Video games are addictive, officially

Addiction and Recovery

By Bob Gaydos

Some young males may be addicted to video games.

What many parents the world over have been proclaiming for quite some time is now official: Some individuals -- mostly young males --- are literally, not just figuratively and annoyingly, addicted to playing video games. That is the determination of the World Health Organization, which after considerable study and debate, recently added gaming disorder to its International Classification of Diseases, a primary source of information for doctors worldwide.

The United Nations agency did not put a time frame (how many hours a day) on what would be considered addictive gaming, but rather, put video gaming in the same category as gambling addiction -- a behavior that becomes “a priority” and which the individual is unable to stop despite numerous negative life consequences. These include loss of a job, loss of friends, broken relationships, poor health, bad grades and other assorted issues that might arise for someone who played, say, Fortnite, the current video game rage, for 14 to 16 hours a day while neglecting work, school, food, sleep, family, friends, showers … real life.  

While this classification might seem overdue to some, it is not without controversy. For one thing, the W.H.O. zeroed in on video gaming, both online and offline, but did not include use of the internet and smartphones, which certainly are vehicles for obsessive behavior. For another, the American Psychiatric Association did not include gaming in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, choosing to call it a "condition for further study."

Some critics of the WHO classification suggest that gaming was targeted because of heavy lobbying by some countries, such as China and South Korea, which have large populations of video gamers and are desperately looking for help in treating them. But some mental health professionals say official WHO designation could improve public education, research, insurance coverage and development of treatment programs, which at the moment are scarce and expensive. They say including the gaming industry -- with its legion of experts on creating reward-and-reinforcement scenarios -- in the conversation can only help.

Not surprisingly, most creators of video games (who have an economic motivation to be considered) and their legion of players responded negatively to the classification, arguing with the methodology of some studies and saying the results have been far from conclusive. They also say studies on gaming are relatively new and note that some studies have shown benefits to playing video games, including improved thought processes (lots of strategy to figure out), greater motivation (lots of levels to reach and competition to be won), and improved memory and hand-eye coordination (essential for good gaming). In these regards, they say, gaming is akin to young people playing sports or joining clubs.

Finally, there is also disagreement among mental health professionals about whether the gaming is the cause or the effect of such common co-occurring disorders among obsessive gamers as anxiety and depression.

Still, whether it is an official mental health disorder or one deserving further study, no one argues that playing video games to the point that the player suffers negative consequences in other areas of life is good for one’s health. So, while the APA has not classified gaming as a disorder, it has come up with nine criteria for identifying it, should it make that official decision. They are similar to those used to identify other officially classified addictions:

1. Pre-occupation. Do you spend a lot of time thinking about games even when you are not playing, or planning when you can play next?
2. Withdrawal. Do you feel restless, irritable, moody, angry, anxious or sad when attempting to cut down or stop gaming, or when you are unable to play?
3. Tolerance. Do you feel the need to play for increasing amounts of time, play more exciting games, or use more powerful equipment to get the same amount of excitement you used to get?
4. Reduce/stop. Do you feel that you should play less, but are unable to cut back on the amount of time you spend playing games?
5. Give up other activities. Do you lose interest in or reduce participation in other recreational activities due to gaming?
6. Continue despite problems. Do you continue to play games even though you are aware of negative consequences, such as not getting enough sleep, being late to school/work, spending too much money, having arguments with others, or neglecting important duties?
7. Deceive/cover up. Do you lie to family, friends or others about how much you game, or try to keep your family or friends from knowing how much you game?
8. Escape adverse moods. Do you game to escape from or forget about personal problems, or to relieve uncomfortable feelings such as guilt, anxiety, helplessness or depression?
9. Risk/lose relationships/opportunities. Do you risk or lose significant relationships, or job, educational or career opportunities because of gaming?

Obviously, the more “yes” answers there are, the more likely the individual has a problem with video gaming, whether it’s labeled an official addiction or not. Denying it out of shame or guilt or fear won’t help. In fact, the WHO classification is intended to eliminate those obstacles and provide an avenue to help. If the video gamer has trouble stopping or cutting back, consider consulting a professional addiction counselor.

There is also help available online from those who understand the problem because they’ve been there:

-- On-line Gamers Anonymous, a 12-step, support and recovery organization “for gamers and their loved ones who are suffering from the adverse effects of excessive computer gaming”: olganon.org

-- Computer Gaming Addicts Anonymous (CGAA), “a recovery fellowship, based on the model of Alcoholics Anonymous”: cgaa.info.

