Video Game Addiction

Like drugs and alcohol, video games can become an addiction you can’t control, despite their harmful effects. Too much screen time and gaming can hurt your health and relationships. Video game addiction is also called internet gaming disorder.

Even though gaming has been around for more than 50 years, studies about its effect on your well-being are still in early stages. 

The World Health Organization (WHO) added gaming disorder to its medical reference book, International Classification of Diseases, in 2018. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), published by the American Psychiatric Association (APA) in 2022, doesn’t include video game addiction. But it does include gaming disorder as a condition needing further study.

Studies found “better and better evidence that this really is a problem for some children and adolescents and adults,” says researcher Douglas Gentile, a distinguished professor of psychology at Iowa State University.

Still, the APA notes some researchers see problem gaming as a sign of another underlying issue, such as depression or anxiety, rather than a disorder itself.

Millions of people play video games, but only a small percentage develop a gaming addiction or disorder. It’s estimated that 1.7%-10% of the U.S. population has this condition. While it can affect adults, teens, and children, it’s more common in adults.

Signs you’re addicted to video games may include: 

• Thinking about gaming all or a lot of the time
• Feeling bad when you can’t play
• Needing more screen time to get the same level of enjoyment
• Not being able to quit or play less
• Not wanting to do other things you used to like
• Having problems at work, school, or home because of your gaming
• Lying about how much you play
• Using gaming to relieve feelings of hopelessness, sadness, or guilt 
• Not caring about your physical appearance or grooming 
• Being angry or irritable when forced to stop playing

How to recognize signs of video game addiction in children

Look at how your child is doing at school and with their friends. Having good grades and good relationships with peers are signs that their video gaming may not be a problem. But when an issue is developing, “parents notice their child stops being interested in things that they used to be interested in,” Gentile says. “They give up sports and they give up clubs and they give up music, and other things they used to enjoy.” Also, their grades often fall, he says.

Kids with a gaming problem might start to lie about their gaming habits or try to cover them up. “They will go to bed at their bedtime and then they’ll get up at one in the morning and game the rest of the night,” Gentile says.

Parents and kids might find themselves arguing about attempts to set limits.

A leading theory is that playing video games puts the brain in a highly alert state that scientists call hyperarousal. Players become highly engaged in the world of the game, almost as if it’s real life. Playing and winning feel good. Hyperarousal and pleasure lead to the release of a chemical called dopamine in your brain’s reward center.

When a behavior triggers a dopamine release, you’re driven to repeat that behavior. That’s how drug addiction works. Gaming addiction may work that way, too.

As with all addictions, some people are more vulnerable than others. Some studies found high rates of depression and attention problems in people with gaming problems, but it’s not clear if they’re cause-and-effect relationships. Other risks include being impulsive or anxious, having low levels of self-control, and playing more than 30 hours a week.

There are several mental health conditions linked to possible video game addiction. But it’s hard to sort out whether mental health problems cause the gaming problem, result from it, or just happen in the same people.

Psychosocial issues linked to video game addiction may include:

• Depression
• Anxiety
• Attention deficit hyperactivity disorder (ADHD)
• Loneliness
• Feeling unsatisfied with life
• Low self-esteem
• Aggression, especially in boys

There’s less research on physical effects, but they might include:

• A sore neck (gamer’s neck)
• Sore thumbs (gamer’s thumb)
• Vision problems, including dry eyes
• Headaches

Children and teens who play a lot of video games may miss sleep and exercise they need for good health and growth. Lack of sleep and exercise are also concerns for adults.

There’s no standard test for diagnosing video game addiction. Your doctor may refer you to a psychiatrist or other mental health professional. Researchers have developed some questions they may use. They’ll look for evidence that you’ve lost control of your gaming habits and that gaming is interfering with your life. 

To get accurate and complete information about a child who may be addicted to video games, their doctor may get information from their parents, teachers, coaches, or others. Children with gaming problems might also be screened for disorders such as ADHD, depression, and anxiety.

If you’re worried your gaming may be a problem, here are some tips that may help you know. Counting the number of hours you play each week won’t tell you whether you’re addicted. Instead, ask yourself if your gaming gets in the way of your relationships, job, or school. Do you feel you’ve crossed the line between loving to play and having to play? Are you using gaming to try to deal with a deeper problem, such as depression?

It can be hard to see a problem in yourself. Your gaming habits might seem fine to you. But if people close to you say it appears you have a problem, it might be time to think about cutting back or getting professional help.

Because people with gaming problems often have other mental health challenges, any treatment should address those as well, Gentile says.

The most commonly used approaches are forms of talk therapy, including:

Cognitive behavioral therapy (CBT). This involves working with a therapist to better understand your thoughts and behaviors and learn how to change them in healthy ways.

Group therapy. You might meet with others who share your problems with gaming and talk about your struggles under the guidance of a therapist. Group members can support and motivate each other.

Family counseling. This can help parents, spouses, or other family members support the person with the gaming problem. If you’re the parent of a gamer, a therapist can show you how to place limits on your child’s playing time if you have a hard time saying no. One study found that making parents part of a child’s treatment makes it work better.

Are there medications to treat video game addiction?

Using medication for this possible addiction is experimental. Some studies have found promise in bupropion, a drug used to treat other kinds of addiction. It’s also an antidepressant.

Also, you might take medication for other issues that can add to or complicate your gaming problem, including ADHD, depression, or anxiety.

If you see signs that gaming is taking over your life or the life of your child, seek help. You can start by talking to your doctor or your child’s pediatrician. If they see cause for concern, they may refer you to a mental health professional, such as a psychologist or psychiatrist. Pediatricians can also advise families on how to encourage healthier media use in children and teens who might be developing a problem.

To keep gaming under control, try these tips for adults and kids alike:

Set time limits for play. In many cases, you can limit the use times in apps.

Keep gaming devices out of the bedroom. That will help you stop playing at night. 

Do other activities every day. Include some exercise. This will lower the health risks of sitting and playing for long stretches of time.

No one knows whether certain kinds of games are more likely to lead to problem gaming. For the time being, make sure that your child is only playing games rated for their age.

The American Academy of Pediatrics also has these tips for parents:

Have a family media plan. Set rules for how much screen time is allowed and what it’s used for — including homework, having fun, and playing with friends.

Pay attention. Know what games and apps your child uses and guide their use.

Encourage gaming in common areas. While teens may resist, try to keep an eye on their gameplay. 

Play video games with them. You can learn more about the games they like and set a good example by sticking to time limits yourself.

Focus on non-video, real-world games for younger children. Traditional play helps them connect with other people and build other skills. Think toys, books, and crayons.

Like drugs and alcohol, video games can become an addiction you can’t control, despite their harmful effects. It can harm your health, relationships, and career or school. It affects adults more than teens or children. Only a small percentage of video game players are addicted. You may have a higher risk for this addiction if you have anxiety or low self-control. It can be linked to certain mental health conditions. Treatment includes psychotherapy provided by a mental health professional.