Video games have come a long way since the likes of Pong, Pac-Man and Space Invaders. However, while these simplistic games captured the hearts of millions, they quickly proved that games had the potential to retain peoples’ attention for hours on end. Now, over 2 billion people play video games across the world, and the average gamer spends approximately 8 hours gaming each week.

For most, gaming is nothing more than a way to unwind, enjoy a good challenge or spend time with friends. But for some, it can turn from a fun pastime into an all-consuming addiction.

If you (or a loved one) are struggling with video game addiction, you won’t have to battle through this alone. With a wide array of treatment options available, recovery is possible.

In this guide, we will go over what video game addiction is. We’ll then discuss the warning signs, symptoms and long-term effects of this type of addiction.

What is Video Game Addiction?

Gaming has become one of the most popular mediums out there, but research into video game addiction is still in its infancy. Debates are ongoing about what gaming addiction is and whether it should be classed as a diagnosable disorder.

While video game addiction is not included in the DSM (Diagnostic and Statistical Manual of Mental Disorders) yet – and is only mentioned as a “condition that requires further study” –  the World Health Organization (WHO) does officially recognize it. In fact, they added “gaming disorder” to the International Classification of Diseases in 2018.

No matter how it’s perceived, if an individual’s gaming is interfering with their daily life, health and long-term goals, it’s clearly a problem that needs intervention.

What Makes Video Games Addicting?

As technology progressed, so did the gaming industry. Within mere decades, games left the confinement of arcades and broke into our homes, hands and pockets. From PC to mobile, games can now be found everywhere and anywhere.

Games haven’t just become more accessible, either; they’ve also become more complex, more immersive and more enticing. Developers are constantly implementing new ways to keep their players “hooked”.

All these factors may contribute to gaming’s addictive tendencies. Below, we’ll discuss them in greater detail.

Accessibility

Unsurprisingly, the more accessible something is, the harder it becomes to avoid it and not think about it.

As mentioned above, video games are one of the most easily accessible mediums out there. Even if you leave the house, you can still play games through portable devices, such as handheld gaming consoles and cell phones. In fact, mobile games alone make up over 50% of total gaming revenue worldwide.

Rewards

Virtually all video games are structured to reward the player for their efforts, and these rewards trigger a release of dopamine in the brain, the “feel-good” chemical that boosts mood and energy levels. Put simply: it is a rush of pleasure.

This feeling of pleasure is what prompts an individual to play games again and again; the more pleasurable a behavior is, the more likely you are to repeat it. Additionally, dopamine, by its nature, causes the brain to desire and focus on the thing that triggered its release.

Intermittent Rewarding

Most games also employ intermittent rewarding mechanics, which means your in-game actions may or may not go rewarded. The possibility of a reward ultimately encourages individuals to keep playing, even if they haven’t been rewarded for some time.

Types of In-Game Rewards

In games, there are emotional and material rewards. The most common material reward is loot (rare items). Often, players will go through arduous (and time-consuming) challenges to gain this loot.

Emotional rewards, on the other hand, include the likes of beating an opponent, conquering a difficult level, or reaching a fulfilling point in a game’s story.

Increasing Difficulty

Games tend to increase the difficulty of the challenges as the player progresses. However, rather than deterring the individual, research has shown that the challenge actually encourages them to play for longer as they receive a greater emotional reward.

Dopamine Tolerance

The more your brain becomes accustomed to dopamine, the greater amount you need to feel its effects. If an individual is frequently gaming, after some time, they will need to play for longer and longer durations to experience the same rush of pleasure they initially felt.

Dopamine Exhaustion

When your body becomes used to the constant stream of dopamine you get from gaming, and your tolerance becomes extremely high, it can lead to dopamine exhaustion. This can cause the enjoyment from other activities to be “dulled”.

As a result, an individual may become more dependent on gaming since other activities do not fulfill them in the same way.

Gambling-Like Mechanics

In recent years, video games have implemented more and more gambling-like mechanics, one of the most common being “loot boxes”.

Loot boxes give the player a chance to obtain highly valuable items, but they come at a price: you can usually only gain them by buying them with in-game currency or by completing time-consuming tasks.

As such, loot boxes encourage players to keep investing both time and money into the game.

