Harmless relaxation? Or addiction?

While classifying video games as an addiction might have seemed unimaginable twenty years ago, what started out as harmless fun may be interfering with the daily lives of people across the country.

Brothers Mike and Steve can attest to the addictive power of gaming.

“A year of my life is gone,” Mike said, describing how he has trouble remembering what happened outside the game world during 2007, when he played 25 to 30 hours just on weekends. “I know how, but I don’t really remember why I did those things. That’s what’s scary.

“It’s weird, it’s like everything I value, my family and friends, just disappeared.”

The brothers spoke on condition of anonymity (the names Mike and Steve are pseudonyms) because of the embarrassing nature of their problem. Mike attends Missouri State, while Steve just started at Ozarks Technical Community College.

Both men said they play more video games than they should. Steve play games nine hours on his days off from work and a couple of hours on work days as well. Mike said he has cut down slightly from his gaming peak and now spends closer to 20 hours a week playing.

Both spoke of the sense of achievement they felt from playing video games, even while acknowledging it was all virtual. “I love the teamwork aspect,” Mike said, “how everyone has a job to do and we all rely on each other to get things done.”

Steve likes how games are always available. “Doesn’t matter what time it is, you can always play,” he said. “It’s easy; it’s a good way to fill time.”

Behaviors like these impact college students all over the country. According to the American College Health Association’s National College Health Assessment, 10.8 percent of students reported internet use or computer games had a negative impact on their academic performance, compared to 11.2 percent for depression and 4 percent for alcohol use. One-fifth of students reported sleep difficulties, some of which could be caused by late nights of gaming or internet use.

“I’ll get home from work at eleven,” Steve said, “and I’ll be like, ‘I’m only going to play for an hour,’ and suddenly it’s three in the morning.”

“It’s not that I put off this or that specific thing to play,” Mike said, “but I’ll be so tired the next day that I won’t do as much as I want to or need to.”

Dorothy Warner, in Current Psychiatry, wrote video games facilitate, “the experience of ‘flow’ — a mental state of positive energy and effortless focus.” She compares it to the sensation reported by athletes and artists, including how time seems to become distorted.

Liz Woolley is the founder of On-Line Gamers Anonymous, whose website, www.olganon.org, supports an online community helping people recover from the problems caused by excessive game playing. She believes warnings about excessive gaming should get equal time in university programs with warnings to students about drug and alcohol abuse.

“The gaming companies spend millions of dollars a year on ‘research’ to try to figure out how to keep the gamer,” Woolley said. “Supposedly, (video games) are better than drugs or alcohol (for students), but I don’t think so.”

The OLGA website offers a list of over 40 questions people can use to assess their relationship with gaming. Some of the questions in this self assessment describe symptoms commonly associated with alcoholism, such as, “Do you try to hide how long you’ve been gaming?” and “Have you missed work/school because of your game playing?” It’s offered as a guide, not a diagnostic tool, with the website telling visitors, “You must determine if you think excessive gaming is a problem.”

Whether excessive gaming amounts to addiction is still an open question. As reported in Current Psychiatry, the American Medical Association determined last June that insufficient evidence existed to declare gaming as an addiction. The report said the American Psychological Association may consider adding gaming or internet addiction to its Diagnostic and Statistical Manual of Mental Disorders, or DSM-V, due to be published in 2012.

Woolley supports the addition of a gaming diagnosis to call more attention to the problem, but she doesn’t like the word “addiction.”

“Some people call it excessive gaming, others say obsessive, others say compulsive, others use gaming addiction,” Woolley said. “We tell a person if they think they have a problem with excessive gaming, they probably do.”

Woolley also urges more research to be done on the effects of excessive play on the brain. “I have seen day after day the effects excessive gaming can have on a person’s life,” she said. “It is very sad.”

Dr. Doug Greiner, Director of the Counseling and Testing Center at MSU, also shies away from the word “addiction” in connection with gaming. He describes addiction as involving chemical and biological changes in the brain, as well as social and behavioral effects. Dr. Greiner said behaviors like obsessive, uncontrollable thinking about gaming are symptoms he doesn’t see often.