Whatever you do, be honest. If you or a loved one are talking about it, if it is a cause for concern, if it has caused problems, then it’s a problem, official addiction or not. Don’t wait for the debate to be resolved.

It’s all in the game

• About 2.6 billion people play video games worldwide.
• Two-thirds of American households include video game players.
• The great majority of those who play video games do not display addictive behavior.
• Young males log more hours weekly on video games than do young females.
• The Entertainment Software Association says annual worldwide revenue for the industry should reach $180 billion by 2021.
• Fortnite: Battle Royale, the current hot video game in which 100 players battle to be the last one standing on the island, recently earned a reported $300 million in one month. It has a reported 40 million-plus players, some of whom are obsessive. The game is free to play, but players can buy add-ons (weapons, tools, resources, etc.) to enhance their chances of victory.

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Technology opens up new avenues to addiction

Addiction and Recovery

By Bob Gaydos

Which came first, the Internet or the addiction?

That existential question is at the heart of a debate among psychiatrists, psychologists and other professionals in the addiction treatment field. Is all that time people spend on their laptops, computers, tablets and smartphones a sign of addiction to the technology itself, or is the technology merely an extraordinarily convenient vehicle by which to accommodate the addiction? And, either way, is there potential harm?

The answer to that last question is yes.

Internet addiction disorder (sometimes called technology addiction or Internet Use Disorder) is not listed in the latest DSM manual (DSM-5 2013), which is used by psychiatrists to officially diagnose addictions. However, Internet gaming disorder (video games that are especially popular with men in their 20s and 30s) is listed as a condition worthy of further study.

The only non-substance related addiction included in the manual is gambling disorder. And yet, it doesn’t take a scientific study to know that there are people who spend hours online looking at pornography, still others who will shop at e-bay and other Internet sites as long as PayPal will allow them to and still others who have become day traders (and night traders) on the stock market -- either because it’s right there in their living room or because of some other less obvious reason that might come out in therapy.

And, of course, there are the those who frequent social media sites, such as Twitter, Facebook and Instagram (often at work), as well as ubiquitous texters (mostly teenagers) with smartphones at the ready wherever and whenever it’s necessary to share some news, or photo, or, you know, whatever.

Officially classified or not, some researchers believe that some of these behaviors -- hours of gaming, sex-related surfing or non-stop e-mailing or texting in particular -- have a lot in common with recognized addictive behaviors. To wit:

• A high tolerance
• Withdrawal symptoms
• Negative repercussions.

The researchers say people who use their cell phones or computers for hours at a time may feel a “high,” similar to substance-centered addicts, as well as a feeling of restlessness when cut off from technology.

Some video gamers have been known to play non-stop for several hours, eating junk food, drinking soda or energy drinks for the caffeine, and ruining their eyesight and posture. They may have trouble sleeping or may feel depressed. School work goes undone. Job performance suffers. In-person friendships suffer. Hobbies and other interests that do not involve technology disappear. Life revolves around the game.

For gamers, or those who spend excessive time shopping online, looking at pornography, taking selfies or constantly checking Facebook postings, it’s possible, even likely, that there are issues involved beyond the constant use of technology that would benefit from the expertise of a psychotherapist.

Which brings us back to that which-came-first question. Given the constantly expanding role of technology in our daily lives -- work, school, social communication depend on it -- treating the harmful behavior is not as simple as don’t pick up the drink, the drug or the credit card, or stay out of bars or casinos, or knock off the french fries. It’s more likely to consist of recognizing when the behavior is getting out of hand and working with a therapist on a plan to address it.

There are, for example, apps that will tell you it’s time to shut off your smartphone or do it for you and others that will shut off your computer internet connection or block specific Web pages. Figure out if any of these could work for you. If you’re a concerned parent, talk to your child about cutting back before arbitrarily confiscating the phone.

Whatever the addiction is --  whether it’s in the official DSM manual or not -- it’s all about control, or lack thereof. Bottom line: If a behavior is causing problems in your life, it’s a problem.

There’s a movie about it

With all addictions, it’s always comforting to know you’re not alone. With Internet addiction, there’s an award-winning movie that discusses the challenges and struggles of young people growing up in the digital age. “SCREENAGERS” explores family conflicts over video games, social media and academics. Screenings are available only through community events at a school, community group, church, synagogue, workplace, theater, etc. The Warwick Valley School District hosted a screening last year at the high school. It was followed up with a discussion featuring a panel of teens at the Albert Wisner Public Library.

More  information: http://www.screenagersmovie.com/host-a-screening/

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