Tomer Shaked, an 18-year-old high school senior in Florida, started gaming around age 9. "I began spending more and more time playing video games in what I now know was a gaming addiction," he says in an interview.
"At first, I didn't play all that much, and still put school and homework first. And when I turned 10, I was still playing only during the weekends," he reports. "But the screen time increased. My parents set some limits, but I eventually learned to get around my parents' rules to get my 'fix' of gaming."
By the age of 12, gaming consumed every free moment and was the only thing he thought about. He began lying to his parents about how much time he was gaming, which damaged his relationship with them. "All I wanted to do was game, game, game."
Soon, "gaming wasn't just one activity I enjoyed. It had become the only activity I enjoyed."
Most youngsters who play video games do so "as a form of entertainment, which is what it's supposed to be, but approximately 5% to 6% of video game users do so to the point where it interferes with their lives and use it as an addiction," says David Greenfield, PhD, founder and clinical director of the Connecticut-based Center for Internet and Technology Addiction.
Considering that there are about 2.7 billion gamers worldwide, with 75% of U.S. households having at least one gamer, even 5% to 6% is a staggering number of people.
Shaked has written a memoir, Game Over, which he hopes will "highlight important topics associated with gaming addiction that can speak to both teens and their parents who are experiencing this conflict in their own lives."
He hopes other teens "can realize they can also live a full and productive life away from a video screen."
A Problem of Staggering Dimensions
Video gaming has been around since the mid- to late 1970s, but not at the level it is now.
"When video gaming met the internet, it was like mixing peanut butter and chocolate together. As the internet's popularity blossomed in the late 1980s and 1990s, that's when it got out of hand," Greenfield says. His clinic treats people who have addiction to internet content, and "by far the most common area we see is video gaming."
What Makes Video Gaming So Addictive?
Greenfield says brain mechanisms involved in video game addiction are similar to the brain mechanisms involved in other addictions.
"The brain doesn't know the difference between a drug and a video game because gaming activates the same receptors responsible for all other addictions, including substances and gambling."
The key brain chemical involved is dopamine – a neurotransmitter involved in pleasure and reward, Greenfield says. From an evolutionary point of view, dopamine is what made mating and eating – the two most important survival activities – pleasurable and "increased the likelihood that we would continue to engage in them."
In addiction, "you're piggy-backing onto these ancient neural pathways and hijacking the reward mechanism that dopamine is responsible for," he says. "On some weird level, your brain acts as if the activity is survival-enhancing when in fact it's the opposite."
Soon, people with this type of addiction feel there is no other source of pleasure in their lives because they've allowed other parts of their lives to fall by the wayside in their almost exclusive focus on gaming.
That's what happened to Shaked.
"I think the appeal of gaming is the constant reward system in place," he says. "These are virtual worlds that allow you to win battles that can't be fought in the 'real world' in real time, allowing you to win soccer and basketball games and making you very popular in the 'virtual' world."
You get to the point "where you know the games and how to play them, you get attention and admiration online, which have no value in the real world but are very addictive in the virtual world."
And time goes by seamlessly. "Anyone who has ever played a video game – even someone without an addiction – can attest to the fact that time simply gets lost," says Shaked.
Red Flags for Parents
What might start out as a break for parents – the kids are busy playing their video games and the parents have a few minutes to themselves – expands into something much bigger. But the progression doesn't happen overnight, and parents might miss the clues.
Not wanting to leave the house unless required
Not wanting to go on vacation without gaming equipment
Refusing to go outside
Rushing through normal activities, like meals, to get back to the games
Greenfield says parents should look for changes in patterns of daily living – fewer social interactions, changes in patterns of hygiene, less physical activity, eating less, and worse academic performance.
"The majority of people who come to treatment in our center are brought in by parents or other family members. Many have stopped showering and taking care of themselves, they've become more isolative, their friendships are related only to gaming or through apps they can use to communicate while gaming," says Greenfield, who is the author of the book Overcoming Internet Addiction for Dummies.
Addictive video gaming can take a toll on the body, even leading (in extreme cases) to blood clots from sitting for so long, electrolyte imbalances from going without food for days, and other problems (like obesity) associated with sedentary living. Being in front of a computer can contribute to neck and back problems, headaches, and visual problems, among others.
Kicking the Gaming Habit
Shaked's journey was unusual: at the age of 17, he had an epiphany while driving home from school. "I looked at myself and asked how I had been spending my childhood. I had been in front of the computer screen more than in front of my parents. You never want to say you've been in front of a computer screen more than in front of people, because that's pretty sad."
He realized that he had "lost" himself. "I had been so lost in a fake video game world that I had lost my identity and had become a video game character, not a real person." He decided to completely stop playing video games.
But most people don't have these types of epiphanies and need family intervention or even professional help to give up gaming, Shaked notes. He doesn't advise others to "go cold turkey," although that's what he did. Doing so creates a tremendous void because the person does not yet have an activity to fill that time.
Greenfield, who's also author of the book Virtual Addiction, agrees. His center helps parents gradually reduce screen time by helping them install software that limits how much time the teen can spend on the screen. "Kids have to get used to real-time living because the brain gets used to the level of dopamine that comes from gaming. They need to relearn how to experience normal pleasure in other areas of life."
Some parents and kids might simply need education about gaming addiction, although others also need therapy. Some might even need residential treatment. "The needs of gaming addicts run the entire gamut."
It's important to find a therapist familiar with video gaming addiction, Greenfield warns. Because videos are so pervasive, less knowledgeable therapists might dismiss a gaming addiction as harmless fun. But gaming addiction should be taken as seriously as any other addiction.
Today, Shaked leads a full and meaningful life. He's involved in rowing and has received a varsity award. He completed a law fellowship for high school juniors, joined a beach cleanup crew, and received first prize in a state Spanish competition. He also has volunteered at the Jack and Jill Foundation of America and plans to donate the proceeds of sales of his book to the foundation, which helps children from underprivileged communities get access to educational programs.
"The organization really touched my heart, and that's why I dedicated this book to them," he says.
Tomer Shaked, 18, Florida, author, Game Over.
David Greenfield, PhD, founder and clinical director, Center for Internet and Technology Addiction, West Hartford, CT; author, Virtual Addiction and Overcoming Internet Addiction for Dummies.
International Trade Administration: "Video Games Sector."
Center for Internet and Technology Addiction, West Hartford, CT.
Journal of Addiction Medicine and Therapeutic Science: "Gaming Disorder and Effects of Gaming on Health: An Overview."
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Cite this: Video Game Addiction: Noticing Warning Signs, Getting Help - Medscape - Jan 23, 2023.