“Usually, behaviors like these are symptomatic of avoiding other activities, like going to class or going out with friends,” he said. In this way, excessive gaming or internet use can mask deeper problems such as social phobias, depression, or other addictions.

Steve acknowledged, since he has moved back from Kansas City, he plays games more and goes out drinking less. “Now that I’m back here,” he said, “I don’t really know anyone anymore and playing video games really fills the time where I used to be partying a lot.”

Steve’s experience of adjusting to a new social setting mirrors that of many college freshmen. Woolley said freshmen are more vulnerable to excessive, habitual playing. “This may be their first time away from home,” she said, “They may feel overwhelmed with life as an adult. They may be failing some classes. An easy escape is gaming.”

Dr. Greiner said that freshmen do typically go through an adjustment period, but they are not any more at risk than other students. “You usually see, as time goes on, freshmen getting more involved with classes and with activities at the dorm and so on,” he said, “and so I would say anyone is at risk.”

“Anybody can get pulled too far into it because it’s not something they ever think they have to be careful about,” said Peter Mastroianni, Health-Education Coordinator of the State University of New York at Stony Brook, to The Chronicle of Higher Education. “They know about the risks of drugs and sex, but who ever thinks they have to approach a computer carefully? Their guards are down.”

Dr. Greiner said this kind of problem develops slowly over time. Students may notice more and more preoccupation with the game or the internet, manifesting in avoiding commitments, cutting class, or missing assignments. He said a particular warning sign would be spending extraordinary amounts of money on your habit and borrowing or even stealing to support it.

Dr. Greiner also suggested using common sense. “We’ve all been there,” Grenier said, “where we look up something on the internet and ten minutes later we look up and say, ‘How did I get to this site?’”

Woolley said to remember to not let any one thing dominate your time. “We promote balance in a person’s life,” she said. “Do all things in moderation.”

The Counseling and Testing Center at MSU has counselors experienced in dealing with gaming and internet compulsion. Students seeking help with these or other issues can visit their offices at Carrington Hall, Room 311, or call them at 836-5116. The Center also encourages students whose friends may be showing signs of trouble to contact them for a consultation about the best way to help.

The OLGA website, www.olganon.org, has many active forums for gamers or friends and family of gamers dealing with the fallout from excessive gaming problems. They also host live weekly chats and can help find face-to-face counselors. These services are free and anonymous.

“When I was at my worst, I was deep in denial about it,” Mike said. “I would keep making plans to cut back and control it, but they never worked.” The futility of these efforts, Mike said, lead him to see the extent of the problem and begin to make real changes.

Mike plans to go “cold turkey” from games this semester, taking it as far as deleting Minesweeper and Solitaire from his computer. Steve said once he gets into school, he’ll be able to put down the games and focus on studies. Neither one ruled out seeing a counselor if gaming continues to be a problem.

Read the complete interview with Liz Woolley.

Online Approach

Jason McGill: Please discuss your experience with doing counseling online. What unexpected challenges have you met and overcome?

Liz Woolley: When we started our organization, this was the only venue that would work, because everyone was so spread out. We had to follow what the gamers were doing and were already comfortable with or they would not seek help. We changed the focus of gaming from excessive gaming, to getting back to your real life, and finding fulfillment there.

As far as challenges, sometimes, when a gamer leaves the game, he/she cannot even have a computer in the house, because it is too tempting to use it to feed their cravings. This means they also cannot get to our website for support.

Also, many of the family members reaching out for support have not used the computer because the gamer is on it all the time. They do not know how to navigate on our website, how to post, how to register, etc.

JM: What would you say to someone that has a gaming problem but is skeptical of the effectiveness of support/counseling online?

LW: I would first suggest they go to our website and look at all of the tools offered. Print out what they can use and work them, off-line – in their real life. That is our main goal. Spend more time in your real life. By looking at your real life, and bringing the principles we offer into it, you will have a much better life. Here is a link to our principles: http://www.olganon.org/?q=12_principles_atheists

I also suggest they get a sponsor, and communicate with them by phone. This will also get them off of the computer.

DSV-V in 2012

JM: How do you define clinical game addiction?

