This column deals with the sensitive topic of addiction, and may be uncomfortable for some readers.
In 2018 the World Health Organisation surprised and upset a number of fans of video games when it formally designated “gaming disorder” as a distinct clinical condition. The reaction was, sadly, predictable, and boiled down to some variant of the following argument: “I’m not addicted to video games! Therefore video games can’t possibly be addictive!” Many commentators and outlets that focus on video gaming piled on with complaints and criticism, and the result is that the subject is still controversial even today, almost two years on from the WHO’s initial decision.
I’m not a doctor or psychologist, but I wanted to take a moment to defend the decision to categorise gaming disorder/video game addiction as a separate condition, because I feel that too many people who don’t really understand the topic had a knee-jerk reaction to attack it. To them it felt like an attack on their hobby, and perhaps what we can gleam from that is that the messaging surrounding the decision could have been better and clearer.
Firstly, the commentators who criticised the decision, even those who work for major publications, are universally not medical professionals. Their knowledge of the subject is limited at best, nonexistent at worst, and quite frankly having a bunch of uninformed people criticising doctors for a medical decision is comparable to conspiracy theories like the anti-vaccine movement or the Earth being flat. The people who made the decision to categorise video game addiction in this way are qualified to do so, and they will have made their decision on the basis of investigations and evidence, all of which has been peer-reviewed. The people who took offence to the decision simply aren’t on that level.
The biggest problem some people seemed to have is that the decision felt like an attack on gaming as a hobby. Many people have long derided games, dismissing them as children’s toys and even blaming gaming for criminal and violent acts, so I can understand why, to some people, this felt like just another attack in a long line. But it isn’t, because the designation of gaming disorder in no way says that all video games are a problem or that all gamers are addicts. The classification of alcoholism as a disease doesn’t mean that the vast majority of drinkers are alcoholics; no sensible person would even dream of making that argument. Alcoholism affects a small minority of drinkers, just as gaming disorder affects a small minority of gamers. And no one is trying to say otherwise.
Something that can become a problem for one person isn’t going to be a problem for everyone. Many gamers – by far the majority – play games in a sensible and responsible way, enjoying their hobby without allowing it to dominate their life. But some people will take it too far, and will allow it to take over, perhaps as an expression of other mental health issues but perhaps simply because they allowed it to get out of hand.
Choosing to classify gaming disorder as a separate and distinct condition means that more studies can be performed in the field, more information disseminated to psychiatrists and other healthcare professionals, and the result of these things is that for those people who do suffer, better help, and help more tailored to their specific problem, will be available. This can only be a good thing, as it will mean more people will have access to specialist help.
In order to meet the criteria for an individual to even be suspected of having gaming disorder, there’s actually quite a high bar. The most important factor is that their gaming is having a detrimental effect on their life. This could manifest in many ways, which will vary from person to person.
When I was a student at university many years ago, I witnessed gaming disorder firsthand. I was living in a rented apartment which I shared with just one other person, and this person (who will of course remain nameless) became addicted to video games. The individual in question was, like me, an exchange student, which is how we met and how we came to share an apartment. He had friends back home who he liked to play games with, and this was around the time that online gaming was just taking off. He would spend endless hours playing an online game, often late into the night, and over the span of a few weeks it began to have a huge impact on his life. He stopped attending classes, which saw him end up in a mess of trouble with the university as he failed every class that semester. His parents found out, which caused personal problems for him with his family, and his failure to pay rent – despite promising me he’d paid his share – almost wound up getting the pair of us evicted. This was in addition to the weight he lost from not eating properly, the destroyed social relationships with other exchange students at the university, and the missed opportunities to have the once-in-a-lifetime experience of living in another country. Ever since then I’ve used his story as a warning, because his addiction to gaming had serious and lasting consequences.
There is a happy ending to this individual’s story, however, and that is that he did eventually get his life back on track and scale down his gaming. When we parted ways we didn’t keep in touch, so I can’t be certain he’s still living his best life, but as of the last time we were together it definitely seemed that he was moving in the right direction. It took an intervention from his family – who flew halfway around the world to see him after he failed all of his classes – and a twice-weekly therapy appointment to get him to that point, though.
Any time someone tells me that they know loads of people who play games who aren’t addicted, I tell them the story of my ex-roommate, and make the same point: “just because it hasn’t happened to you or someone you care about doesn’t mean it hasn’t happened to anyone.”
I hope that nobody tries to use the designation of gaming disorder to attack what is for most people a fun and innocent hobby. That would be counterproductive, and would lead to people who genuinely have issues with gaming addiction finding it harder to get help. But so far, that doesn’t seem to have happened. The designation is just that: a clinical classification designed to help that small minority of people who have a problem.
