In the 11th revision of the International Classification of Diseases in September 2018, the World Health Organization (WHO) defined "gaming disorder." Many news outlets expressed concern over the looming danger video games possess in the form of a new diagnosable disease. Others suggested that a lack of discernible evidence compared to other addictions indicates that the addiction to video games may be a symptom of mental illness rather than a mental illness itself. Some play video games to escape to unimaginable worlds, but the case for video games to positively help those with mental illness is beginning to take shape.
In some cases, long term progression is most easily accomplished through a balancing act of various methods, whether it be some form of psychotherapy, medication, or a variety of healthy coping mechanisms. While perhaps not as effective as psychotherapy or medication in an extreme case, healthy coping mechanisms can significantly improve mood and overall well-being if used effectively. Some traditional examples include exercise, volunteering, trying out a new hobby, or improving an existing one. Various forms of entertainment, explicitly playing video games, are often viewed as satisfying in the short term, but run the risk of becoming a source of dependency.
That being said, there may be a chance for video games to be used effectively by those who suffer from various mental illnesses, specifically depression. Addictions come in multiple forms, and the dangers of such should be apparent, but if the public eye can try to understand the core motivational factors of why people play video games, a new perspective of why and how games are played can be found. Instead of using video games as a means of escape, using video games to focus on improving real-life skills may be able to provide more substantial and long-term improvement. It could even be considered a healthy coping mechanism if used correctly.
So what is this "Gaming Disorder"?
The WHO defines gaming disorder as "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." This compulsion to play video games takes over other interests and daily activities. Drastic changes to sleep patterns, eating, and bathing are also symptoms, along with withdrawal-like effects. The WHO says that if significant destructive behavior comes as a result of obsessive video gameplay for at least 12 months, a diagnosis can be made.
While that sounds terrifying, the WHO claims that a tiny population of the video game community is affected. Despite this, it is encouraged to be aware of the time one spends playing video games and its impact on other areas of one's life. Not everyone who plays video games loses their lives to it, but some may find it difficult not to express at least some of the symptoms shown. Most won't have to worry about losing their job because of a late-night spent trying to finish Red Dead Redemption 2's epilogue, but these symptoms can often happen on a smaller scale. The behaviors above are also signs of maladaptive coping mechanisms. Social isolation and overindulgence are overlapping factors between the WHO's gaming disorder and unhealthy coping mechanisms.
Well, why do people even play video games?
If video games are ever to be used as effective coping mechanisms, it is essential to acknowledge the potential dangers and understand why they exist in the first place.
Everyone has their reasons for playing video games, but actual gray matter activity may provide some more insight. More overt symptoms of depression include pessimism, apathy, and insomnia, with more subtle symptoms, including difficulty with decision making, remembering details, and planning and setting priorities. In 2008, Thomas Frodl conducted a study over three years focused on the differences in the brains of patients with and without depression. Frodl found that compared to the healthy group, those with depression show a significant decline in gray matter density in the hippocampus (the brain's memory core), the anterior cingulum (problem-solving station), the amygdala (the brain's fear center), and areas of the prefrontal cortex (planning and setting priorities). Mainly, depression causes portions of the brain to shrink over time due to under-stimulation, similar to muscle atrophy.
Over the years, researchers have found that the interactive aspect of video games creates a positive-feedback loop rooted in the reward-related neural circuits of the brain. The WHO's gaming disorder and behaviors similar to that come into play when this positive-feedback loop is applied to overindulgence and addiction. The more people wish to escape from their problems; the more time is spent playing video games. More time spent playing video games means less time spent making an effort attempting to solve any real-life obstacles. When the areas of the brain that control priority setting and decision making are altered, escapism can lead to more potential problems.
The goods news is that this idea of a positive-feedback loop can be used to take a more in-depth look at the reasons why people play video games. Przybylski, Rigby, and Ryan conducted a study in 2010 aimed to understand the effect of impaired control over gaming. They found that those who "needed" to play enjoyed the experience less and felt worse after playing than those who "wanted" to play. They also found that while games can improve player mood in the short term, precise needs must be met to satisfy the player. This includes factors such as scaling difficulty throughout the game, the scope of player choice and impact, and connectivity to others. Using video games as a means of escape can be a slippery slope, but perhaps focusing on, or even being mindful of, a specific need during each session may pave the way for better moods and higher motivation.
Okay, so what can we do?
Jane McGonigal's book SuperBetter, along with much of her other work, illustrates the idea that video games can be used to create and build confidence, sustain friendships, and improve problem-solving and decision-making skills. Her research aims to prove that video games can be used positively by playing with a goal in mind instead of playing to find purpose. Playing a cooperate game to strengthen a relationship with a friend, a challenging game to increase resilience, or maybe a sandbox game to inspire creativity are all realistic goals that can be accomplished with the right mindset.
Understanding why people play video games and adjusting it for a more goal-oriented mindset can help those either in need or those addicted. This knowledge can be used to create more effective health and education tools and possibly help those with addictive or aggressive behaviors.
It's no secret that the video game industry exploded over the past few years, and 2018 wasn't any different. Making around $138 billion last year, 13.3% higher than 2017's overall revenue, it's safe to say that video games will be around for a while. Przybylski and his colleagues cited that the video game's market growth is "inevitable."
With its growth, video games still have a chance to be regarded as a potential tool to help those with depression if used correctly. Many can explain why any addiction can lead to unhealthy coping mechanisms. Perhaps a more understanding perspective is that people who are inclined to play video games are not drawn to them because they're predisposed to depression or addiction. Instead, they use video games as a means to understand depression and cope with it.
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