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Video Game Addiction: Diagnosing Myself with a rare 21st Century Phenomenon

“In 2022 Gaming Disorder (or video game addiction) will be officially entered into the WHO International Classes of Diseases” read the announcement publicised on Saturday May 25th 2019. When the news broke, I pessimistically envisaged millions of people thinking “Well, I guess video games are bad after all.”

But for me though, a natural worrier and hypochondriac, my initial thought was: “Oh my God! Does this mean I am addicted to video games?”

This wouldn’t be the first time I’ve let my imagination run wild either. It was a rainy Saturday in March when I last I had an eight hour gaming session and ended up going to bed feeling slightly ashamed. The next morning in an attempt to feel better about myself, I decided to do something proactive. I laced up my running shoes, put on my expensive running top and began sprinting down the banks of the River Trent near my flat. Afterwards, panting in my kitchen, my running top now an amalgamation of sweat and what is clearly a standard textile (although to justify the price tag is branded as something like ‘ProAtheleteCotton++EliteTM’), I ate all five portions of my fruit for the day in the form of a gigantic fruit salad. Then, if word spread that I’d spent all day gaming I could immediately interject with “Actually I went for a run over the weekend and made a fruit salad. You can’t say that’s not healthy, can you?” Before rushing to the toilet due to the insane amount of fibre coursing through my body.

You see, video game addiction is present on my long list of things I worry about, probably somewhere in the low to middle region sandwiched between ‘constantly checking I have trousers on when I’m in public’ and ‘being 90% sure I have developed some kind of adult autism’ (which is definitely not a thing). When I think about it though, my relationship with video games has always been intense and borderline obsessive at times. But does this just mean I’m passionate about video games or does it indicate a potential addiction? I need to know more.

The first place to start is the definition of Gaming Disorder, which is classified as:

 “…a pattern of persistent or recurrent gaming behaviour…manifested by:

  1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);
  2. increasing priority given to gaming… [which] takes precedence over other life interests and daily activities; and
  3. continuation or escalation of gaming despite the occurrence of negative consequences. [impairment in relationships, school/work or other important areas of functioning]

over at least twelve months”

I identify with some of these criteria and since I have been gaming since I was seven (and I am older than eight years old) I am really starting to worry. But before I let my imagination run wild again, I must delve deeper. I need to understand how video games are addictive.

How Video Games are Addictive

Addictions start, on a simplistic level, because of dopamine. Dopamine is a motivational chemical created in the brain which primitively was released as a reward, for example after a successful hunt. The feel-good dopamine sensation encouraged us to continue hunting, to seek out the next reward and therefore increase our chances of survival. Now though, dopamine can be released artificially through the use of drugs such as cocaine or alcohol or more naturally through rewards structures present in activities such as gambling. Since the late 90’s these reward structures have been identified within video games and especially within MMORPGs and the looter shooter genre.

One of the main loops of these games is to become stronger by collecting extremely rare gear through a slot machine-like system called a Random Number Generator (how likely it is that these weapons are dished out to each player). When one of these items ‘drops’ a spike of dopamine is released creating a rush for the player. In fact, I have experienced this rush first hand playing Destiny 2 and I admit, it is a great feeling. As I have never gambled, I can only compare it to when England score a last minute equaliser in the World Cup – a joyous, but intense celebration.

It is also thought that the skill based elements of many games can be addictive. As players become more proficient they are urged to seek out the next challenge and ultimately the next reward. Games like Dark Souls, Cup Head and the recent Sekiro: Shadows Die Twice, are brutally difficult, with the main hook of each game associated with overcoming seemingly impossible challenges. Having recently completed Sekiro, I understand how addictive it can be. When trying to overcome the challenge the feeling is excruciating, frustrating and even demoralising, but when a boss falls, emotions run high in a blissful cocktail of adrenaline, dopamine and unrivalled satisfaction. However, it is important to highlight that Sekiro isn’t designed to be addictive. Its difficulty exists to teach us that we are stronger than we think and to encourage us to rise up to challenges that we might face in life. A worthy lesson I am sure you’ll agree.

If you have ever started gaming in daylight, lost track of time and looked up to find it is dark outside, you have experienced flow. Flow is a sense of intense enjoyment accompanied by a distortion in time while playing an immersive game. As the gaming industry advances we are presented with even more detailed games with photorealistic graphics which blur the lines between game and reality (and even more so with Virtual Reality Games). For example, Star Wars Battlefront 2 uses photorealistic graphics for immersion, whereas other games obsess over tiny real life details such as visible rain drops on your visor in Metro: Exodus or natural beard growth in Red Dead Redemption 2 (which isn’t even the most insane detail in that game). It is thought that the flow state offered by video games is a significant predictor for gaming addiction.

Video Game Addiction Metro Exodus Visible Raindrops on visor
Visible Raindrops on screen in Metro: Exodus (Captured on Xbox One)

So, we have three elements of games that are potentially addictive; reward structures, overcoming challenges and flow states. Out of all three, I definitely play games for flow, that is, fun, story and being fully focussed on what I’m playing. But can experiencing these flow states lead to me becoming addicted? Or are certain people more susceptible than others?  

