I grew up with video games and have followed their technological development over the years. As such, video games have been and have been a huge part of my life to this day. These games are a source of entertainment and relaxation, and can even provide opportunities for social interaction and connection. They can help improve a person's cognitive skills, creativity, communication, and reflexes. Many people use them as a healthy coping mechanism for decompression.
On the other hand, there is growing concern about the potential negative mental health consequences associated with playing video games. Some of these concerns include gambling addiction, negative coping mechanisms, unhealthy lifestyle, loneliness and isolation, depression, and even suicidal ideation.
As someone who still plays video games, I have met an alarming number of people struggling with these concerns. In many cases, these people do not have a support system or do not know how (or when) to seek professional help. My concern is that many counselors are unaware of the devastating effects gambling can have on a person's life – just like any form of addiction.
The development of gaming
As a gamer, I have always been fascinated by what makes people play games and how games influence and influence people, from their thoughts to their worldviews and their social identity. It begs a question: How does playing a game give meaning to life?
Playing a game is not just playing a game. A lot happens in the player's mind while playing, which is often a hidden meaning behind game interactions. As the world around technology evolves and evolves, video games will evolve and evolve too. Video game addiction has increased alarmingly in recent years, and this trend is likely to continue. For this reason, concerns about video game addiction and the gaming population are growing in the psychiatric community.
Video games have been around for decades, and over time their popularity has grown exponentially, as has the size of the gaming community. In 2020, it was estimated that more than 2 billion people around the world played video games. In the United States alone, 160 million Americans play online games every day, making the game industry worth over $ 90 billion.
Video games have evolved into esports and are widely recognized as an electronic but real sport. Both share many of the same competitive principles, including professional players, recognized teams and a huge fan base. The stadiums fill with fans as professional esports teams compete against each other and compete for prizes of over $ 1 million. In 2017, more than 250 million online viewers watched popular online games such as League of Legends and Overwatch and generated $ 756 million in revenue that year (see Internet Gaming Disorder: Theory, Assessment, Treatment and Prevention by Daniel L. King and Paul H. Delfabbro).
Also, many video gamers make a living playing games by streaming them to thousands of viewers on online platforms such as Twitch. As the video game industry developed, it has and will continue to gain popularity.
Effects on mental health
As video games have grown in popularity and the gaming community has expanded, certain negative consequences and mental health effects have become more apparent. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), internet gaming disorder was added to the section that recommended conditions for further investigation. Gaming disorder was defined in the 11th revision of the International Classification of Diseases (ICD-11) as “a pattern of gaming behavior (digital gaming or video gaming) characterized by limited control over gaming, with gaming becoming an increasing priority to other activities as long as gambling has priority over other interests and everyday activities and the continuation or escalation of gambling despite the occurrence of negative consequences. "
Internet gaming disorder was not classified as a unique mental disorder in DSM-5 due to a lack of research in the area and debates about behavioral addiction recognition, but I believe recognition could help millions in need. At the same time, the opposing side argues that the inclusion of Internet gaming disruptions in the DSM-5 would only create unnecessary concerns and would lead to the stigmatization of such behavior.
In the meantime, gaming disorder is recognized by the DSM-5 as a form of behavioral addiction and has many similar characteristics to gaming disorder. So I ask why is this problem being ignored? Countries like South Korea and China, in which the incidence of gambling addiction is very high, have already recognized this as a serious illness and developed treatment programs.
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Factors that can lead to addiction
Video games are a fun activity for many people, in large part because of the positive reinforcement that players receive for the fractions of a second they encounter while playing the games. From clicking a mouse button or a controller to moving a character, from killing the enemy to leveling up, games offer their players constant and instant feedback.
Games also contain online environments where real-time players can connect with other players or join a guild. This gives the players a social identity and can instill a sense of self-worth. Many players experience a sense of purpose in the game because they are constantly confronted with goals that need to be achieved or overcome.
In addition, massively multiplayer online role-playing games (MMORPGs) offer players endless possibilities, scenarios and results from quests, intense guild battles, endless levels and intense competition to be the strongest player on the server. But such games motivate players to spend long hours playing a never-ending game, potentially leading to poor sleeping habits, poor diet, isolation from others and the real world, and addiction.
