Video Games, Mental Health, and Addiction – The Good, The Bad, and The Ugly

It seems that every year video gaming becomes increasingly popular, with an estimated 3.2 billion video gamers reported worldwide in 2021.  Contrary to popular belief, the bulk of gamers are not children and adolescents, the average gamer is actually 33 years-old.  Also contrary to popular belief, gaming can be surprisingly good for psychological wellbeing despite the negative stigma associated with gaming.  However, there are caveats to this as a growing body of research in the field of mental health and video game addiction demonstrates.

The Good – Are Video Games Good For Mental Health?

There is a growing body of research that reflects the benefits of gaming including but not limited to socialization, improvement in focus, multitasking, working memory, cognition, and emotional regulation, among other benefits.  Gaming has even been found to be beneficial for mental health.  A 2021 study published in the journal JMIR Serious Games found that there may be mental health benefits to playing video games that address symptoms of depression and anxiety.  Researchers of this study concluded that video games can serve as a promising resource to mitigate depressive and anxiolytic symptoms in the absence of, or in addition to, traditional therapy.

Specifically, in relation to depression, studies have shown that moderate use of games such as Candy Crush, Angry Birds, and Limbo among others can improve mood by decreasing negative affect and promoting enjoyment, a flow state, and motivation.  With respect to anxiety, moderate use of games such as Mindlight, Max and the Magic Maker, and Rayman among others can significantly decrease anxiety.  Note the wordmoderate,” we’ll come back to that later.  Early research has also shown promise with some virtual reality games to help reduce mental health symptoms as well.

A more recent 2022 study conducted by the University of Oxford found that gaming does not have a significant impact on mental wellbeing, positive or negative.  Data from this study suggests that the amount of time spent gaming has a negligible effect on mental health, and that only when participants of the study played 10-hours or more than they typically would in a day were there noticeable negative changes to their mental health.

There are other studies that show mental health benefits of gaming, or at the very most a negligible effect. Despite such findings, more research is needed.  Studies such as the ones noted above may be limited in important aspects such as having a representative population, pre-existing mental health conditions among participants, and the types of games being used in the studies among other factors.  Furthermore, such studies may have a bias in that individuals who do experience mental health issues from gaming may be less likely to participate in such research studies or provide honest feedback in surveys as to how gaming impacts their mental wellbeing.

What about attention deficit/hyperactivity disorder, or commonly referred to as ADHD (formerly ADD)?  There is a common belief that video games can cause or exacerbate ADHD, but there is currently no empirical evidence that shows that video games cause ADHD.  However, it does appear that people with ADHD, especially children with ADHD, are captivated by video games.  Subsequently, many individuals who experience excessive gaming may also have ADHD, but the two issues appear to be more correlational than causational.

However, an Iowa State University Study showed that the more time children spent playing video games the more impulsive they were and the more attention problems they had.  Nonetheless, researchers interpreted these findings to suggest that video games only exacerbated pre-existing attention problems, and that the children who spent the most time playing video games already had the most severe ADHD symptoms prior to their gaming.  More recent follow-up studies have shown similar findings, and have also shown that those with ADHD may be more susceptible to developing a video game addiction. 

The Bad – Are Video Games Bad For Mental Health?

A 2019 study published in Frontiers in Psychology found that excessive video gaming coincided with mental health symptoms including depression, anxiety and hostility.  The study also found a relation between problematic gaming and maladaptive coping strategies, negative affectivity, low self-esteem, a preference for solitude, and poor school performance.  These findings are in line with other research that has shown a connection between video game addiction and poor psychological health.

The key difference in the aforementioned study and others like it that demonstrate the negative impact of video games on mental health are that these studies looked at excessive gamers, whereas other studies that found mental health benefits of gaming looked at moderate gamers.  In other words, the phrase, “everything in moderation” appears to play a role when it comes to the impact that video games have on mental health according to many studies in this space.  So, while those who engage in moderate gaming may experience mental health benefits or a negligible impact at worst, those who game excessively may experience a detriment to their mental wellbeing.  The problem arises when video games are not used in moderation and when not balanced with self-care, work, school, relationships or other important life areas.

The Ugly - Are Video Games Addictive?

Any substance or behavior that triggers the brain’s reward system by releasing neurotransmitters that induce feelings of pleasure such as dopamine has the ability to become addictive.  Playing video games are one of those activities that can be addictive and develop into a pathological dependence.

