In June this year the World Health Organisation (WHO) announced that obsessive digital gaming can be considered a mental health disorder.
‘Digital addiction’ as a mental health issue is an idea that has gained currency over the past decade. While mental health issues can indeed cause obsessive-compulsive behaviours in relation to any activity including use of the internet, it is worth asking if it is always a mental health issue, or if we need to be careful not to jump too quickly to a self-analysis.
The WHO’s criteria for a person to be diagnosed as suffering from a gaming disorder includes impairment to everyday activities, disruption of work, school, education or family life, an ongoing preoccupation with games, risk to relationships and withdrawal symptoms when not gaming.
Although based on research in psychology and psychiatry, I feel the decision to include digital gaming as a disorder may be premature. The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) noted in 2013 that while compulsive online gaming might be a disorder, more research was required before it can be considered a disorder.
There is a long tradition of anti-gaming thought that leads to this decision, although it is a narrow one that tends to view most digital and online activity as risky, rather than creative; as problematic rather than relaxing; and as individualising rather than as social. An avid, long-term player of World of Warcraft or Final Fantasy games, for example, will know that playing is not a solo activity, but one firmly grounded in online and offline friendships. If looked at from the perspective of networks of friends, online gaming may be more akin to TV fandom than to a disorder.
Equating gaming and drug addiction or substance abuse has played a powerful role in giving the impression that online gaming is a risky or dangerous mental health problem.
Does gaming work in the same way as addictive substances such as heroin, crystal methamphetamine or cocaine, where regular and increasing use will likely lead to an addiction? Not really.
Injecting or ingesting a substance that alters mood can damage the body’s dopamine receptions, such that to feel the same mood again one requires more of the substance. While the adrenalin of online gaming can adjust a mood, it does not have the same damaging effect on the body’s physiology and does not produce physiologica addiction in the same way.
While the WHO decision to include problem gaming as an addictive disorder is important and useful for early intervention in cases where gaming has genuinely become problematic (and where it is most often a symptom - not a cause - of pre-existing mental health issues), it has its pitfalls. These include wrongful amateur diagnosis, particularly by parents, teachers, friends and young people themselves.
More than a decade ago, I took a social sciences approach to understanding digital addiction in the language of games studies and everyday avid users. There is no new evidence to suggest we should step towards seeing gaming as addictive.
Key, here, was understanding that stereotypes of gamers are common, and one of those stereotypes is that game players are prone to addiction.
Taken from an alternative perspective, there is a risk that parents, teachers, friends and others can apply that stereotype to encourage gamers to believe they have a mental disorder when the reality is they feel compelled to play games for other reasons.
Some of those reasons include:
― The goal orientation of gaming: most digital games are goal-oriented, compelling a person to continue playing towards that goal in much the way a career-focused individual might spend many hours working late to achieve a career goal. The difference is that gamers are seen as youth-like (and therefore at risk) while career-oriented folk are viewed as adults (and therefore self-managing).
― Real versus digital worlds: Separating ‘real worlds’ from ‘virtual worlds’ was meaningful in the 1990s when most online activity was text-based. Today, in a world of online visual representation and social networking it has much less bearing. However, it continues to be used wrongfully to differentiate gaming (non-real) from, say, reading a book (real). This is the product of nostalgia rather than understanding what motivates activities in moderation.
So while the WHO view that compulsive gaming can be diagnosed as a mental health issue is undoubtedly true in some cases, there is a genuine need for gamers, their families, friends, educators and other professionals to exercise caution in understanding why they might be gaming for very long hours across long periods of time before labelling it an addiction.