Although it’s a very real problem, the 2013 edition of the Diagnostics Statistics Manual of Mental Disorders classified Internet Gaming Disorder as a category for further study, meaning that it’s a condition that requires additional research before it can be formally classified.
However, gaming addiction, including both video and online gaming, was listed as a mental health condition for the first time by the World Health Organization (WHO) in its 11th International Classification of Diseases (ICD) in January 2018.
What are the tell-tale signs of gaming addiction?
The WHO defines Gaming Disorder as: “A pattern of gaming behaviour characterised by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences”.1
“The behaviour pattern must be severe enough that it significantly impairs personal, family, social, educational, occupational or other important areas of functioning, and it must have been evident for at least 12 months,” says Hein Hofmeyr, a clinical psychologist at Akeso Clinic Nelspruit. “It’s a disorder which may be classified as a substance-related and addictive disorder as it exhibits the same signs and symptoms.”
Hofmeyr says the signs and symptoms include:
- Withdrawal symptoms, including anger, depression, feelings of restlessness and/or irritability
- Preoccupation with thoughts of previous online activity or anticipation of the next online session
- Experiencing intense feelings of guilt because of playing
- Lying to friends or family members about the amount of time spent playing, as well as an inability to cut back on playing hours
- Losing friends and isolation from others as more time is spent gaming
- Reckless spending of money on gaming
- Being so immersed in the gaming that the individual loses touch with reality
- Losing interest in previous enjoyable activities
- Fatigue and migraines due to intense concentration or eye strain
- Falling behind in school and work, and performing poorly
- Carpal tunnel syndrome caused by the overuse of a controller or computer mouse
- Poor personal hygiene
A growing global problem
While there are no statistics available on gaming disorder in South Africa, local research by PwC on video game sales shows that these increased by 23,1% between 2011 and 20162 which, says Hofmeyr, is indicative of the burgeoning preoccupation with online games.
“According to Dr Brent Conrad, a Canadian clinical psychologist, and founder of TechAddiction, the incidence of gaming addiction globally is between 3% and 12%,”3 says Hofmeyr. “PwC research reveals that console or handheld games are the most popular, followed by mobile, online and PC games.2 Online games, and especially multi-player, role-playing games, are the most likely to lead to addiction.”
What need does gaming addiction fulfil?
As is with any addiction, it’s important to question what unmet emotional needs gaming fulfils. Whether it is the unmet psychological need of belonging, avoiding hurtful emotions or improving one’s self-esteem, addiction takes on the role of replacing those needs, Hofmeyr says. “In addition, people often enter a hypnotic state when playing video games, during which the subconscious mind learns that the playing of the game is an escape from the real world and a ‘safe space’. This further reinforces the dependence on gaming.”
Numerous risk factors could increase the likelihood of developing a gaming addiction3. They include:
- Personality characteristics such as aggressiveness and neuroticism
- Impulsivity or having a need for adrenaline producing experiences
- Having a low self-esteem
- Having depression or anxiety (this may be both a risk factor and a symptom)
- Need to fit in or connect with a family-like system which can be found in the online community
- Having social anxiety or poor interpersonal skills
- Individuals hoping to avoid their emotions or emotional experiences
- Being male
- Having Attention Deficit Hyperactivity Disorder (ADHD)
- Being subject to authoritarian parenting styles
Other risk factors related directly to the world of gaming include the player becoming attached to the developing story of the game, the freedom to act autonomously within the game, the liberating use of violence, the use of gaming to escape real-life situations, and the desire to accumulate awards within the gaming world.4
“The producers of games use these risk factors to their advantage to make the games more addictive, and increase sales,” says Hofmeyr. “They tap into the serotonin and dopamine levels of the brain to produce feelings of euphoria. As soon as these levels are depleted, the gamer may experience withdrawal symptoms and therefore up their gaming. It works on the same principles as substance - related addictions.”
When to seek help
If you or someone you know displays compulsive gaming behaviour, it’s important to start managing the number of hours spent playing.
The first step to rehabilitation is acknowledging that there is a problem. Family members or friends could also try to determine which needs the addiction fulfils, and to provide more appropriate alternatives.
Because gaming disorder is newly diagnosable, there is limited research available on ways of managing and treating gaming addiction. Parents or concerned family members or friends should determine what types of games the addict is playing. Discussions around dependency and certain rules around usage should then also be established.
This includes:
- Helping them by choosing suitable games which are still fun
- Talking about the content of the game and helping them to understand the difference between make-believe and reality
- Discouraging them from playing alone
- Guarding against obsessive playing
- Discussing the possible risks of gaming addiction
- Ensuring they have other activities to consume their free time
- Setting limits around mealtimes, homework time and family or bedtime, hoping to establish the idea that gaming is something to do only during play time
If none of these steps help, professional assistance is advised. This may include individual therapy with a psychologist who has a special interest in addiction. Family therapy is another option, especially if the addict is a child or teenager. In-patient treatment facilities such as Akeso Clinics enable addicts to work through their addiction within a safe and secure environment, with maximum input from a multi-disciplinary treatment team.
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