DIGITAL HEROIN: THE RISE OF GAMING DISORDER

When 14-year-old Motty spends five hours locked in his room playing video games, his parents aren’t concerned. After all, he is on his vacation; isn’t this what all teenagers do nowadays?  

But what Motty’s parents fail to understand is that as video games have become more sophisticated in sound and graphics, they have also become more addictive. Some people have become so obsessed with gaming that they do not leave their rooms for up to 14 hours a day and avoid all forms of social contact.    Excessive gaming has gotten so out of hand that the World Health Organization recently labeled it a disorder.

Don’t think gaming can ever be that serious? Consider these current tragic news reports.

This May, an illegal African immigrant nicknamed “The Human Spiderman” made national headlines and was granted French citizenship after he saved a toddler who was dangling off an apartment building balcony. The child’s father left his son unsupervised to play Pokémon Go.

In April 2017, three men punched, stabbed, and ultimately killed a teenager in a Queens’s internet café because he wouldn’t give up his seat so they could play League of Legends.  

Ever since arcades entered the scene in the 70s, followed by home video games in the 80s, parents questioned the health effects of playing too much Pac-Man and Mario Brothers.  In addition to encouraging a sedentary lifestyle, often, players get so involved in their artificial universe that they lose sight of the real world. This is what compelled the World Health Organization to designate compulsive video gaming as a mental health disorder, adding it to the International Classification of Diseases, the agency’s official list of medical conditions. The WHO is hoping that the new classification will lead to better awareness in families, governments, and healthcare providers.

It’s Not a Game…It’s an Addiction

What does it feel like to have gaming disorder? Besides for a powerful urge to play video games, users will go to extremes to play despite the negative consequences that may result.  When gamers cannot play they are consumed by thoughts of playing, which lead them to withdraw from family, friends, social events, and academics. This is why some refer to video games as “digital heroin.”

Arthur Saltzberg runs Key Transitions, a transitional living and mentoring program for adolescents who struggle with mental health and substance abuse issues. He believes that video games are like drugs in that both activate and trigger similar parts of the brain that can lead to addiction.  The initial level of dopamine, the “feel good” neurotransmitter, soon becomes inadequate and users are in constant need of more and more gaming to get that original rush.  Playing games can create a neurological response that induces feelings of pleasure and reward, manifesting in potentially addictive behavior. “The number of those affected is quite small, but it does occur, with a higher propensity for addiction in individuals suffering from mental health issues such as depression, anxiety, or autism. Many use it as an escape from reality and as a means of coping with feelings they want to repress, the same way many drug addicts do,” he says.

Gaming disorder is included in the Diagnostic and Statistical Manual of Mental Disorders (DSMV-5), the authoritative guide used by most healthcare professionals when diagnosing and treating patients. It is also listed under “disorders due to addictive behaviors” in the final draft of the International Classification of Diseases (ICD-11), to be presented at the World Health Assembly in May 2019, scheduled to go into effect January 1, 2022.  In a news conference, the WHO said it released it early as a “preview” to give countries time to prepare and train people for its implementation.  

Who’s Playing?

Although both genders can exhibit signs of gaming disorder, it seems boys 12 to 20 years of age are most vulnerable because as minors their brains are still developing, and as males, more so than females, they are attracted to violence in games. Autistic, ADHD, shy, or bullied children are also more likely to play compulsively because they don’t have to be accepted or make friends in person when gaming, explains Dr. Collen Carol, a global leader in ending childhood screen addiction and author of Hooked on Screens.  

Compulsive gaming has had an interesting effect on millennial males, causing a drop in their work productivity and interest in other leisure activities.  Since 2004, time-use data show today’s millennial males as increasingly unemployed and spending significant amounts of time facing screens as they shift their leisure to recreational computer activities. According to a 2017 published study conducted by Princeton University of Chicago titled “Leisure Luxuries and the Labor Supply of Young Men,” in 2000, 8% of younger men, (excluding full-time students) worked zero weeks in the last year. By 2016, the numbers had risen to 15%.  Researchers point to computer gaming as the dominant source of the problem. “The paper further cites survey data showing that these men reported increased happiness overall despite their reduced circumstances, suggesting that advances in gaming are making imaginary worlds more enjoyable than the real one,” wrote David Z. Morris, a technology reporter for Fortune Magazine.

