When video games become an addiction

Gaming is an incredibly popular pastime. According to a recent study from the Entertainment Software Association ^[1], about 160 million American adults play video games. Gaming can be a source of entertainment, a temporary escape from life’s stressors, and a way to connect with others. 

Playing video games isn’t necessarily unhealthy. But it’s possible to develop a problematic relationship with it. Video game addiction can take a toll on your mental health, relationships, and functioning. In severe cases, a person may meet the criteria for internet gaming disorder ^[1] (IGD). This condition is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a condition that requires further research. 

There’s limited data on IGD. But experts estimate that it affects around 2% ^[2] of the world’s population. This is a small fraction of the people who enjoy playing video games. But if you’re having trouble controlling your gaming, know that you’re not alone. Understanding the difference between healthy and unhealthy gaming can help you know when to ask for help.

Warning signs of problematic video game habits

If you or someone who cares about you is concerned about your video game habits, that alone can be a sign that you might want to make a change. But to be diagnosed with IGD ^[3], a person must exhibit the following symptoms:

• An intense preoccupation with gaming that disrupts sleeping, eating, and personal hygiene

• Negative symptoms like anger, hostility, or irritability when they can’t game (known as withdrawal)

• Needing to game for longer periods of time to experience desired effects (known as building tolerance)

• Multiple unsuccessful attempts to stop or limit gaming

• No longer participating in activities or hobbies they used to enjoy because of gaming

• Unable to stop gaming, even when problems occur due to it

• Lying to family or friends about how much they’re gaming

• Using gaming as a way to avoid or suppress unwanted feelings like sadness or hopelessness

• Facing serious consequences like losing a job or an important relationship due to gaming

There’s no single sign that a person has a gaming addiction or IGD. But if you’re showing any of the signs or symptoms listed above, consider seeking a professional evaluation. Early detection and intervention can help ensure you get the support you need to develop a healthier relationship with video games.

What causes video game addiction?

We aren’t yet sure why some people develop a video game addiction and others don’t. 

But research suggests ^[3] that you might be more vulnerable to video game addiction if:

• You have preexisting struggles with depression, anxiety, low self-esteem, or other mental health concerns.

• You lack healthy coping skills and have developed an over-reliance on gaming as a way to escape uncomfortable emotions.

• You have trouble fitting in and making friends in the “real world,” and video games offer an alternate reality where you feel more confident and accepted.

• Your brain is wired in a way that makes dopamine-inducing experiences like gaming difficult to resist (research shows that video game addiction can cause brain changes similar to those that occur with an addiction to substances or gambling).

• You’re young, or you started gaming when you were young.  

Mental health effects of video games

Being a gamer doesn’t automatically mean that you’ll develop a mental health condition. But having an unhealthy relationship with video games can be harmful to your health and well-being. 

Studies have shown a link ^[4] between problematic gaming habits and the following concerns:

• Anxiety

• Depression

• Social phobia

• Social anxiety

• Trouble making and keeping friends

• Low self-esteem

• Sleeping disorders

• Loneliness

How to find a healthier relationship with gaming

If you don’t want to quit gaming entirely but like to get your habit under better control, you’re not alone. When it comes to gaming, like other enjoyable activities, many people struggle with moderation. 

These tips can help you set boundaries with gaming: 

• Determine your baseline. Pay attention to how much time you spend gaming per day. This will help you understand your “baseline” and set achievable goals to reduce time gaming. For example, if you’re spending six hours each day gaming, you might try to reduce that amount of time to five the next week. A slow, gradual change is often easier to maintain.

• Set a timer. You probably know what it feels like to get absorbed in a game and lose track of time. People who struggle with video game addiction often game for longer than intended. So the next time you pick up a controller or sit down at your computer, set a timer to remind yourself to take breaks every so often. Get up, stretch, move around, and eat a snack.

• Mindfulness. During your game play, check in with yourself. Are you getting tired, hungry, or less interested in the game? Sometimes, we can get sucked into the games and not realize how we’re actually feeling. The more you practice self awareness during game play, the more control you have to reduce gaming and take breaks as you need them. 

• Experiment with other activities. If gaming is your go-to for fun, connecting with others, or resolving stress, it makes sense that it would be important to you. To change your gaming behavior, you need to find other healthy activities that can help you achieve those goals. Think about other pastimes that make you feel good. Having a longer list of healthy coping strategies can help you become less reliant on gaming.

Treatment for internet gaming disorder

Talk therapy is considered the most effective form of care ^[5] for behavioral addictions like IGD. 

If you’re struggling with your relationship with video games, you may benefit from:

• Individual therapy: Cognitive behavioral therapy (CBT) is frequently used to treat IGD. It helps people interrupt unhelpful thought and behavior patterns and replace them with healthier ones.

• Group therapy: Since IGD often accompanies social challenges, it may be helpful to connect with other gamers via group therapy. Being around others who understand what you’re going through and who are working to make a positive change can be a healing experience.

• Family or couples therapy: When someone develops an unhealthy relationship with gaming, it can take a toll on their loved ones. Attending therapy as a family can be a way to repair relationships, improve problem-solving, and strengthen communication skills.

Clinician’s take

Focusing only on screen time limits is often unhelpful because it treats the behavior instead of the underlying need. Real change usually comes from addressing purpose, emotional regulation, relationships, and creating meaningful alternatives that meet those same needs in healthier ways.

Ashley Ayala, LMFT

Clinical reviewer