While many of us were setting up the new computers, phones, and consoles we received over the holidays, world health experts released news that may make some think twice about video games. The World Health Organization released a draft of its 2018 edition of the International Classification of Diseases, which added “gaming disorder” to the list of disorders due to addictive behaviors. It states that the disorder is behavior that includes impaired control of use, prioritizing gaming over other interests and activities, and continued use despite severe negative consequences for a period of at least 12 months (or shorter for more extreme cases).
Does this mean governments are going to put warning stickers on PS4s and parents will have to give their kids Minecraft withdrawal patches? Will temperance groups rise up and demand a ban on Candy Crush? Not yet, anyway. But this may be a step toward getting better help for the children and adults whose excessive use has begun to destroy their health and well-being.
“This is great, because we can actually call it as we see it,” Michael Rich, MD, the director of the Center on Media and Child Health and an associate professor of pediatrics at Harvard Medical School, told Yahoo Lifestyle. The ICD would not only allow clinicians to code their diagnoses so that insurance companies will pay for treatment, but it also helps raise awareness of the problem among both patients and medical professionals.
“It sets up an environment in which people can get trained in how to recognize, diagnose, and treat it,” Rich explained.
Not that this is an entirely new idea, of course. Since the 1990s, people have been debating the idea of internet and gaming addiction. The American Psychiatric Association has only gotten so far as to declare “internet gaming disorder” as a proposed category in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Just as with sex and gambling addictions, the experts have disagreed about whether one can equate this behavior with drug or alcohol abuse or if it’s just another way for people to make moral judgments.
“[P]utting that official label on [games] recklessly trivializes real mental health issues like depression and social anxiety disorder, which deserve treatment and the full attention of the medical community,” the Entertainment Software Association said in a statement urging the WHO to reconsider this classification, according to PCGamer.com.
After treating many adolescents at Boston Children’s Hospital, Rich said that the issue is real.
“Patients I’ve seen have dropped out of multiple schools,” he told Yahoo. “I’ve had two kids who were brought to me after they attempted suicide, one by drinking bleach, because their parents took their router out.”
There are other horror stories that received plenty of media attention over the years, like the 28-year-old man in South Korea who died of a heart attack after playing a video game for 50 hours.
Rich does agree with the ESA on one matter, though, which is that calling this “gaming addiction” doesn’t work. “The problem is that when we think of the word addict or addiction, we think of bums on skid row sucking down cheap wine or junkies in a shooting gallery. We don’t think about our 10-year-old who has a fit because he’s got to stop playing Minecraft and go to bed.”
The Center on Media and Child Health instead uses the term problematic interactive media use (PIMU) to encompass not just video gaming but also compulsive use of social media, pornography viewing, and online information bingeing (following Wikipedia or YouTube links for hours at a time). Rich said that PIMU often occurs in adolescents who have anxiety or attention deficit issues and seek out interactive media as a way to self-medicate or distract themselves.
The overuse of these media can lead to physical problems such as obesity, poor hygiene, dehydration, and sleep deprivation, and mental health problems because they’ve withdrawn from the world.
When kids come to Rich, they usually don’t believe they have a problem. “They will say, ‘It’s not out of control. I can quit any time,’” he said. But when he asks them to try to restrict themselves to two hours a day, they find they can’t do it. “That’s their come-to-Jesus moment, when they realize that they’ve been fooling themselves. Many of them at that point will say, ‘I think I need to stop it completely for a while.’”
Sometimes treatment of the disorder means going cold turkey, but unlike with drugs or alcohol, most people are going to have to go back online eventually to live their lives. Luckily, Rich has found that this is possible. “Many of them will not go back to what they got in trouble with — gaming, social media, or porn,” he said. “They focus their self-regulation on everything else, on emails, getting work done.”
Ideally, Rich would like to see the medical and research communities work on ways to reach people before they’re dropping out of school, losing jobs, and ending relationships. A key to this is to include the creators of interactive media in developing solutions rather than make them out to be villains.
“If we make them evil, they’re not going to come to the table,” he said. “We need their expertise at creating tools and devices to approach the situation, introducing a second bottom line — not just profit margins but also social outcomes.”
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