Playing video games can be an immersive hobby. But if gaming interferes negatively with your life, you may have internet gaming disorder.
As a gamer, it’s easy to find yourself spending hours playing one of your favorite video games, from World of Warcraft and Fortnite to Candy Crush. But there’s a difference between gaming as a fun, enriching hobby and excessive gaming that negatively impacts your life.
The latter is known as internet gaming disorder (IGD). Knowing the symptoms of this compulsive behavior can ensure that your hobby is healthy and not potentially problematic.
Gaming disorder is a mental health condition that involves compulsive playing of video games that significantly interferes with your ability to function in important areas — like school, work, or personal life — over an extended period.
The World Health Organization (WHO) recognized internet gaming disorder as a diagnosable mental health condition in its International Classification of Diseases, 11th Revision (ICD-11) in 2018.
Internet gaming disorder is also the only behavioral addiction, or “excessive behavioral pattern,” listed under section III of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). IGD is considered a non-substance-related addiction disorder and a subtype of internet addiction disorder.
The DSM-5 does not classify IGD as a formal diagnosis, though, due to the current lack of evidence to support it as a unique condition.
There isn’t a consensus among clinicians and researchers around gaming disorder or the DSM-5’s diagnostic criteria. There’s an ongoing debate over what the line separating highly-engaged gaming and problematic gaming should be and whether IGD pathologizes normal teen behavior.
But this doesn’t make it any less valid for those who live with obsessive and overwhelming compulsions to play video games.
In fact, it can feel just as real as any other addiction, says psychotherapist Hanly Banks Callahan, LPC, MA of The Zilker Center, a teen mental health center that primarily focuses on gaming disorders. “It can prevent people from doing daily tasks, hold jobs, relationships, and really consume them.”
In the WHO’s ICD-11 and the American Psychiatric Association’s DSM-5, internet gaming disorder is characterized by the following behaviors, lasting 12 months or longer:
- lack of control over time spent gaming
- prioritizing gaming over other interests, important tasks, and daily responsibilities
- continued or escalated gaming despite negative consequences
- significantly impaired functioning in personal, family, social, work or school life
- denying or concealing gaming habits or amount of time spent playing
- using video games to escape negative emotions
If the above symptoms are severe, the ICD-11 saysa diagnosis can be made sooner than 12 months. The ICD-11 also notes that gaming behavior can be online or offline — one of the points some clinicians and academics call confusing.
According to Olivia Grace, a clinical psychologist who specializes in therapy for video game addiction at The Mindful Gamer, other symptoms of internet gaming disorder include:
- obsessive thinking about video or internet games
- loss of interest in other hobbies or activities
- poor work performance and strained relationships
- poor concentration or motivation
- lack of social engagement outside of gaming communities
- symptoms of anxiety or depression
- decline in physical health and hygiene
- digital eye strain or repetitive strain injuries
Grace adds that someone with IGD may not exhibit all of these symptoms, and they may vary in intensity for different people. But “if compulsive gaming is having a significant negative impact on their life, then it may be time to take action.”
Connection to mental health and other effects
A 2012 literature review found evidence that excessive gaming is associated with various mental health conditions, including:
It’s unclear whether gaming disorder causes these mental health conditions or vice versa.
Some people may use video games as a coping method to help them deal with the symptoms of a primary diagnosis, like anxiety or depression. In these cases, effective treatment for the primary mental health conditions may improve any issues that arise around gaming.
The 2012 review also looked at neuroimaging studies on IGD and found excessive gaming increased brain activity in regions typically associated with addiction. It also concludes that IGD might cause neuroadaptation, meaning brain structure and function changes.
Poor mental health is also commonly associated with gamers who meet the criteria of IGD compared to gamers who don’t meet the compulsion threshold, according to a
Several factors can cause gaming to go from hobby to compulsion — or internet gaming disorder:
It’s not so much the games that are addictive but the act of playing (and its effect on our brains). This is because video games are extremely stimulating and cause high levels of dopamine to release when playing.
Grace explains that this increased dopamine feels good to the gamer in the moment but can lead to their brain receptors becoming desensitized after time. “So they must play more for longer hours to feel the same level of satisfaction they once used to.”
Gamers often play to escape stress or distract themselves from other tough emotions or real-life problems. “Gaming has the unique ability to immerse an individual and distract them from these sensations from the comfort of their own home,” says Grace.
“When [people with compulsions] can’t deal with their negative emotions, they get overwhelmed and resort to playing video games again, and the cycle continues,” she says, noting that this escapism can exacerbate existing issues.
Escapism is seen in both highly-engaged and problematic gaming and isn’t necessarily a harmful coping strategy. A 2016 study found that escapism can be a positive coping mechanism, providing a forum to relieve stress and build self-confidence.
Sense of belonging
Multiplayer gaming is a great way to build communities and virtually connect with like-minded people. This is especially true if you’re naturally introverted or feel anxious in offline social settings.
“As humans, our need for social interaction has to be satisfied, and video games offer this without having to meet face to face,” says Grace. “The anonymity of interacting online makes it very appealing to those who are shy or suffer from social anxiety.”
Gaming disorder can affect folks of all genders and ages. But neuroimaging studies outlined in a 2018 study suggest that males have a genetic predisposition to be more susceptible to compulsive gaming.
“In summary, it explains that the areas of the brain that respond to the addictive qualities of gaming, such as reward-based behaviors, show more activity in males than in females,” says Grace.
“Video games create challenges that are achievable and consistent, which shortcut and distract us from important goals outside of gaming,” says Grace, noting that humans tend to feel good when finishing tasks.
She explains that gaming can be addictive because we’re instantly gratified for completing these in-game achievements. This reward system ultimately leads to reinforced behavior (e.g., more gaming).
Support is available for folks with gaming disorder or an unhealthy relationship with gaming.
Working with a therapist can help you find the root cause of obsessive gaming and offer helpful coping skills to better manage compulsions that come up.
For folks with gaming disorder, Grace notes that “a large part of [treatment] is learning to healthily deal with their thoughts so that they can act in a rational way consistent with their values.”
Mindfulness meditation practices can help you cope and develop self-awareness. “The importance of this is to help the gamer to ground themselves in the presence of negative thoughts that lead to gaming or escapism,” she adds.
Banks Callahan notes that taking breaks and becoming aware of screen time use are two important keys to healing your relationship with gaming. “Parents, teachers, and teens [also] need to be aware of the mental fatigue and [compulsions] that can come with overuse of screens and gaming.”
Detoxification programs are another long-term recovery option for those whose condition is more severe, where taking breaks may not be an easy task.
“This is a great option if it’s beyond the point of self-control,” says Banks Callahan. “A residential program would benefit in helping to find new outlets, healthier hobbies, and inclusive therapy.”
Internet gaming disorder is a mental health condition recognized in the ICD-11 and the DSM-5, which calls for more research. Whether or not it’s officially labeled as an “addiction” or goes by another name like “problematic gaming,” gaming can become an unhealthy obsession and negatively impact your life.
If you feel a loss of control over how much time you spend playing video games, speak with a mental health professional about whether you have internet gaming disorder.
You don’t have to completely give up the fun and community of gaming to discover more control. Instead, pursue positive options for managing excessive gaming to make sure time spent online and in-person relationships is rewarding.