What Makes People Susceptible to Video Games?

First of all time spent gaming is not linked to video game addiction with many people frequently playing for extended periods and experiencing no negative side effects (perhaps I shouldn’t have felt guilty after my last eight hour session). Secondly there are often a myriad of factors that may affect people on different levels.

One major factor is poor mental health associated with anxiety, social anxiety, depression or even loneliness. If people are struggling with stresses in their life, or going through an incredibly difficult period, the escapism offered through flow states can provide much needed alleviation. This can lead to an overdependence on gaming to cope with negative health conditions similar to how other addictions may start. However, as many studies highlight, people with poor mental health use video games as a coping mechanism making it impossible to tell which one is fuelling the other.

Outside of poor mental health, there are certain personality traits linked to video game addiction such as narcissism.  In MMORPGS or looter shooters, by having the best gear, players gain instant recognition from people in-game or through a top ranking on an online leader board. I’ll always remember playing RuneScape growing up and of course the top ranked player; Zezima. Everybody knew their name and they were basically a cyber-celebrity. Now, in 2019 there are even more gaming celebrities with the rise in popularity of ESports. There is even an award for best ESports team at the Gaming Awards providing global recognition for the best players.

Other traits are shown to be linked to video game addiction such as ‘high sensation seeking’ or lack of self-control. Because children and teenagers have lower self-control and less responsibility (i.e. less obstacles to play), they are usually the focus of many studies. For example a study of around 5,000 adolescents in the Netherlands found that 3% were identified as video game addicts. Other studies suggest around 8.5% of U.S youths are addicted. While this is only two studies, the low percentages suggest that video game addiction is actually quite rare.

eSports Team Cloud9 collected the rocket league champions trophy
ESports Team Cloud9, won best team at the Game Awards last year. Image: Windows Central

Prevention and Responsibility

As the video game industry isn’t regulated it is hard to impose any significant preventative measures which creates a grey area of responsibility (whether or not regulation is positive for the industry is a discussion for another time). Is it the responsibility of the gamer, the game developer or the publisher to act against addiction?

It is hard to hold gamers responsible, because people who are susceptible to addiction often have little control over their own actions, but there are some minor and simple self-help measures that could be employed to encourage people to take control. For example something as simple as setting an alarm to break the immersion and flow states created by games is thought to be a viable preventative measure.

Developers and publishers could also take further responsibility by adding features that indicate it’s time to take a break after a set amount of time has passed. I am currently playing Detective Pikachu on DS and at the end of each chapter a message pops on screen asking if you would like to continue. The game is creating a natural opportunity for you to take a break, just like finishing a chapter in a book or watching the credits roll at the end of a movie. As this is a game which is mainly aimed at children I think it is a commendable addition which deserves special praise. Good job Nintendo!

Whether or not other publishers would be in favour of this approach is questionable in the age of endless micro-transactions. A situation where a game tells you to stop playing could be seen by publishers as a gap in a chance to earn revenue. That sounds incredibly harsh and cynical, but given the way a lot of triple-A games now have in-game stores, loot-boxes (sorry, ‘surprise mechanics’) and annual passes, I honestly wouldn’t be surprised.

Above all I believe it is important for people of all ages to be educated about video game addiction to help prevent serious issues later in life. This is a method used during treatment [link] where people are made aware of the addictive tendencies present in video games. If people are aware of how video game addiction starts it will be easier for them to take control and put down a game. Furthermore, education around video game addiction will lead to less demonising of the medium as the difference between passion, engagement and addiction becomes widely accepted.

Final Thoughts

Video game addiction is a rare 21st century phenomenon which is far more complex than it first appears. People who have no interest in gaming may confuse high engagement (i.e passion or time spent playing) with addiction, or worse label video games dangerous as a whole. But for most of us, we have a happy and healthy relationship with video games and they have produced so many positive effects in all of our lives.

Although I am now confident I am not addicted to video games, I am unfortunately susceptible to some degree. I have an anxiety disorder which revolves mainly around social anxiety. If you have a similar condition, or other mental health conditions, then you will know how difficult it can be at times. Games honestly help me in so many ways and being immersed in a flow state allows a break from my negative emotions or simply an opportunity for me to relax. My social anxiety can be horrendous at times, especially within groups of people I don’t know, so as you can imagine online gaming is something that is difficult for me. For this reason it is unlikely I would get addicted to the social elements associated with online games, but I completely understand how other people could.

Finally, I hope I have highlighted that video game addiction is a serious issue, albeit a rare one. If you have also been worried about video game addiction then I am now confident that you won’t feel the need to annihilate a fruit salad or sprint down a watercourse after your next eight hour gaming session. It is perfectly normal to spend a weekend doing something that you love, but it is not normal to ingest that much fruit in one go. If these projects didn’t take so long, I’d probably look into the even rarer 21st century phenomenon of fruit addiction next. Something which, as I write the final line of my two month research project, I am already starting to worry about.



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