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If you are a gamer, this is a big fall. The ninth generation of game consoles have been released, with the PlayStation 5 and Xbox Series X. Normally this is very exciting, yet something this time is different: we've got lockdowns, and with them, millions of new gamers. The gaming industry tops almost 3 billion gamers worldwide and over 120 billion in revenue—more money than movies and tv rake in combined. And those numbers are growing.
Video games are not a niche anymore, but the medium of our age. Yet from all that new exposure to gaming, there is a growing concern bubbling underneath the surface: that some gamers are stuck in a loop and the culprit seems to be Video Game Addiction (VGA).
For those unfamiliar, let us set definitions: Addiction is defined as repeating compulsive behavior that seems rewarding but is ultimately detrimental. Or in other words, you do stuff that hurts you, and you cannot stop doing it. Statistics for different disorders vary, but a meta-analysis shows that roughly 3.1 percent of the human population is susceptible to addiction of one kind of another.
People usually think of addiction as primarily chemical (e.g., alcohol). Yet, behaviors such as gambling, or sex have long been recognized as addictions. Those sufferers can face many of the same problems as, say, an alcoholic. They may miss large amounts of work and eschew life events in favour of fulfilling their addiction. They can end up unable to take care of themselves, stuck in loops of harmful behavior that they cannot shake themselves out of.
VGA, as a behavioral addiction, is very much debated. In 2013, the American Psychiatric Association found there to be insufficient evidence of it, and instead encouraged more research. Only last year, under intense pressure from Asian countries, the World Health Organization controversially added gaming disorder to the International Classification of Diseases. The ever-so reliable WHO would, a year later, and unironically, due to COVID-19 demand that everyone should start gaming despite the risk of addiction.
Top psychologists Andrew Przybylski of the Oxford Internet Institute and Chris Ferguson of Stetson University are skeptical. Along with 26 others, they wrote an open letter against the WHO, arguing that the available research on the topic is muddled and would cause a moral panic.
I contacted Ferguson, and he expressed real concern that the field of psychiatry is entirely wrongheaded on this issue. Worried that "Indulging moral panic over games could end up with parents hyper focused on gaming hours rather than investigating the underlying depression, anxiety, etc., that is the real issue."
Ferguson says that VGA is not an addiction unto itself, but a part of a general compulsive behavior disorder. It's an interesting argument: that it should be "about the pathology within the individual, not a feature of the technology or media." The general understanding is backwards, don't put the VGA cart in front of the behavioral horse.
Yes to Diagnosis
Dr. Mark Griffiths of the University of Nottingham-Trent, disagrees. He's the Director of the International Gaming Research Unit and specializes primarily in gambling disorder, a 30-year veteran on the topic. No one's published more on gaming than him.
"There are countless neuro-biological studies now, we have about 15 nationally represented epidemiological studies. There are hundreds of studies now. The real big argument is to what extent prevalence of the problem is." Griffiths told me over the phone.
Dr. Griffiths agrees with Ferguson that the pro side overplays the percentage of gamers addicted. He thinks 1 percent or less of gamers addicted would be accurate. That seems low, but in truth is no small amount; if 244 million people are gamers in the US, then even at 1 percent, means potentially 2.4 million people are struggling with a terrible addiction.
"We know from treatment clinics around the world, that there are those people turning up for treatment because gaming has taken over their life. We're not just talking about the kind of 12 or 13-year-old adolescent sitting in his bedroom all day. We're talking about grown adults in their 30s or 40s where gaming has taken over their life, loss in their job, loss in their relationships, and they're doing it, in neglect of everything else." warned Griffths.
After talking to Griffiths, I reached out to gamers on social media for their stories. What I learned from these gamers' experiences is thought-provoking.
After his stepfather's death, one man told me that he tried to cope using video games and would game from when he got home after school from 4 pm until 5 or 6 am the next day. He would sleep 2 hours, & then go back to school, rinse and repeat.
A divorcee shared the story of her ex-husband becoming addicted to World of Warcraft, which led to increasingly erratic behavior that eventually ended in affairs and a divorce.
A property manager vented his frustration to me about having to watch VGA impact several of his tenants, such as elderly an couple forced to work for rent while their adult sons game 24/7. A gamer himself, this experience so soured his stomach he refuses to introduce his kids to gaming for fear of addiction.
Joseph Kracht is a gamer from my home state of South Dakota. He described how as a kid, he got started as a gamer with the Pokémon games of the late 1990s. As a teen, he struggled to balance schoolwork and marching band practice with his time devoted to gaming. The problem got much worse in college: "Black Ops. Call of Duty Black Ops came out when I was a freshman in college. And there were about four or five of us that would meet up online, and we would skip our classes. And we would just play [COD] all the time. And only one of us would graduate from college. The rest of us are dropouts."
As an adult, Kracht is in control & keeps his gaming to an hour or two a day. What is so fascinating about Kracht's story is that he is no stranger to addiction. He supported friends and family with substance abuse problems & himself struggles with smoking. He noted that the similarities between VGA and drug addiction are alarming.
It's a frequent theme noticed by those who face video game addiction and substance abuse. Just as drug and alcohol abuse is often born from self-medicating, so too is gaming a way for those suffering to try to find solace.
Dr. Kruti Kanojia is a Harvard-trained psychologist and co-founder of Healthy Gamer, a company dedicated to helping gamers with their mental health challenges. Dr. K. meets with VGA clients regularly and is famous online for his long-form Twitch & Youtube therapy sessions with popular game-streamers. Addiction is often very difficult because it is an inadequate response to genuine problems.
Dr. K told me, "The reason VGA is so problematic is because games fulfill certain psychological needs," he pointed out. "People turn to video games as a coping mechanism for a lot of negative and common things in life. We work with a lot of people who started gaming as a result of being bullied in school, their parents' divorce, or social anxiety, for example."
According to Dr. K, the major trick to helping people find healing from this addiction is to help patients figure out what they are psychological getting out of video games feeding their addiction. "Some people who game for 14 hours a day wouldn't even call it fun. So, people have to figure out what the game is doing for you," said Kanojia.
Those in addiction specialties like Dr. Griffiths and Dr.K recommend a multimodal approach, which would mean CBT, pharmacological treatment, and other therapies.
As I've learned with the opioid crisis, wherever there's an addiction crisis there will inevitably spawn a call for government action. South Korea, China & Japan have all enacted policies aimed at dealing with VGA. So far what we have seen in the west is a corrective to the growth of virtually naked gambling design intruding into video games.
The development of trends like paid loot boxes and mobile gaming pay-to-win "whale"-reliant games are disconcerting not just to gamers but world governments. The first is being pursued in a push led by the UK government, and the days may be numbered for games like Rise of Kingdoms. We are likely to see a push for government action from there.
As readers may remember, I am a nerd of the highest caliber, including a prolific gamer (Sony & Microsoft, call me). I came into this wanting this to be largely smoke & paranoia. But after exploring the issue and talking with experts and sufferers, I am convinced that whatever you want to call this, something is happening to a small division of gamers.
Perhaps this is just part of a growing society in adjusting to media technology as we have done countless times since the printing press. VGA and screen addiction may well be something we adapt to. Regardless, there is something happening to gamers, and I hope all of us can show a little more empathy and a little less condemnation to those stuck in the loop.