It’s worth noting that some games, especially in recent years, have gone out of their way to introduce potentially addictive elements to their gameplay. In particular we can look at lootboxes and randomised rewards, which in many games are little more than gambling – often using real-world money. There are frequent news stories, some of which end up in the mainstream media, of individuals who end up spending hundreds or thousands of pounds on these in-game “micro” transactions. In one case last year here in the UK, a child inadvertently spent his parents’ entire monthly wages in a game.
Putting a warning label of some kind on games that have in-game “micro” transactions is definitely a good idea, but in an era where physical sales of games in boxes (where such a label would be affixed) are in terminal decline, that probably won’t be good enough. And as I noted from my former roommate’s experience, which came long before such in-game transactions were commonplace, gaming addiction doesn’t always manifest with titles that have such systems in place.
We also have to be careful how we use the terminology of addiction – and of mental health in general, but that’s a separate point. When reading reviews of new titles, I often see the word “addictive” thrown around as if it were a positive thing: “this new game is incredibly addictive!” That kind of normalisation and misuse of the term can be problematic, as affected people may simply brush off their addiction by thinking that’s how everyone plays the game. I feel that writers have a certain responsibility to try to avoid this kind of language. Presenting addictiveness as a positive aspect could indirectly contribute to real harm. I’m sure I’ve made this mistake myself on occasion, but it’s something I hope to avoid in future.
Gaming addiction, like other addictions, is a complex problem that is not easily solved. It’s no easier for someone suffering from some form of gaming disorder to “just turn off the console” than it is for an alcoholic to “just stop drinking vodka”. The temptation is always present and it can be overwhelming. Anyone suggesting that it’s a simple case of “just stopping”, as if it were that easy, doesn’t know what they’re talking about. Again, it comes back to the point I made earlier: just because it might that easy for you doesn’t mean it is that easy for everybody. One person’s subjective experience is not a complete worldview; many people find it impossible to break the cycle of addiction without help. This classification has the potential to make more specialised help available, which is the primary reason I support it.
So that’s my take on the subject. Gaming can be addictive, and for a small number of people, that addiction can cause real harm and create lasting problems for themselves and their families. Recognising this reality is a good first step if it means more research can be conducted into the subject as that will hopefully lead to better and more effective treatments for people whose gaming addiction requires outside intervention. I’ve seen firsthand how this can happen, and I have absolutely no time for the argument that goes: “well I don’t have a problem with gaming addiction, so it must be fine for everyone!” That is a blinkered and selfish way to look at the subject.
For anyone reading this who thinks they may be affected by gaming disorder or video game addiction, I’ve prepared a quick checklist of questions you can ask yourself. If you find yourself answering “yes” to any of the points below, I would suggest you reach out to someone who can help – talking to a friend, family member, or someone you trust could be a great first step, and of course professional medical help is always available.
Question #1: Do you find yourself thinking about video games all the time, and planning ways to get back to your game as quickly as possible if interrupted?
Question #2: Have you missed important events – such as work, school, meetings, or other appointments – because you couldn’t tear yourself away from gaming?
Question #3: Do you find yourself unhappy, depressed, angry, or irritated while not gaming? And/or would you say that your happiness is inextricably tied to gaming?
Question #4: Have you ever lied about how much time you spend gaming to cover it up? And/or do you break rules or limits set by others on how much time you may spend gaming?
Question #5: Have you tried to spend less time gaming but failed?
Question #6: Do your friends, family members, or people close to you ever tell you that you spend too much time gaming? And/or do you feel that you have neglected your relationship(s) as a result of gaming?
Question #7: Do you forget to eat or skip meals because of gaming? Do you skip showering or fail to take care of basic hygiene and grooming because of gaming?
While not everyone who answers “yes” to the above questions will be an addict, these points do indicate that something may be amiss with your relationship with gaming.
At the end of the day, if you’re happy with your life and gaming is a hobby, that’s okay. If it isn’t causing any harm to yourself or other people, there is no problem. But for some people gaming can get to a point where it stops being a harmless bit of fun and becomes something more sinister: an addiction. Missing important events, skipping school, neglecting friends, skipping meals, skipping showers, etc. are all points which can indicate an individual’s relationship with gaming is becoming unhealthy, and if you recognise these signs in yourself, I encourage you to reach out and get help.
Yes, gaming disorder or gaming addiction is a real phenomenon. The World Health Organisation did not invent it, all they have done is classify it and formally recognise what many people have known for a long time – that it is real. Far from being an attack on gaming as a hobby, this should be seen as a positive thing, as it has the potential to help affected individuals get better and more appropriate help.
This article contains the thoughts and opinions of one person only and is not intended to cause any offence.