NintenDON’T  Say It’s a Disorder

According to the American Psychological Association, compulsive gaming only applies to 3% of all video game players. This statistic triggered a group of scholars to submit an open letter to the WHO expressing their concerns that the proposed diagnosis is premature and can “cause significant stigma to the millions of children who play video games as a part of a normal, healthy life.”  The gaming industry maintains that today’s video games are more complex with sophisticated characters and storylines that encourage digital social connections.  The Society for Media Psychology and Technology, a division of the American Psychological Association, argues that although video game addiction research has been going on for nearly 30 years, it’s not clear how to define the condition, symptoms, and prevalence or to determine whether it is an independent disorder or a symptom of a pre-existing disorder. The European Games Developer Federation (EGDF) also criticized the move. The group said in a statement to the WHO that it was concerned by the organization’s action to include it, “despite significant opposition from the medical and scientific community. The evidence for its inclusion remains highly contested and inconclusive.”

In justifying the decision, Dr. Vladimir Poznyak, a member of WHO’s Department of Mental Health and Substance Abuse said, “I’m not creating a precedent here. The WHO has followed the trends and the developments which have taken place in populations and in the professional field.”  In classifying compulsive gaming as a disorder, the WHO is reiterating what the DSMV-5 has already noted, that gaming can be more than child’s play and needs to be taken seriously as a legitimate sickness.   

Should Parents Worry?

Kids and video games go hand in hand. Literally.

Parents should not immediately panic and assume that their son or daughter has a disorder just because they play video games, even if they do so frequently. Rather, parents should be mindful of signs that perhaps their child is engaging in unhealthy video game playing. For instance, how does the child react when you turn off his PS4?  Heather Ness, a psychology professor, admits that there’s the normal disappointed response versus a complete meltdown. (Also consider if the child regularly has meltdowns over other things; that probably would not indicate a gaming disorder.) “Does the child become agitated or anxious if they are not allowed to play video games? When not playing, are they constantly focused on how to get back to their games? Have they steadily increased their playing time because just an hour is no longer enough?” Ness asks.   If parents can answer “yes” to any of these questions, there might be cause for concern. Parents can further investigate by setting limits on screen time, such as allowing play only on weekends or after chores are completed, to determine if their child can prioritize gaming. Parents should also restrict games that have multiple player options as this can strengthen an addiction. Devices should be designated to high-traffic areas and never be allowed in the child’s bedroom. It is also advisable that parental controls be installed on all devices. If all these measures fail and the child cannot adhere to the rules, gaming may have evolved into a more pressing matter that requires professional intervention.  

Xing out the Xbox

Like any addiction, the user just needs “one more hit” before he can put it away.  Because the diagnosis is so new, there are not many treatment options currently available. There are a few rehab centers, boot camp programs, and some wilderness camps, but they are costly and there is little evidence to suggest that they are successful.  Saltzberg says the individuals he’s worked with often respond better to Gamblers Anonymous programs, as video gaming is a process addiction (a compulsion to continually engage in behaviors despite the negative impact on one’s life), and they have a larger network of established programs. Dr. Carol, who runs Digital Detox Success, a detox center that offers programs for families, recommends a full detox of 90 days or more. As with any addiction, treatment will cause classic signs of withdrawal such as irritability and agitation. By classifying compulsive playing as a disorder, the goal is to encourage those in the mental health field to create new and more diverse options for treatment, and for insurance companies to offer coverage so those affected can seek help.    

As a teenager, Motty’s gaming will affect him minimally: he may have few friends, perform poorly in school, or be out of shape. But fast forward into adulthood, and if Motty’s addiction is uncaught or left untreated, he may end up unemployed, socially awkward, and not living up to his full potential.    Perhaps if his parents realize how serious gaming addiction can be, they will pull the plug long before it becomes a disorder.

Sidebars

Signs You Are an Addicted Avatar

To be officially diagnosed as having a gaming disorder, the individual must exhibit the negative behaviors of excessive playing for at least 12 months. Here are some signs of a problem:

• Gaming takes precedence over other daily interests and activities.
• Player becomes aggressive or hostile to those that prevent him from gaming.  
• Decrease in the number of human friends, with an increase of virtual friends.
• When the player is not gaming, he is involved in chatting about video games in online forums.
• Player exhibits traits of oppositional defiance or depression.
• Player presents poor hygiene and neglects his overall health.
• Change in sleep patterns (too much or too little sleep).

Gaming Lingo

This common playing terminology may help you get that gamer off the computer.  

AFK: Acronym for “away from keyboard.”

Gank: Verb meaning to have your character killed by unfairly overwhelming odds. For example, my guy was ganked when he was attacked by a player ten level above me.  

HP: Hit points. This is a term commonly used in RPGs (role-playing games), which refers to the number of points of damage that a character can take before dying.  

Sim: Short for simulation. Also refers to any character in the popular life simulation game series The Sims franchise.  

Smurf: An advanced player who is taking the easy way out by creating a new character or account to play against lower-leveled players.

WTS/WTB: Acronym for “want to sell/want to buy.”

The American Psychological Association estimated that 160 million American adults play video games.

Last year the gaming industry earned 108.9 billion dollars, according to market analyst firm Newzoo.