Perhaps the most important factor leading to video game addiction is the increased dopamine levels experienced during gaming. This is where the concern arises as it can lead to inappropriate behavior, unhealthy coping mechanisms, and potentially addiction. Given the constant feeling of reward for game decisions and the often endless levels or possible outcomes in a game environment, gaming can be addicting. It can end up serving as an alternate reality and escape from real life because the game gives the player a "better" version of it.
According to DSM-5, the presence of five or more of the following symptoms over a period of 12 months characterizes such behavior as worrying and maladaptive. These nine symptoms include:
1) Occupation with internet games
2) Withdrawal symptoms such as irritability, fear and sadness
3) Tolerance or the need to increase the time when playing
4) Unsuccessful attempts to stop gambling
5) Loss of interest in other activities
6) Psychosocial problems caused by excessive gambling
7) Deceiving family members, therapists or others about the time they spend playing games
8) Use of internet games to escape or alleviate negative moods
9) Endangerment or loss of an important relationship, training, job or career opportunity due to online games
Three stages
The process of gambling addiction takes place in three stages. In level one, the game is actively played for fun. In the second phase, games are no longer fun, but the individual still spends many hours eliminating negative emotions such as stress, sadness, and worry. At level three, the game is no longer fun and no longer removes negative emotions.
During the third stage, a constant and sustained high level of dopamine release leads to a biological dependency, which leads to a state of dopamine exhaustion. When dopamine depletion is reached, not only do games lose their potential for fun and enjoyment, but other areas and activities as well. In this phase, people often feel apathetic, directionless and meaningless in life. We can compare this development with alcoholism, in which the effect of alcohol decreases over time and more alcohol is required to achieve the same effect.
Treatments and theoretical approaches
An effective way to restore normal function, regulate dopamine levels and improve quality of life is to simply take a break from playing. During this time, which can be three weeks to two months, addicts are encouraged to try other interesting activities and hobbies as alternatives to gambling while dopamine levels are reset.
What sets gambling apart from other addictions is that addictions do not require you to give up gambling forever. Instead, recovery focuses on learning to control the time spent playing. Strategies such as creating a schedule that integrates healthy gaming habits into a routine while prioritizing other aspects of life have proven effective.
Much research on video game addiction is still needed to address the most efficient treatments and theoretical approaches to work with this population. When considering intervention strategies in counseling for gambling addiction, it is important to remember that no one-size-fits-all approach will work. What works well for one person may not work well for another. No single treatment has proven to be superior or most effective. According to King and Delfabbro, cognitive behavioral therapy is the standard approach for many professionals.
Professionals have also achieved positive results in treating video game addiction with narrative therapy, particularly in children and adolescents. As Alice Morgan in the book What Is Narrative Therapy? An easy to understand introduction, such therapy is effective because it “sees problems as separate from people and assumes that people have many skills, competencies, beliefs, values, commitments, and abilities that help them control the impact of problems on their lives. "Narrative therapy can address strengths that include success in a game, such as being among the top players or leading the team to victory. It examines these strengths and skills further by applying them to real-world scenarios It is just as important to assess the degree of addiction as easy, moderate or difficult by analyzing the severity of the symptoms and the negative effects of gambling behavior.
It is important to build trust and relationship during the first few sessions. An effective way to build rapport and trust with such clients, especially those who are resistant, is to mindfully disclose any video game experience the counselor has. Consultant and client can find common ground through such common interests and experiences. Unlike substance abuse and alcohol addiction, often the ultimate goal in gambling addiction is not to eliminate gambling once and for all, but rather to effectively control and reduce the time spent playing video games. The aim is to normalize behavior that does not negatively influence or influence other areas of life and general physical and mental health.
As we rapidly penetrate technological and online environments in many aspects of our daily lives, video games will continue to evolve exponentially and the growth of the gaming communities will follow. Mental health problems are also on the rise among this growing group of diverse players. Using games as a coping strategy for other underlying problems can lead to addiction as real life is replaced with a virtual and cheaper one. Research in this area will continue to evolve, as will the emphasis on this topic and the population by mental health professionals. In order to promote mental health and well-being, a greater awareness of Internet gaming disorders and the struggles of this population group is required.
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Doyle L. Raymer Jr. is a student in mental health counseling at Walden University. As a gamer himself, he has a deep interest in internet gambling addiction. It is his deep desire to work and create awareness to improve the overall mental health of members of the gaming community. Contact him at [email protected].
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Opinions and statements in articles appearing on CT Online should not be construed as the opinions of the editors or guidelines of the American Counseling Association.