LW: We do not use like to use the word addiction. The medical field does not use that term either. We prefer, “problems caused by excessive gaming.” There are huge issues with terms used when it comes to gaming. Some people call it excessive gaming, others say obsessive gaming, others say compulsive gaming, and others use gaming addiction. Do they all mean the same thing?

We tell a person, if they think they have a problem with excessive gaming, they probably do. We also have a screening they can take, to help determine for themselves if they think they have a problem. Here is the link to the screening: http://www.olganon.org/?q=self_tests_on_gaming_addiction

We do not diagnose. This is our mission statement: On-Line Gamers Anonymous is a fellowship of people sharing their experience, strengths and hope to help each other recover and heal from the problems caused by excessive game playing.

JM: Do you support the addition of Internet or Gaming Addiction as a diagnosis in the APA’s DSV-V, slated for release in 2012?

LW: Absolutely. There needs to be more services offered by the professionals to people who are having issues with excessive gaming – be it the gamer or the family member. Also, the professionals all need to get on the same page with this issue, and stop prescribing gaming as a treatment method.

JM: How do you answer those who say formulations of an Internet Addiction diagnosis are too vague or flimsy to be included in the DSV?

LW: There are several issues here. Will the DSV include all uses of the internet of just gaming? Will the “treatment” be different, depending how the patient is abusing their use of the computer?

I prefer to address gaming in particular. Many of the games have been designed to re-wire the brain to get the person addicted to the game so the gaming companies can make more money. The gaming companies spend millions of dollars a year on “research” to try to figure out how to keep the gamer. Are they any better than drug pushers? They have no regard for the well-being of their own customers. They just want to make more money.

I believe more research needs to be done, to show what excessive gaming actually does to a person’s brain. This is your brain on games. They do not make the person better in their real life. I have seen day after day, the affects excessive gaming can have on a person. It is very sad.

Freshmen and Vulnerability

JM: Are new college freshmen more vulnerable to falling into game addiction? Why?

LW: I believe college freshmen are more vulnerable to falling into using games excessively. Gaming is an escape from real life. The first year of college is very trying for the student. This is new to them. This may be their first time away from home. They may not have the discipline to create a schedule and keep it. They may have only played games in their real life up until this time and know how to do little else. They may feel overwhelmed with life as an “adult”. They may be failing some classes. An easy escape is gaming. Supposedly, “it is better than drugs or alcohol”? (I don’t think so…) There is not enough awareness on the college campuses or in the student services to steer students away from gaming.

JM: What are warning signs students and friends should look for?

LW: 1. Unable to predict time spent gaming.

2. Can’t control gaming for an extended period of time.

3. Sense of Euphoria while playing.

4. Craving more game time.

5. Neglecting family and friends.

6. Restless, irritable or discontent when not gaming.

7. Lying about your gaming.

8. Experiencing problems with school or job performance.

9. Feeling guilt, shame, anxiety or depression resulting from gaming.

10. Changing sleep patterns.

11. Health issues: Carpel tunnel, eye strain, weight change, back ache, sore neck, arms

12. Denying, rationalizing and minimizing bad consequences of gaming.

13. Withdrawing from real life hobbies.

14. Eating more and more meals at the computer while gaming.

15. Increased free time surfing game-related websites

16. Constant conversation with uninterested friends/family/partner about the game.

17. Attempts to get friends/family/partner to play

18. Purchasing in-game items for real life money

19. Feeling the need to “stand up for gamers” and proclaim that your life is perfect by listing all of your life’s achievements, and yet you still game for 4-6 hours per day.

JM: What do you recommend colleges do to raise awareness and help their students with game addiction?

LW: I strongly suggest there be a section in the student manual discussing excessive gaming, just as there is about excessive drug and alcohol use. We promote balance in a person’s life. Do ALL things in moderation.

Sending students to our website will help them realize they are not alone. This has happened to THOUSANDS of other people before them. Have a place they can go for help, on the campus, if they have excessive gaming problems.

When other students see someone who is falling into this trap, have a place and procedures for what can be done for that student to help them with their excessive gaming. Excessive gaming can harm your real life.