Gaming has become more prevalent with the rise of easily accessible and portable devices that can be used to game. I have noticed that as gaming has become more popular, parental concern about video game addiction has increased. According to the Pew Research Center, 97% of teen boys reported playing video games using a gaming console, phone, or computer. Although teen boys tend to game more frequently than teen girls, 83% of teen girls reported playing video games on a device. It seems that most teens that game, 41% of teen boys and 42% of teen girls, feel that they spend the “right amount of time” gaming. What is the “right amount” of time? I would say that a “right amount” means that a teen plays enough to enjoy the game, but not so much that their gaming interferes with their life.
While gaming can be problematic for some, it can be a positive hobby for others. Gaming can be a way for teens to connect socially, to relax for a few minutes, or to explore interests. Some introverted teens that have trouble making friends can find a social community through playing video games. For those teens, talking while playing video games can let them connect with other people and practice their social skills in a relatively low-stakes way. Also, gaming is not always a solitary activity. I have frequently seen groups of teenagers sitting together bonding over a game. In addition to being a social activity for some, gaming can also provide a means of escape and stress relief.
Although the majority of teen gamers do not seem to have a problem with overuse, 41% of teen boys reported spending too much time gaming compared with 11% of teen girls. It is important to note that although spending a lot of time gaming can be concerning, that symptom alone does not mean that the teenager has an addiction to gaming. Parents often ask me what they should know and whether they should be concerned about their teen’s gaming habits. My answer to that is often long and somewhat complicated because the truth is that there is no one size fits all solution. Below is the information that I usually share with parents to help them decide what is concerning, what behavior indicates that gaming could progress into a problem, and what is healthy for this generation of teenagers.
Is Video Game Addiction an Official Diagnosis?
- Currently, we do not have a consensus among professionals regarding video game addiction.
- In 2018, The World Health Organization officially included Gaming Disorder in its list of mental health conditions. The criteria are, “impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences” over 12 months.
- The American Psychiatric Association is still in the process of conducting research and reviewing data to determine whether Internet Gaming Disorder will become an official diagnosis in the next edition of the DSM. Currently, Internet Gaming Disorder is not a formal diagnosis. Internet Gaming Disorder is in the “Conditions for Further Study” section of the DSM V. The provisional criteria listed in the DSM are: “Preoccupation with gaming. Withdrawal symptoms when gaming is taken away or not possible. Tolerance, inability to reduce playing, giving up other activities, and continuing to game despite problems. Deceiving family members or others about the amount of time spent on gaming. Use of gaming to relieve negative moods, such as guilt or hopelessness. Risk, having jeopardized or lost a job or relationship due to gaming.”
- Unlike drug withdrawal, the withdrawal symptoms in Gaming Disorder are emotional and behavioral.
- Some of the symptoms of Gaming Disorder can look a lot like symptoms of Depression.
How Exactly Does a Behavioral (Process)Addiction Occur in The Brain?
A very simplified way of explaining how a process addiction works is that the reward pathway in the brain gets hijacked. The neurotransmitter dopamine plays a role in reward, attention, and motor control. The reward pathway in the brain is supposed to provide a reward for things that will increase your likelihood of survival (such as eating, hydrating, etc.). When you engage in those survival behaviors, your brain releases some dopamine. This process helps your brain establish a hierarchy of essential behaviors, placing the behaviors that received the dopamine reward at the top of the hierarchy. In an addiction, the hierarchy becomes messed up; The brain gives a higher dopamine reward to the addictive behavior (in this case, gaming) than it does to other behaviors. As a result, whatever someone is addicted to becomes the most significant thing to that person.
The individual that is addicted then inundates their reward pathway by continuing to engage in the behavior that releases a lot of dopamine (they game a lot). If this continues for a prolonged period of time, then the individual can develop a tolerance as the brain adjusts to the higher level of dopamine entering their brain regularly. A tolerance occurs when the brain regulates to the new level of dopamine and thus raises the threshold at which an individual will feel pleasure. Once a tolerance occurs, individuals will often increase the amount of time (and possibly the intensity) of their gaming to get the dopamine reward that they initially got. In some cases, people can become so focused on gaming that it becomes compulsive. They need to gain more and more to feel the rush of dopamine that they used to feel when they started gaming. I want to note that this is almost always not done on a conscious level. I don’t imagine that teenagers are sitting around thinking, “Before, I felt good after I gamed for one hour, but I am not feeling the same dopamine rush anymore. I am going to game for longer so that I will feel good.”
Teenagers can become addicted faster than adults
It is important to note that it is easier, and it takes less time for teenagers to become addicted. Why? Two main culprits are the prefrontal cortex and the rate at which teenagers can learn. The prefrontal cortex, which is responsible for impulse control and planning, is not fully formed until the brain finishes developing at the age of 25. As a result, teenagers may act impulsively and take more risks than they might as an adult. Also, teenagers can become addicted faster than adults due to the faster rate at which they learn. During the teenage years, the brain learns more quickly than an adult brain because it can form strong connections between brain cells at a faster rate.
