Video Games And ADHD: What’s The Connection?

There is often speculation about whether video games play a role in the development or severity of attention-deficit/hyperactivity disorder (ADHD) and its symptoms. Supporting evidence on both sides can be found, leading to inconclusive results overall. Overall, whether playing video games is potentially beneficial, harmful, or neutral on ADHD symptoms and mental health seems to depend on a few factors.

While parents are typically encouraged to manage their children’s video game time, screen time, and internet usage, it’s possible that skill-building video games may be used for ADHD treatment at some point in the future. Generally, engaging in activities like music, art, and sports can be helpful for children with ADHD, while their parents may benefit from online therapy, where they can receive support.

Video game addiction and other concerns

Video games have long been questioned as potential contributors to many social ills and mental health conditions. Regarding ADHD, it’s possible video games and electronic use have been blamed because—as very rewarding stimuli—they’re probably more engaging for those with ADHD than homework or other tasks that they naturally struggle with.

Offline gaming, specifically, has been questioned because it does not typically facilitate communication skills when compared to online games, where players can join groups, chat with friends, and work as a team. The general consensus so far seems to be that whether video games are problematic depends on the individual.

Gaming disorder, for instance, is a recognized condition by the WHO. In the 11th Revision of the International Classification of Diseases (ICD-11), gaming disorder is defined as “a pattern of gaming behavior (‘digital-gaming’ or ‘video-gaming’) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”  This may apply to general screen time as well. Internet addiction (video games included) has been described by some as a genuine health concern.

But whether video games “cause” or exacerbate symptoms of disorders like ADHD is less clear, especially given that the brains of those with ADHD struggle to engage with less rewarding stimuli like work or chores. It can be difficult to parse whether someone is avoiding homework because video games actually take priority or is instead avoiding homework because they just can’t focus on it for long periods of time like they can focus on video games. After all, avoiding activities that require sustained mental effort , hyperfocus on rewarding activities, and difficulties with time management or prioritization are all key symptoms of the disorder.

The effects of playing video games on the ADHD brain

Due to the stimulating nature of video games, people with ADHD tend to be more vulnerable to video game addiction. In addition, video games may reinforce specific traits that are prominent within the condition.

While three hours per day may be the average time spent on electronics, it has been shown that adolescents who spend just one hour a day playing games or using the Internet can have more severe symptoms than those who do not participate in these activities. But it may not necessarily be a causative relationship—that is, there may be other factors that explain this association.

Video games can be attractive to those with ADHD because they typically offer immediate rewards, and there are often great incentives to reach the next stage of a game. This can encourage the user to play video games without stopping, especially if they’ve felt deprived of feelings of accomplishment because of their symptoms.

Additionally, screen changes in video games tend to happen quickly, and video games generally don’t demand attention or working memory from the user, nor does focusing on the screen typically require much effort. All in all, it’s much easier for the ADHD brain to engage with video games than with many other activities. Because ADHD inhibits reward pathways within the brain, patients who have the condition tend to continually seek its stimulation. Video games may therefore just be an easier way to achieve that.

Research shows that stimulation video games can amplify the release of striatal dopamine and encourage reward dependency. This also correlates with a previous study that shows that individuals with internet addiction often have the same increased reward dependency. These same genes can be tied to alcoholism, pathological gambling, and other types of addictive behaviors.

How and why does this happen?

Although gaming has many features that can attract those with ADHD, it is hypothesized that there is a “bidirectional relationship” between the two: Gaming may provide things that individuals with ADHD want; however, it could also make the condition worse by exacerbating symptoms, and increase individuals’ need or desire for stimulation, thus making them more attracted to video games, and so on.

Below are some symptoms of ADHD that are believed to be potentially reinforced by prolonged video game use:

• Disinhibition

• Quick responsiveness

• Need for rewards

• Inattention

• Impulsivity

Because of this, it is speculated that spending more time on video games can increase the negative effects that ADHD has on scholastic performance, for instance.

Impact on students with ADHD in the classroom

Sitting in class and completing homework can be challenging as is, but students with ADHD struggle primarily because these activities require mental effort that their brain struggles to maintain. Aside from receiving good grades, there may not be immediate incentives for completing school work efficiently, and even those with ADHD who prioritize their schoolwork may struggle so much with time management, memory, and other symptoms that their academics suffer anyway.

The combination of ADHD and games may be problematic because it could allow these symptoms to affect important aspects of life rather than relieving them, or may hijack effort that could be directed to skill-building and behavioral change.

Other activities such as sports, martial arts, music, and art are often argued to be a more effective and better use of one's time for someone with ADHD because they can improve attention, self-control, self-discipline, and behavioral intervention.

Can online play help?

Video games have frequently been a cause for concern, particularly with parents, because of the potential problems presented in the previous two sections. However, it may be the case that games could be helpful for those with ADHD when used intentionally and in a healthy way–that is, one that still allows the person to pursue other avenues for managing their symptoms.

Both anecdotal and empirical evidence point to games having a positive effect on the minds of those with ADHD. This may not necessarily discredit other research so much as be an addition to that research. It is possible for something to be risky in some ways and beneficial in others.

Contrary to the notion that time spent gaming reinforces inattention, many parents of children with ADHD have reported that gaming can be evidence of good attention. Certain games may also improve reading and other skills if the game is, say, more text-driven or strategy-heavy. Role-playing games may be a good example of this because they are often lengthy and require mental effort and engagement to continue the story.

Technology-based treatment approaches

Instead of relying solely on medication, there have been many new device-based approaches to improving memory, attention, and inhibitory control, and their effects can be measured through EEG and neurofeedback.

As mentioned previously, the brain's reward pathway often plays a crucial role in the relationship between ADHD and video games. Cognitive training is generally designed to be fun and engaging, and it tends to reward good performance, so video games may be a natural avenue for that. However, it is also possible that something can be too engaging and lead to hyperfocus and hypersensitivity to instant gratification, which would be counterproductive. The evidence just isn’t cut and dry.

And because these studies are typically controlled and specifically created to address various skills, they may only make a case for those specific games. Recreational games typically are not designed with any particular skills in mind and may make task switching more difficult, so it may not be accurate to say that all games can be assets.

Despite this disclaimer, it’s still possible that some video game play that actively promotes skill-building could be part of the future of treating ADHD, and it might be another avenue to try alongside medication and therapy.

Online therapy may be helpful for parents of children with ADHD

Parenting a child with ADHD can come with various stressors, especially when it’s not always clear how you should be approaching daily habits that could affect their symptoms. One way for parents to learn how to handle their stress healthily could be through therapy. Online therapy can be an excellent alternative to face-to-face therapy for those with busy schedules, as you can connect with a licensed therapist from the comfort of your own home at a time that works for you.

According to one systematic review, online therapy can be highly effective in treating a number of mental health concerns, especially anxiety and the effects of stress. If you’re a parent experiencing anxiety, stress, or any other mental health challenges, you may wish to consider giving online therapy a try.