When individuals playing video games hit a new high score, beat a record time, move on to a new level, earn money or rewards, or beat an opponent the brain is stimulated and the gamer has a pleasurable experience.  Over time the gamer may become addicted to playing video games as they continue to seek out that rush of dopamine.  Research in this area has shown that approximately 3-4% of gamers are addicted to video games, and many more experience an unhealthy relationship with video games.

Video game disorders have been recognized as an addiction by a multitude of addiction specialists, researchers and psychological institutions such as the World Health Organization, but others such as the American Psychiatric Association believe that more research is needed despite proposing a clinical diagnostic standard for gaming disorder.  It is highly likely that the American Psychiatric Association will officially classify video game disorder as a mental health condition upon their next revision of their diagnostical statistical manual if research allows, just as they officially deemed gambling disorder a mental health condition in their previous fifth revision in 2013.

What exactly is video game addiction?  Video game addiction involves the persistent or recurrent pathological compulsion and obsession to engage in gaming despite negative consequences to personal and/or professional activities such as poor school or work performance, disruption to relationships, lack of sleep or personal hygiene, and other such negative consequences.  Video game addiction is sometimes referred to as internet gaming disorder, excessive gaming, problematic gaming, binge gaming, gaming dependence, or pathological gaming. 

Video game addiction goes beyond the frequency and duration of gaming.  Two people in the same household can play video games for the same amount of time every day, and one may be addicted to video games while the other may not.  The cornerstone of video game addiction includes a psychological craving to play, loss of control to abstain or moderate gaming, and continuing to play despite negative consequences that result from gaming.

Some other signs of video game addiction may include but are not limited to:

Excessive gaming can have a significant negative impact on relationships, education, career, sleep, mental and physical health, stress, maladaptive coping, and a negative impact on other important life areas.  Video game addiction has been found to be related to personality traits such as low self-esteem, low self-efficacy, attention problems, impulsivity, aggression, anxiety, and depression.  In severe albeit rare cases, gamers have actually died from gaming addiction due to excessive exhaustion, insomnia, stress, malnutrition, and dehydration that can occur from days of gaming on end.

Conclusion

All individuals are unique, and therefore every individual will have their own unique experience with gaming and the impact gaming has on their mental health.  As such, it should not be surprising that in a 2019 survey approximately 80% of gamers said that video games helped them with mental stimulation, relaxation and stress relief while other gamers said that video games contributed to or exacerbated feelings of stress, depression and anxiety.  Your current mindset and mood, the frequency, duration or intensity of your gaming, your life outside of gaming, and why you game are all factors that contribute to how video games will impact you.

Taking Care of Your Mental Health While Gaming Should Be A Priority

Regardless of what your relationship is with video games, it is always important to make mental health a priority in all aspects of life, including in gaming.  As such, be mindful of how you are feeling before, during and after playing video games.  Furthermore, it is important to take breaks from gaming, engage in physical exercise, go outside, talk with friends or family, and engage in other forms of self-care.

If gaming is being used as a means to escape, excessive in duration and frequency, contributing to negative consequences in your life, or if gaming is leading to increased mental health symptoms or dependence, then you may want to reevaluate your relationship with gaming or speak with a mental health professional or a video game addiction expert.

Because the pathogenesis for video game addiction is still being determined by researchers, there is currently an absence of standardized treatment measures for gaming disorder.  As such, video game addictions are commonly treated similarly to substance use disorders or gambling disorders utilizing psychobehavioral treatments such as Cognitive Behavioral Therapy.  There are also promising pharmological interventions that can reduce cravings to game and impulsivity to game, but more research in this area is needed.

Some suggestions to safeguard your mental health while continuing to game include but are not limited to:

If you enjoyed this article, you may also enjoy reading “The Ultimate Guide To Video Game Addiction” where you can find answers to questions such as: What is video game addiction?  Why do people become addicted to video games?  What are the signs and symptoms of video game addiction?  What is the treatment for video game addiction?  And what can family and friends do about a loved one who has a video game addiction?

For more information on video game addiction and recovery please read Family Addiction Specialist’s Digital Addiction and Gaming Recovery service page.

For more information on New York City video game addiction treatment and to find the best video game addiction counselor in NYC or near you, or for general therapy and mental health counseling, or to inquire about Family Addiction Specialist’s private concierge sober coach Manhattan, recovery coach Manhattan, sober companion Manhattan, Manhattan addiction therapy services and/or our Manhattan teletherapy services (online therapy/virtual therapy) for drug addiction, alcohol addiction, gambling addiction, sugar addiction or digital addiction and technology addiction please contact our undisclosed therapy office location in the Upper East Side of NYC today at (929) 220-2912.

Author
Lin Sternlicht & Aaron Sternlicht

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