Immersion

Games are an extremely immersive medium – you play as the character and take on their story, journey and actions. This is particularly true for role-playing games, such as World of Warcraft, where you can design your own playable character.

Furthermore, the rise of virtual reality (VR) has brought with it another layer of immersion, where the game penetrates reality and makes it feel as if you’re genuinely inside it.

Escapism and Sense of Community

Games give individuals a way to escape the troubles they experience in reality. MMORPGs, in particular, allow you to live out your “ideal self”.

Many games also have “guilds” or “clans”, where players can become part of a tightly knit group, socialize with one another, and work together to complete challenges. Often, players build friendships within these groups that can feel more authentic than those in real life.

Hinders Learning Circuitry

Pain is the quickest teacher in life. If an action results in a painful outcome, it’s incredibly challenging to force yourself to repeat that action. This is because the pain is retained within our amygdala, the part of the brain which detects threats and activates behavioral responses to them.

However, research has shown that gaming suppresses negative emotions, and ultimately, this learning process. This means even if an individual is consciously aware of the negative impact gaming addiction is having on their life, they will still struggle to stop; in other words, the amygdala isn’t giving them the “threat response” it should be giving.

Video Game Addiction Statistics and Facts

  • Approximately 1% of gamers experience video game-related compulsive addictive issues.
  • 18 to 24-year-olds are most susceptible.
  • 94% of those who suffer from gaming disorder are male.
  • 1% to 16% of young gamers have video game addiction.
  • Individuals with social anxiety or depression are more likely to develop an addiction, and use gaming as a coping mechanism.
  • South Korea introduced a “shutdown law” – which bans youths under 16 from playing games between 12 am and 6 am – due to the high levels of video game addiction in children.
  • The COVID-19 pandemic has led to an increase in video game addiction among students.
  • Globally, the time spent gaming has increased by 39% since the start of the pandemic.

Warning Signs of Video Game Addiction

To help you better understand how to identify video game addiction, we’ve compiled the common warning signs below. These are organized into two main categories: emotional and physical.

Emotional

  • Gaming in secret
  • Feeling irritable when you can’t play
  • Downplaying the amount of time you spend gaming to others
  • Seeing your friends less; isolating yourself
  • Skipping essential tasks like eating so you can spend more time playing
  • Thinking about gaming throughout the day, even when you’re not gaming

Physical

  • Experiencing fatigue
  • Migraines or hand pain related to gaming
  • A decline in personal hygiene

It’s important to note that the amount of time an individual spends gaming is not always an accurate way to determine whether or not they have a video game addiction.

Diagnostic Criteria of Video Game Addiction

Currently, there are no official diagnostic criteria for video game addiction. That said, the DSM-5 does discuss and propose potential symptoms.

The DSM-5 stresses that gaming must cause significant impairment or distress to multiple areas in an individual’s life, and they must exhibit five or more of the following (experienced over one year):

  • Preoccupation with video games
  • Exhibited tolerance — a need to spend more time gaming to gain pleasure from it
  • Withdrawal symptoms, such as feeling down or agitated when not playing
  • Unsuccessful attempts to stop or lessen gaming time
  • Loss of interest in other activities and hobbies
  • Continuing to play video games despite detrimental consequences
  • Deceiving others about the amount of time spent gaming
  • Using gaming as a coping strategy to relieve negative feelings such as guilt or anxiety (escapism)
  • Putting relationships or opportunities at risk due to gaming

Risk Factors of Video Game Addiction

Like any addiction, there are various factors, both genetic and environmental, that can make an individual more susceptible to developing a gaming disorder. According to a 2015 study, psychopathological conditions are the “strongest risk factors” for video game addiction, such as anxiety, depression and ADHD.

Other research found that “problematic gamers” are more likely to use games as a way to escape, cope or socialize. Using games to “live in a fantasy world” was also identified as a risk factor for video game addiction.

The type of gaming can also play a role: “time spent playing online games showed stronger correlations with IGD than time spent playing offline games” (Lemmens & Hendriks, 2016). Moreover, certain game genres – role-playing games and real-time strategy games – appear to be particularly linked to video game addiction.

