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Dear Dr. Mark,

I was recently having a conversation with my brother about a video game we both love. He told me he was trying to stop playing because he was worried he was addicted due to a recent conversation he’d had with a friend’s mother who is “studying addiction” in college.

My concern isn’t really whether or not my brother’s addicted (from what I can tell he’s perfectly healthy), but the conversation did start me wondering about what videogame addiction looks like, and whether any serious gamer might be labeled as addicted.

Is videogame addiction real, or is it simply a sensationalized stereotype for TV news shows? I have a friend who games at least five hours per day, but he’s got a perfectly healthy social/family life, plays sports and what have you. Would you call that healthy enthusiasm or dangerous addiction?

As I wrote in my first column, I am suspicious about calling habitual, compulsive behavior addiction. As I explored the question more deeply, I became more convinced that difficulty engaging in any activity in a controlled way, despite significant negative consequences, can be thought of as addiction. I even think it is possible that such strong behavioral tendencies, and the kinds of stimulation they provide, may well affect neurophysiological pathways in a fashion that mimics substance abuse.

My own experience tells me that certain gaming experiences have a strong pull and create a kind of craving–for enjoyment, stimulation, excitement, interpersonal engagement, challenge, progress, victory, or simply just making mayhem–and that these cravings can be extremely hard to control. Call that addiction, habit, hobby, or whatever else you like–for me the question is, what ensues? Serious detrimental consequences mean problematic, potentially addicted gaming.

What does this look like? In my experience, it isn’t very pretty. Game play comes to fill most free moments in a person’s day and eventually edges out other obligations, activities, and even relationships.

Students understandably find gaming more interesting than school work, so it doesn’t get done, which can lead to poor grades, diminished learning, and even failing out of school. With their minds on gaming, many bright students drift through school in a kind of detached fog. They may barely graduate, but have they really learned what they need to know to cope with the next steps in their lives? Some go on to crash at college, where every dorm room has a Playstation, Xbox, computer, or all three, and gaming is everywhere at all hours.

Family relationships are ignored or neglected, which can create tremendous conflicts at home. The fight between parents and children about how much gaming is enough, which goes on in many households, becomes relentless and in some cases even violent. I have seen these struggles lead to psychiatric hospitalization, police involvement, and even removal of family members from their homes.

Romantic relationships may become secondary to gaming. Marriages can be damaged and even lost when a partner’s libidinal energy becomes invested in a game and is withdrawn from the relationship, leaving an empty husk, with chronic loneliness and despair the result for the non-gaming partner, and for the gamer, when the relationship understandably comes to an end.

For gamers in the work force, there is the potential for unreliable attendance and performance (also characteristic of employees with substance abuse issues, by the way). Problem gamers may have trouble obtaining and holding onto gainful employment, already challenging enough in today’s economy.

Health issues can also emerge around problem gaming. These can include nutrition, exercise, and most especially, sleep. High school teachers can often identify the most ardent gamers by looking at who is sleeping during class each morning–but lack of exercise and eating poorly can also become serious concerns.

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As I have noted before, today’s video games are incredibly psychoactive–they can really get into players’ heads–and that’s what many of us find so intriguing about them. In problem gaming, this can involve a relentless, obsessive pre-occupation with the game and its images, so that they populate the mind in almost every waking moment and even sleep through dreams. This can become part of an addictive cycle if it interferes significantly with other mental activity.

The problem gamers I have known often evidence a profound loss of perspective about their hobby and its consequences. Feedback that gaming may be self-destructive for them is ignored or rebutted. They imagine that some real world benefit will result from their devotion to the habit (most common example: I’ll get so good at a game that I’ll win big money on the pro tour or be able to put my accomplishments on a resume and surely get hired by a gaming company). Real-life failures don’t seem to help them clearly assess the impact of their habit. Another way to think of this is that they will protect the habit–and the wonderful experiences and feelings they have when they play, from any threat or risk–even if this leads to deterioration of basic life structures. After all, it’s hard to game if you don’t have a place to live, electricity, food, and money for gaming. But some try.

To me a very interesting question is why some people get addicted to gaming and others don’t when the game and level of activity may be the same. Do some of us simply have “addictive personalities,” or are there issues and problems in living that we are fleeing when we lose ourselves in gaming in an extreme way? Does all the technology that young children are exposed to today somehow prime them for this kind of problem? We don’t know the answers to these questions but I think they are worth asking.

As I have stated often in this column, I do believe that many devoted gamers are able to achieve a balance between gaming and the rest of their lives, so I don’t believe that intensive gaming is necessarily problem gaming or gaming addiction. I’m also fascinated by the many ways gamers get legitimate and important psychological needs met through this hobby. For some it becomes a way to develop and sustain key relationships that might never have emerged without gaming. For others, it can be a way to tolerate physical and psychological pain. Or perhaps gaming is a new mode of learning, interaction, and problem solving that is becoming a norm for today’s generation–as poorly understood as it continues to be by elders.

I think it’s impossible to say someone’s gaming habit is addictive based on how many hours per day they devote to it. Your brother may be the kind of super-organized person who can game five or six hours a day and still attend to other basic human needs and life obligations. If so, it’s not for me or anyone’s mother to insist they must have a problem.

So, in answer to your question, I do think problematic, potentially addictive videogaming is a reality, but definitely not the only reality. My hope is that we can look at our behavior and its consequences and develop the perspective and motivation to keep it in balance.

Dr. Mark Kline wants to know what a blu ray player is and why they spell blu without the “e”. Will this affect blu cheese in any way? Have a question for Dr. Mark? Send it to [email protected]. Your identity will remain confidential.

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