varied behavioral interventions may occur that will set boundaries around game play and encourage other healthy behaviors.
Intended Treatment Outcome & Timeline
The treatment outcome and timeline will depend on the duration and severity of the addiction as well as one’s motivation to change. The more motivated the individual, better the prognosis.
Whether deciding to limit gaming or completely abstain, of utmost importance is to set boundaries around video game use. For some, this might entail removing video game consoles and games from the house. For others, this might entail setting restrictions on websites, apps, et cetera that may be available for use on computers, smart phones, tablets, and smart TVs.
It is also recommended to engage in other healthy behaviors and prosocial activities. Upon filling the void left by video game play with another social behavior, one increases the likelihood of recovery.
How to Get Help for Video Game Addiction
Should you notice that you or a loved one are struggling with video game addiction, it is important to seek professional help. The SAMHSA Locator is a free, government sponsored search engine that locates nearby centers providing behavioral treatment.
How to Get Help for a Loved One
When you notice the signs and symptoms of video game addiction, it is important to have a supportive conversation with your loved one. Recognize that video game addiction is similar to that of any other addiction in that it is something your loved one can no longer willingly control. Upon engaging in agreed upon treatment, it is important to participate as much as necessary and possible. Together, recovery becomes a much more likely possibility.
How to Get Help for a Child or Teen
Parents and guardians should also be as supportive as possible. When children and teens get to the point of video game addiction, it is important to recognize that there are likely complications in other areas of life. By being sensitive and mindful of this, families may work together to support the child or teen through recovery.
Some useful strategies to use with teens may include the following:
- Setting time limits for game play
- Removing video game accessible electronics from the bedroom or other areas where frequent play occurs
- Engaging in family activities that do not include electronic media
- Encouraging the teen to become involved in extracurricular activities or part-time employment
- Having direct conversations regarding concerns about video game play
- Checking with the teen daily insofar as how things are going socially, emotionally, academically, et cetera.
- Speaking with a professional
- Serving as a positive role model by not overusing electronic mediums (particularly partaking in video game play) oneself
Preventing a Gaming Addiction
Again, gaming in and of itself is not problematic, and it does have associated health benefits.5 For some, professional video gaming is a career. Whether gaming is a hobby or career, though, it is crucial to find balance.
It is important to set limitations around how much game play is allowed per day. This will need to include all platforms of gaming. When setting such limitations; one should consider time for work, social, and familial obligations. It is also important to consider what is necessary for healthy living—diet, exercise, et cetera.
One may also consider what other activities are enjoyable as well as meaningful. This may include engaging in athletics, crafts, music, or some other hobby. It may also include philanthropic activities such as volunteer work and advocacy. When one contributes toward something that provides personal and societal benefits, video gaming may remain a healthy, recreational activity.
Living With a Gaming Addiction
Recovery from a gaming addiction requires time and intention. It is important to enact and retain boundaries around game use while engaging in other healthy activities. Further, it may require setting boundaries around other electronic devices that one traditionally used as a medium for game play. While it is expected that some days will be easier than others, it is important to continually reach out for assistance as needed.
Common techniques for those living with a gaming addiction to follow for a healthy recovery may include but are not limited to:
- Participating in support groups
- Avoiding people or situations that may trigger play
- Engaging in new hobbies
- Limiting time on electronic devices that may serve as a medium for game play
- Reaching out for individual support when needed
- Having a healthy diet and exercise regiment
The more points of support one has, the better the prognosis toward recovery. One must remain mindful of thoughts and behaviors that trigger one toward use.
Video Game Addiction Statistics
Because of controversy related to whether video game addiction is truly an addiction or not, research has been relatively minimal compared to that of other diagnosable disorders.
In an overview of current research on video game addiction, The Recovery Village reported the following:12
- 64% of the U.S. population are gamers
- The average male gamer is 33 years old13
- The average female gamer is 37 years old13
- Males between the ages of 18–24 are most at risk for gaming addiction
- 94% of males and 6% of females represent the gender breakdown for gaming addiction
- 69% Caucasian, 13% Asian and 18% of other ethnicities is the ethnicity breakdown for gaming addiction
- The video game industry continues to grow at a rapid rate. In 1999, the industry generated $7.4 billion in revenue, compared to $131 billion in 2018. Some reports speculate that the video game industry could make $300 billion by 2025.
Statistics on video game usage tend to show growth in the average time spent playing video games. One study reports that while individuals played video games for an average of 26 minutes per day in 1999, it had increased to 32 minutes per day in 2004. Another study found that by 2009, 8 to 18-year-olds spent an average of 1 hour and 13 minutes playing video games on consoles, handheld players, and other devices.12
This high number of individuals playing video games yields a higher potential for some to become addicted. Based off the statistics we may continually produce better preventative measures while formulating better plans of intervention moving forward.
Video Game Addiction Tests, Quizzes, and Self-Diagnosis Tools
Diagnostic tools are a practical means of determining whether one has an issue with video gaming. While one should never formally self-diagnose, self-diagnosis tools may indicate whether one should seek professional help. Accordingly, there are many clinical and self-diagnostic tools available to assist in assessing problematic behavior.
Tests Performed by Professionals
Because video game addiction was only recently acknowledged by WHO and still not included in the DSM-5, professional screening and assessment tools backed by evidence-based research are relatively limited.
In a comprehensive systematic review of screening and assessment tools for gaming disorder, King et al. found that of all 32 tools employed in 320 studies, no assessment tool was found “clearly superior” and that the gaming disorder field “would benefit from a standard international tool to identify gaming-related harms across the spectrum of maladaptive gaming behaviors.”14
It is important to note, however, that these 32 tools align clinically with “(1) conceptual and practical considerations; (2) alignment with DSM-5 and ICD-11 criteria; (3) type and quantity of studies and samples; and (4) psychometric properties,”14 making them appropriate for diagnosis.
Quizzes and Self Diagnosis
Again, it should be cautioned that diagnosis should only be done by a mental health professional. For those interested in preliminary assessment as to whether one may need treatment, there are many tools available online. One such assessment is provided by Mind Diagnostics.org.15
Questions for consideration are as follows:
- Over time, have you been spending much more time playing video games, learning about video game playing, or planning the next opportunity to play?
- Do you need to spend more time and money on video games to feel the same amount of excitement as other activities in your life?
- Have you tried to play video games for shorter durations of times but have been unsuccessful?
- Do you become restless or irritable when you attempt to cut down or stop playing video games?
- Have you played video games as a way to escape problems or negative feelings?
- Have you lied to family or friends about how much you play video games?
- Have you ever stolen a video game from a store or a friend or stolen money to buy a video game?
- Do you sometimes skip household chores in order to play more video games?
- Do you sometimes skip homework or work in order to play more video games?
- Have you ever done poorly on a school assignment, test, or work assignment because you spent so much time playing video games?
- Have you ever needed friends or family to give you extra money because you’ve spent too much of your own money on video games, software, or Internet game fees?
These questions align with the diagnostic criteria considered for those with video game addiction. Again, the more questions receiving a response of “yes,” the more indicative of a problem that warrants professional help.
Additional Resources for Video Game Addiction