What Might a Gaming Addiction Look Like?
About a year ago, I saw a clip of a news anchor standing in front of an overturned vehicle interviewing a teenager about the tornado that ravaged his neighborhood. What struck me was the young man’s account of the tornado. He reported that he was playing Fortnite when he saw roofs coming off of the houses in front of him, but he sat back down and continued playing his game. He explained that he only had a few people left in his game, and he wanted to finish his game. He continued playing his game as the storm got worse until he saw power lines coming down. Luckily, he finally decided to go into the bathroom for safety. The news anchor asked him what was going through his mind as he was in the bathroom, and he responded that he was thinking about the game (Fortnite).
I do not know this young man so I cannot say for sure whether he does or does not have an addiction. However, the fact that he prioritized playing Fortnite over his safety during a tornado is a serious red flag that gaming is more than a hobby. While it is good that he eventually moved to a safer location, his focus remained on Fortnite. In a healthy reward pathway, basic survival should always be more important than a video game.
A high school noticed that teenagers were playing Fortnite on their laptops during the school day. To encourage students to focus on academics while at school, they blocked Fortnite on the server so that students could no longer access the game at school on the school’s network. Many students were upset about this, but they could understand why the school made this decision, and they were able to move on and focus on something else. However, some students were not able to tolerate being unable to game all day. They were visibly upset, frustrated, and angry. Some teens took one step farther and set out to find ways to circumvent the restrictions by using a hotspot, a VPN, or accessing the game through Tor.
In this situation, there were several red flags. First, it was a big red flag that they were not able to cope with having a video game taken away at school. Second, it was a red flag that they were willing to risk getting in trouble by continuing to game at school. Third, their behavior demonstrated that they were not able to shift their attention to a different activity. Fourth, the effort to circumvent the rules indicates that they were willing to be dishonest about their gaming.
Parents often ask me for specific examples of things they should be looking for so they can catch a potential gaming issue before it becomes an addiction. While the signs below can be indicative of gaming addiction, they can also be indicative of another mental health issue. Regardless, if a teenager is displaying the warning signs below, it is a good idea to get professional help.
- One of the most significant indicators of an addiction to video games is the teen’s reaction when someone takes the game away. It is normal for teens to be annoyed and a little moody. It is also normal for teenagers to ask if they can play a little bit longer or to make a snide comment before putting the game away. It is NOT normal for a teenager to become intensely angry, to become physically aggressive, or to be unable to move on from having the game taken away.
- If you notice that your teen seems depressed or anxious when separated from the game, that is a concern. In some cases, individuals have a hard time thinking of anything other than their game and feel very anxious when they are not playing.
- If your teenager is either not able to sleep or is not sleeping enough because they are staying up to game, that is a concern. It is important to note that a gaming-related sleep issue is not always indicative of an addiction. In many cases, individuals that spend a lot of time in front of screens have problems sleeping because the blue light in screens inhibits melatonin production. This, in turn, can change their circadian rhythm and shift their sleep cycle.
- Another indication of a problem is isolating from friends and family members. It is concerning when a teenager starts to only connect with people online and are no longer connecting with the people around them.
- It can be a huge red flag when a teenager wants to spend the majority of their time playing, talking about, watching videos about, or thinking about video games. While this could be indicative of tolerance, this symptom alone does not mean that there is an addiction.
- Prioritizing gaming use over responsibilities and other previously enjoyed activities. If someone used to like sports or to hang out with friends and now they only want to focus on gaming, that is a red flag.
- Deceit about gaming is another huge red flag that an addiction is forming. Lying can be a sign that the teen knows that other people would probably be concerned if they knew how much they were gaming. Dishonesty can also be a sign that they are not able to control their gaming.
- If someone is so caught up with gaming that they are no longer attending to basic hygiene, then the chances are that they have a problem.
- While some teenagers may have a decline in academic performance, this is not a symptom that all will have.
- Lastly, if the teenager is suddenly not able to keep up with their regular daily life tasks, that is concerning.
What Should You Do if Your Teenager Has a Gaming Problem?
If removing the gaming device solves the problem, then the teen does not have a gaming addiction, they just game a lot.
Sometimes parents, incorrectly, believe that if they remove the device, their teenager will no longer have a gaming addiction. However, if removing the gaming device solves the problem, then the teen does not have a gaming addiction, they just game a lot. For individuals that genuinely have a gaming addiction, it is not enough to remove the gaming device. Think of someone with an addiction to alcohol- does merely eliminating alcohol from their presence solve their problem? No! While removing alcohol is helpful because the temptation is no longer present, the urge to drink will still be there. The same is true of someone with a gaming addiction. Removing the gaming devices is very helpful, but that alone will not solve the problem. In this day and age, it is unrealistic to think that your teenager will be able to avoid all tempting gaming devices forever. It might help to think of a recovering gaming addict like an individual recovering from an alcohol addiction working as a bartender or waitress. Sure, it is possible to abstain, but they will most likely come face to face with temptation several times a day every day.