More factors that reportedly increase the risk of developing video game addiction include:

  • Aggressive tendencies
  • Feelings of neglect
  • Having a pessimistic outlook
  • Having strict, controlling parents
  • Impulsivity
  • Isolated
  • Lacking empathy
  • Loneliness
  • Lower levels of prosocial behavior
  • Poor school performance
  • Preferring solitude
  • Substance use
  • Using gaming as a way to relieve stress
  • Experiencing workplace bullying

Genetic factors identified include:

  • Gender – men are more likely to have a video game addiction
  • Age – those aged 18 to 24 are most susceptible

Video Game Addiction: Effects and Consequences

Video game addiction can take a toll on several aspects of an individual’s life, especially regarding their mental well-being.

Mental Well-being

A video game addiction can develop due to a mental health disorder, but it can also cause or worsen them. Gaming disorder has been notably correlated with increased depression and anxiety.

Depression

Depression is a mood disorder characterized by a persistent feeling of sadness and loss of interest in life. It affects over 260 million people around the world.

Common symptoms of depression include:

  • A decline in physical movement
  • A lack of energy
  • An increase or decrease in appetite
  • Being in a depressed mood for the majority of the day
  • Fatigue
  • Finding it difficult to focus or think
  • Indecisiveness
  • Loss of interest or pleasure in activities
  • Overwhelming feelings of guilt or worthlessness
  • Slower thought processing
  • Suicidal or death-related thoughts
  • Weight loss or weight gain

You can find the DSM-5 diagnostic criteria for depression here.

Anxiety

An anxiety disorder causes an individual to experience constant and extreme feelings of fear and dread in response to certain things, situations or events. These feelings are typically always out of proportion to the “trigger”: someone with this disorder might feel fearful about going to the shops, leaving their house or answering the phone.

Anxiety disorders are the most common type of mental health disorder in the world. They include:

  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Social anxiety disorder (SAD)

Common symptoms of anxiety include:

  • An increased heart rate
  • An overwhelming sense of dread
  • Avoiding situations, things or events that trigger anxiety
  • Difficulty thinking about anything besides the current worry
  • Dizziness
  • Fatigue
  • Feeling restless, on edge or nervous
  • Irritability
  • Rapid breathing
  • Stomach aches, muscle aches or headaches
  • Poor concentration
  • Sweating
  • Trembling
  • Trouble sleeping

Diagnostic criteria can vary depending on the type of anxiety disorder. The DSM-5 diagnostic criteria for generalized anxiety disorder can be found here.

Other Ways Video Game Addiction Impacts Mental Well-being

Video game addiction has also been related to:

  • Alexithymia
  • Impulsivity
  • Increased aggressive thoughts and behaviors (especially in children)
  • Loneliness
  • Low self-esteem

A 2010 study also found that individuals with video game addiction often had lower social skills than those who didn’t have a video game addiction.

Physical Health

Repetitive stress injuries (RSIs) are commonly seen in those with video game addiction, likely because most games require you to make repetitive and rapid hand, finger and wrist movements.

Stress-related injuries include:

Unsurprisingly, gaming also encourages a sedentary lifestyle, which increases your risk of:

  • Blood clots
  • Cardiovascular disease
  • Diabetes (type 2)
  • Obesity
  • Some forms of cancer

Other physical health problems tied to gaming overuse include sleep deprivation (insomnia), vision issues, malnutrition, musculoskeletal disorders and migraines.

Lifestyle

As is the case for any addiction, gaming disorder can cause financial, professional and social difficulties.

Financial

Someone with a video game addiction may find themselves spending large amounts of money. An overwhelming majority of games, even “free to play” ones, have content that can only be bought with real money. This can range from cosmetic items that change up the look of their character, to “premium” gear that offers in-game advantages.

Additionally, as mentioned above, many games also adopt gambling-like mechanics, making a player spend hundreds (sometimes thousands) before securing the item they desire.

Further financial problems can arise if the individual experiences work-related problems due to their video game addiction.

Relationships

As the addiction escalates, individuals may game for longer durations and spend less time with their loved ones. They may also neglect any in-person communities they are a part of.

It’s also important to note that a common symptom of video game addiction is lying or downplaying gaming usage. This can cause loved ones to become upset and frustrated. Unsurprisingly, it can also lead to conflict.

Moreover, if an individual is experiencing shame or guilt about their gaming usage, they may push away friends, family or significant others.

Gaming can even prevent the development of new relationships; if the individual is spending an overwhelming majority of their time gaming, they won’t have the time to meet new people (outside of the game) or build stronger connections with those they know.

