Can You Really Be Addicted to Video Games?

Ultima Online, World of Warcraft, The Elder Scrolls — he would spend as much as 12 hours a day in these imaginary realms, building cities and fortifications, fighting in epic battles and hunting for treasure.During his childhood, Bracke’s passion for video games, like that of most young Americans, didn’t cause him any serious problems. He kept playing.In May, the World Health Organization officially added a new disorder to the section on substance use and addictive behaviors in the latest version of the International Classification of Diseases: “gaming disorder,” which it defines as excessive and irrepressible preoccupation with video games, resulting in significant personal, social, academic or occupational impairment for at least 12 months. The arguments against the validity of video-game addiction are numerous, but they generally converge on three main points: Excessive game play is not a true addiction but rather a symptom of a larger underlying problem, like depression or anxiety; the notion of video-game addiction emerges more from moral panic about new technologies than from scientific research and clinical data; and making video-game addiction an official disorder risks pathologizing a benign hobby and proliferating sham treatments. After all, millions of people around the world enjoy video games without any marked repercussions; some studies have even concluded that the right kind of game play can relieve symptoms of depression and anxiety.But these denials become more difficult to accept when juxtaposed with the latest research on behavioral addictions. This evidence has emerged from many sources: studies indicating that compulsive game play and addictive drugs alter the brain’s reward circuits in similar ways; psychiatrists visited by young adults whose lives have been profoundly disrupted by an all-consuming fixation with gaming; striking parallels between video games and online gambling; and the gaming industry’s embrace of addictive game design.Timothy Fong, a professor of addiction psychology at the University of California, Los Angeles, says he is convinced that video-game addiction is real. In the case of video-game addiction, the most vulnerable population seems to be young men like Bracke.— Nate Bowman (right), 20, photographed with Wren Viele (left), 18, in September at reStart’s campus in Carnation, Wash.Shortly after Bracke’s employers put him on probation, his parents, Sally and Steve, visited him in Virginia. One day, while driving back from the grocery store, Sally worked up the courage to ask her son a question that had been troubling her for some time: “Charlie, are you a gaming addict?” She was terrified of using that word — “addict” — terrified that Bracke would perceive it as an accusation and that their relationship would suffer for it. He knew his gaming had become a terrible problem, he told them, but he felt powerless to stop.In the following weeks, Sally called every rehab center and addiction hotline number she could find, searching for a program that recognized video-game addiction and knew how to treat it. One day, an exasperated operator interrupted her sobs to tell her that they had already spoken and that he had some good news: His supervisor had recently mentioned a new rehab center in Washington State called reStart, which specialized in internet and video-game addiction.Bracke and his parents were overjoyed to have finally found some recourse — but the price was staggering. (At the time, there was no official diagnostic code for gaming addiction.) “I remember at one point saying we don’t know how we can afford this, and at the same time we don’t know how we can afford not to,” Bracke’s father told me. They concluded that, compared with healthy individuals, compulsive gamers exhibit worse memory, poorer decision-making skills, impaired emotion regulation, inhibited prefrontal cortex functioning and disrupted electrochemical activity in their reward circuits — all similar to what researchers have documented in people with drug addictions.“I don’t think we as psychologists can be justified in saying gaming addiction doesn’t exist,” Kuss told me. We need to think of addiction as an extremely multifaceted problem.” Video-game addiction perfectly exemplifies this multiplicity. In 2018, people around the world spent a collective nine billion hours watching other people play video games on the streaming service Twitch — three billion more hours than the year before. Compared with the game, everything else in my real life suddenly seemed so much harder — and so much less gratifying.The fact that video games are designed to be addictive is an open secret in the gaming industry. Games imbue players with a sense of purpose and accomplishment — precisely the kind of self-worth that can be so hard to attain in their actual lives, especially in a job market that can be punishing for the inexperienced.From 2014 to 2017, American men in their 20s worked 1.8 fewer hours per week than they had in the three-year period 10 years earlier; in tandem, they increased the time they spent playing video games by the exact same amount. For young men like Bracke, who have either not completed a four-year college degree or have not found work equal to their education and skills, video games can become something like a surrogate occupation — a simulacrum of success. It almost sounds corny to say it, but I got there and immediately felt I had made the right choice.”Because video-game addiction is a relatively new disorder, there are few published studies examining how best to treat it. Some clinicians warn that rehab programs and retreats focused on internet and video-game addiction make unsubstantiated claims, give people false hope and take advantage of desperate parents and adolescents. “Toward the end of my time gaming, I was getting to the point where I felt like I couldn’t converse with people at all, unless it was about video games,” Bracke says. Video-game addiction afflicts between 1 and 8 percent of gamers, according to estimates published by researchers. In the course of my conversations with dozens of compulsive gamers, a familiar narrative began to emerge: A young man repeatedly suffered some form of rejection from his peers; hurt, he turned to video games to soothe and distract himself; the games gave him a pretense of the kinship and achievement he never knew in the real world; when he left home for college or moved into his own place — and the familial checks on his day-to-day activities were lifted — his fixation on games intensified until it consumed him.This is more or less the story that Cam Adair, perhaps the leading spokesman for the legitimacy of video-game addiction, tells in his public appearances. And they allowed me to feel a sense of certainty.” To Adair, the gaming industry’s repeated disavowal of video-game addiction is embarrassing. If addiction is an evolving concept, and an official expansion of that concept would profoundly benefit people who clearly need help, can we justify clinging to the status quo?In the summer of 2016, shortly after he started working at a Costco near his home in Redmond, Wash., Bracke found himself surrounded, once again, by video games. Like Adair, he has become an outspoken advocate for video-game addicts, once appearing on the “Today” show.Rehab taught him that in order to stay sober, he would have to do more than avoid video games — he needed to replace them with something else. “I still hung out with people before,” one of Bracke’s friends said, “but most of the time, we would just talk about stuff we were going to do, like playing video games or something else that wasn’t particularly serious. In contrast, the relationships he developed during rehab, in the complete absence of games, felt sincere and enduring: “A lot of the guys I met there were some of the only people I could be totally honest with.”The more I spoke with the young men in Bracke’s living room, the clearer it became that they were not simply friends — they were family.