Daily Archives: June 19, 2018

Push For “Gaming Disorder” to be an Official Diagnosis

Through the sheer coincidence of getting new furniture & thus having nowhere else to sit in the house but at the dinning room table, I had a rare viewing of CNN last night just in time to see a bit about the World Health Organization (WHO) drafting the definition of “Gaming Disorder” to be included in upcoming 11th edition of the International Classification of Diseases (ICD-11).

According to Dr. Vladimir Poznyak, the representative from WHO’s  Department of Mental Health & Substance Abuse, there are three key diagnostic features of Gaming Disorder:

  1. “Gaming behavior takes precedence over other activities to the extent that other activities are taken to the periphery.”
  2. “Impaired control of these behaviors.”
  3. “The condition leads to significant distress and impairment in personal, family, social, educational or occupational functioning.”

The gist of the “disorder” is that the person in question chooses gaming over all other activities, including those that are necessary for their well-being, such as proper personal care & family/career/educational responsibilities.  And even though the person knows there’s a problem, they not only continue to engage in the problematic habits, but actively seek ways to streamline their lives further to devote even more time to gaming.

Regardless of my feelings both professionally as a psychologist or personally as a gamer, I will applaud WHO on their intent.  Rather than looking toward studies that try to blame social ills on gaming, they’re more concerned with the overall health of the individual.  They’re not saying video games shouldn’t exist or even dictate what should be allowed in the games, but rather pushing for a healthy balance, which is not an unreasonable goal.  Dr. Poznyak made a point of stating in the article that, even among avid gamers, it’s actually rare for their hobby to reach the stage where it’s dangerous.  According to the CNN article, the goal of the Department of Mental Health & Substance Abuse is:

That the classification of gaming disorder means health professionals and systems will be more “alerted to the existence of this condition” while boosting the possibility that “people who suffer from these conditions can get appropriate help.”

For those of you lucky enough to never have to deal with the insurance, the ICD-9 (current version) is what most insurance companies look to when deciding what they will & won’t pay for.  Unless you have an officially recognized diagnosis & are following one of the agreed up treatments for said condition, insurance won’t pay.  It’s only recently that insurance will even pay for regular psychological therapy or substance abuse treatment.  If you really want them to pay for people to receive treatment for “gaming disorder” it needs to be a medical diagnosis.  So from that perspective, I appreciate what WHO is trying to do.

And, if we’re being honest, we could all probably point to stories that illustrate gaming gone too far.  I’ve read news articles where someone’s gaming caused real problems for them, either because they were so fanatically devoted that their health & finances deteriorated, or a child was neglected, or even lashing out at others in real life.  I’m sure most of us, if we knew these people, would say, “Dude, you need help.”

However, some psychologists are hesitant about grouping this as a medical diagnosis.  The consensus among this group isn’t that there aren’t people who need help with their overwhelming habit, but that the gaming itself isn’t the problem.  Rather, it’s a symptom of another problem.  According to Dr. Anthony Bean, a clinical psychologist who’s a bit of an expert on working with gamers (including having written a book on the subject that I’m eager to read), problematic gaming is actually a coping mechanism to deal with anxiety & depression.  It’s an escape from other problems, & as the problems aren’t addressed, the person loses themselves in their games.  For anyone familiar with substance abuse, this shouldn’t come as a surprise.  People rarely become substance abusers just for the hell of it.  Often, it occurs comorbidly with other issues.  Treating the underlying cause is crucial for real recovery.

I’d also argue that, on a fundamental level, I don’t agree with calling it an addiction.  People throw around the term “addiction” without really understanding medically what it means.  Without going into too much jargon, “addiction” is when you’ve altered your brain structure by the repeated use of some substance to the point that your body cannot function properly without it + generally requires an increasing dosage of said substance to maintain equilibrium + if you stop you’ll experience withdrawal symptoms, & thus you continue to engage in behaviors to seek out said substance.  As an easy example, when you drink alcohol, you’re chemically altering your brain, & if you do it enough you can permanently change its very structure so that you can’t function without it in your system.  (For the record, WHO uses “dependence” instead of “addiction” but means the same process.)

Now, with that knowledge in mind, do you think you can become “addicted” to gaming?  Does gaming physiologically alter you?  It’s hard to say.  Certainly gaming stimulates the pleasure centers of you mind, as does anything you do that gives you joy.  But can enough of it actually come to mean your body will stop producing endorphins (the chemicals in your brain that make you feel good) without games?  Would you go through actual withdrawal symptoms without it?  Even accepting terms like gambling addiction, I find it’s a hard sell.

Furthermore, who’s to decide what’s “problematic”?  Gaming is one of my biggest hobbies, & I can honestly say in a lot of cases I’d rather stay home & play video games than socialize with people.  My mom certainly questions why I prefer to play games versus anything else.  Would she say I have a disorder?

In the end, I agree with Dr. Bean that it’s a slippery slope, regardless of intent.  Why stop just at gaming?  Maybe I think it’s a disorder to pay thousands of dollars every year on sports tickets.  It’s certainly a disorder when you get so mad your team lost (or so happy they won?) that you start a riot.  By the WHO’s own logic, anything can be a disorder.  And that’s not a road I want to go down, because then everything will be a problem.

Sources

WHO classifies ‘gaming disorder’ as mental health condition“, CNN

Addictions“, American Psychological Association

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