Impaired Work or Academic Performance

A video game addiction can get in the way of an individual’s work or academic life. It may affect their productivity, motivation to improve, as well as their overall performance. It may also cause them to socially withdraw and become isolated from their peers.

It’s worth noting that a recent study found a correlation between increased screen time (TV and video game consoles) and poor academic achievement.

Treatment Options Available

There are several treatment options available for those who are suffering from a video game addiction. The most common include:

  • Cognitive-Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Reality Therapy
  • Family Therapy
  • Group Therapy
  • Rehabilitation programmes
  • Medication: selective serotonin reuptake inhibitors (SSRIs)

If you’re seeking treatment for yourself or a loved one, be sure to familiarize yourself with all the treatment methods. Every treatment method is different, so some will better suit your (or your loved one’s) needs than others. Healthline has an in-depth guide on the various types of treatment and how they differ.

Key Sources

Achab, S., Nicolier, M., Mauny, F., Monnin, J., Trojak, B., Vandel, P., Sechter, D., Gorwood, P., & Haffen, E. (2011). Massively multiplayer online role-playing games: comparing characteristics of addict vs non-addict online recruited gamers in a French adult population. BMC Psychiatry11(1). https://doi.org/10.1186/1471-244x-11-144

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM)) (5th ed.). American Psychiatric Publishing.

Brigham Young University. (2020). Is video game addiction real?. ScienceDaily. www.sciencedaily.com/releases/2020/05/200513143803.htm

Brown, E., & Cairns, P. (2004). A grounded investigation of game immersion. Extended Abstracts on Human Factors in Computing Systems, 1297–1300. https://doi.org/10.1145/985921.986048

Coyne, S. M., Stockdale, L. A., Warburton, W., Gentile, D. A., Yang, C., & Merrill, B. M. (2020). Pathological video game symptoms from adolescence to emerging adulthood: A 6-year longitudinal study of trajectories, predictors, and outcomes. Developmental Psychology56(7), 1385–1396. https://doi.org/10.1037/dev0000939

Eichenbaum, A., Kattner, F., Bradford, D., Gentile, D. A., & Green, C. S. (2015). Role-Playing and Real-Time Strategy Games Associated with Greater Probability of Internet Gaming Disorder. Cyberpsychology, Behavior, and Social Networking18(8), 480–485. https://doi.org/10.1089/cyber.2015.0092

Ferguson, C. J., Coulson, M., & Barnett, J. (2011). A meta-analysis of pathological gaming prevalence and comorbidity with mental health, academic and social problems. Journal of Psychiatric Research45(12), 1573–1578. https://doi.org/10.1016/j.jpsychires.2011.09.005

González-Bueso, V., Santamaría, J., Fernández, D., Merino, L., Montero, E., & Ribas, J. (2018). Association between Internet Gaming Disorder or Pathological Video-Game Use and Comorbid Psychopathology: A Comprehensive Review. International Journal of Environmental Research and Public Health15(4), 668. https://doi.org/10.3390/ijerph15040668

Hyun, G. J., Han, D. H., Lee, Y. S., Kang, K. D., Yoo, S. K., Chung, U. S., & Renshaw, P. F. (2015). Risk factors associated with online game addiction: A hierarchical model. Computers in Human Behavior, 48, 706–713. https://doi.org/10.1016/j.chb.2015.02.008

Laconi, S., Pirès, S., & Chabrol, H. (2017). Internet gaming disorder, motives, game genres and psychopathology. Computers in Human Behavior, 75, 652–659. https://doi.org/10.1016/j.chb.2017.06.012

Mental Health for the Internet | Healthy Gamer. (n.d.). Healthy Gamer. https://www.healthygamer.gg

Nacke, L., & Lindley, C. A. (2008). Flow and immersion in first-person shooters. Proceedings of the 2008 Conference on Future Play Research, Play, Share – Future Play ’08. https://doi.org/10.1145/1496984.1496998

von der Heiden, J. M., Braun, B., Müller, K. W., & Egloff, B. (2019). The Association Between Video Gaming and Psychological Functioning. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01731

World Health Organization. (n.d.). Addictive behaviours: Gaming disorder. WHO. https://www.who.int/news-room/q-a-detail/addictive-behaviours-gaming-disorder

Video Game Addiction Resources

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