When I was in graduate school, I did my internship at a substance abuse treatment facility. One of the questions that we asked all patients during the intake process was, “What is the appeal of substances for you?” Why did we ask that question? We asked because it is nearly impossible to treat addiction without understanding what needs their addiction fulfills. Once a therapist has that information, they can help the addicted individual develop specific healthy coping strategies that can satisfy the need that the addiction was meeting. Yes, addiction is a chemical process in the brain, but addictions also usually serve another purpose for individuals. For real recovery to occur, an individual needs access to comprehensive treatment that will focus on getting to the root of why excessive gaming is happening in addition to removing temptation.
Below is a list of potential areas a therapist might explore to determine what need gaming is meeting:
- Is gaming a means to escape? Is the individual overwhelmed or unhappy in life and gaming is their only way of checking out? Are they stressed and they do not have any other coping strategies, so they use gaming to either hide from or to cope with life stressors?
- Is the individual depressed or anxious? Do they feel unable to control their moods and gaming gives them the feeling of being in control? Are they able to focus on gaming and thus distract themselves from their negative thoughts?
- Is it an identity issue? Are they trying to explore their identity and gaming offers them the opportunity to try out different identities in a safe environment?
- Is the individual struggling with social anxiety and gaming/ being online is their way of engaging with other people in a way that feels safe?
Once someone figures out what purpose gaming are serving for them, they can then have treatment for that underlying issue. This will allow them to work on developing specific coping strategies to fulfill the need that gaming was previously fulfilling. Once that occurs, the individual is much more likely to be successful in their recovery.
Do not wait until your teenager has a problem with gaming to start setting limits!
The easiest way to manage a gaming addiction is to prevent gaming addiction from developing by teaching them about balance. Sure, being proactive will not stop everyone from developing an addiction, but it can reduce the likelihood. Why? Because if you can teach your teenagers how to have appropriate limits when it comes to game and general technology use. The more they practice having limits, the higher the chance that those limits will turn into habits.
Be proactive, do not wait until your teenager has a problem with gaming to start setting limits! I strongly recommend that parents have at least one (ideally more than one) talk about appropriate technology use. Here are some tips to help parents have a technology talk with their teenager(s).
- Avoid a power struggle with your teen by having a collaborative conversation. Teenagers are much more likely to adhere to your guidelines if they had a say in establishing the rules. Also, this is an excellent opportunity for you to help them practice setting reasonable limits. If all goes according to plan, within the next few years, they will be out of your house on their own, and they will have to negotiate setting limits by themselves. This self-limit setting will be much easier for them in the future if they practiced before being out on their own.
- Keep in mind, approaching the conversation from a “my way or the highway” stance will likely cause a power struggle. You want to work WITH your teen to set these rules. Of course, parents as the adults have an ultimate say, but it will be a MUCH easier conversation if teens are involved in negotiating the boundaries.
- Teenagers are much more likely to live up to your expectations when they completely understand what you expect. Establish clear expectations and boundaries for screentime use. These boundaries should include specifics around how long at one time, how many hours total, when, and where they can game. For example: Are teens allowed to come home from school and game for a few hours before they start their homework? Do you want them to finish their homework and chores before they start gaming? If they have a free period at school or a study hall, are you okay with them gaming during that time? Are they allowed to spend more time gaming during breaks from school then they are during the school year?
- Make sure to discuss and set clear expectations about what types of games are acceptable and which are not. Be clear!
- When setting boundaries around screen time, explain your reasoning behind your limitations. I strongly recommend doing your research before this point in the conversation. Common Sense Media provides a lot of great information about Apps and games. Here is an example of something you can say when explaining why you do not want your teen to play a game. “I know that you want to play this game, but I did a little research. After looking into it, I am not comfortable with you playing Grand Theft Auto because the game has a lot of violence, nudity, and substance abuse. We can talk about this game again in the future if you are still interested; However, right now, it is not something that I am comfortable with.”
- Gaming is something that should happen during downtime. Gaming should not take the place of responsibilities like homework and chores.
- Make sure that gaming does not keep your teen up at night by establishing a family hub for laptops, tablets, and phones at night. If your teen has a TV in their bedroom, make sure that their gaming console is NOT attached to the TV in the bedroom. I have seen some parents take the gaming console cords at night to ensure that their teen can only play the game when they have permission. This step is not necessary unless you are worried that there is a problem.
- If the conversation gets heated, take a break, and return to the conversation when both sides (parents and teen) can have a calm discussion.
- Consider creating a family contract that both parents and teens can refer back to and amend as needed.
- Good luck!