Internet Gaming Disorder
Overview
Online games have become a popular source of entertainment, with estimates showing that around 160 million adults play internet-based games. However, overindulging in online games can negatively affect an individual's daily life. Internet gaming disorder, sometimes called internet gaming addiction, is a relatively new condition that may be common among young people, who are more likely to be drawn to online gaming and can develop an unhealthy dependence on it. Internet gaming disorder has been included in the International Classification of Diseases (ICD-11). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), includes internet gaming disorder as a relatively new condition that requires more research to better understand its prevalence, causes, and potential treatments.1
Researchers have developed various tools to measure the symptoms2 of internet gaming disorder. The IGDS-SF9 is a short psychometric scale that helps professionals determine the severity of internet gaming disorder based on the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders. For example, people with internet gaming disorder may often experience a loss of interest in other activities, which could lead to challenges with social, academic, and work-related functioning.
In some cases, IGD can be linked to other mental health conditions, including attention-deficit hyperactivity disorder (ADHD),3 depression, or anxiety. As a result, internet gaming disorder may significantly impact the lives of individuals and society as a whole. However, treatment interventions like therapy may help individuals manage the symptoms of internet gaming disorder.
Symptoms
Internet gaming disorder can cause various symptoms, including physical, emotional, and social changes. However, symptoms can vary in severity from person to person.
Physical symptoms of internet gaming disorder
Physical symptoms of internet gaming disorder often include the following:
- Constant fatigue or sleep difficulties
- Neglect of personal hygiene, grooming, and overall appearance
- Carpal tunnel syndrome, back and neck pain, or other physical discomforts from prolonged gaming sessions
- Decreased physical activity, leading to potential weight gain
- Vision-related problems, such as dry eyes or eye strain, from staring at a screen for extended periods
- Poor dietary habits, which may lead to malnutrition
- Headaches or migraines from extended screen time or gaming stress
Emotional symptoms
Emotional symptoms of internet gaming disorder include the following:
- Irritability, mood swings, or depression when not gaming or facing reduced gaming time
- Feelings of guilt or shame about excessive gaming habits
- Constant thoughts about gaming and difficulty controlling the urge to game
- Loss of interest in previously enjoyed activities and hobbies
- Restlessness or boredom when not able to game, even if other activities are available
- Developing a tolerance by having the sense one must spend more time gaming to satisfy the urge
- Using gaming as a way to relieve “negative” emotions
Social symptoms
Social symptoms of internet gaming disorder may include the following:
- Neglecting relationships with friends and family members, prioritizing gaming over social interactions
- A decline in academic or work performance due to gaming distractions
- Loss of personal relationships or career opportunities
- Lying to others about the amount of time and effort dedicated to gaming
- Defensiveness when questioned about gaming habits
- Increased isolation and withdrawal from social situations that do not involve gaming
To be diagnosed with IGD based on the criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, an individual must present with five symptoms. Not everyone who engages in gaming will develop the disorder, as the activity can be done in moderation. However, when symptoms of excessive gaming start to affect a person’s mental health and overall functioning, more serious problems can arise. A healthcare provider may consider each of these symptoms in the broader context of a person's life to determine if an individual has internet gaming disorder.
Causes
While exposure to gaming does not automatically cause internet gaming disorder, several factors may play a part in the development of the condition. One of the main factors that may lead to internet gaming disorder is one’s psychological state. For example, people who experience anxiety, depression, or low self-esteem may find comfort and escape in gaming, which may lead to excessive time spent playing games and neglecting other parts of their lives.
Certain personality traits, such as impulsiveness and motivation to seek rewards, have also been linked to IGD. Individuals with these traits may be more prone to gaming addiction due to the immediate gratification they experience from the games. In addition, the social aspect of online gaming can appeal to some people who experience challenges forming and maintaining relationships, which may lead to an increased risk of internet gaming disorder.
Other risk factors that may predispose individuals to internet gaming disorder may include:
- Male gender
- Younger age (under 21)
- Early and frequent exposure to gaming without proper parental supervision
- High levels of stress or aggression
- Lack of other hobbies or interests
- Social or emotional isolation
In some cases, internet gaming disorder may be related to trauma4 or other underlying mental health disorders. Those affected by unresolved trauma may find that internet games help them escape from negative emotions or cope with stress. As a result, gaming might become a cause of internet gaming disorder symptoms.
The causes of IGD can be complex and are still being investigated. By considering specific causes, healthcare providers may be better able to treat internet gaming disorder.
Treatments
There are various potential ways to treat IGD, depending on the symptoms and causes. An effective treatment may reduce the adverse effects of excessive gaming while resolving the underlying causes. Treatment options may include therapy, medication, and self-care.
One standard treatment for internet gaming disorder is therapy. During therapy sessions, individuals can work with a mental health professional to adjust their gaming habits. Cognitive-behavioral therapy (CBT) is often used to help individuals identify what incites them to want to partake in excessive gaming. A therapist can guide them to recognize unhelpful thoughts and engage in more productive behaviors. Some studies show that CBT may decrease addiction behaviors, anxiety, and social withdrawal while improving overall functioning.
Group therapy is another potential option, which may provide a supportive environment where individuals can discuss experiences and learn from others with the help of a clinician. Specific programs, such as the PIPATIC program, are designed to treat IGD in children and adolescents and may include both individual and group therapy sessions.
Family therapy may also have benefits in treating internet gaming disorder, as it may improve communication within the family. Family members may support the affected individual and resolve any conflicts that could be a cause of internet gaming disorder.
While there are no medications specifically approved for treating IGD, some individuals may be prescribed medications for co-occurring mental health conditions, such as anxiety and depression.
Antidepressants and anti-anxiety medications may be prescribed to treat co-occurring depression and/or anxiety. It's important to note that while medications may help to treat some symptoms associated with internet gaming disorder, they are typically used as part of a comprehensive treatment plan that includes therapy.
It is important to consult with a doctor or medical professional before beginning or changing any medication plan. The information provided in this article is not intended as medical advice; please consult a qualified healthcare professional for personalized guidance.
Other treatment options for internet gaming disorder
Some alternative treatment options for IGD may include:
- Motivational interviewing: This therapeutic technique helps build an individual’s motivation for change and set realistic goals.
- Mindfulness-based interventions: Meditation and relaxation techniques may help individuals develop self-awareness when managing urges to game excessively.
In addition to professional interventions, self-care may be a valuable part of managing internet gaming disorder. Some self-care strategies include:
- Having a structured daily routine, which may promote a sense of balance and reduce the time available for gaming
- Exercising regularly, as physical activity may improve mood and provide a healthy alternative to gaming
- Connecting with friends and loved ones, as social support can help an individual manage addiction and stay accountable to treatment goals
Treating internet gaming disorder may involve various approaches, including therapy, medication, alternative treatment options, and self-care. Individuals can work closely with healthcare professionals to create a treatment plan personalized toward their goals.
Resources
Different resources are available to provide support, guidance, or treatment for individuals with internet gaming disorder. One resource to help cope with IGD is an online therapy platform. BetterHelp offers online therapy services that may be helpful for those struggling with internet gaming disorder.
In addition to therapy, there are organizations and support groups specifically focused on helping individuals with mental health conditions. The National Alliance on Mental Illness (NAMI) provides education and support to help individuals and their families improve their lives while living with mental illness. Mental Health America (MHA) is a similar organization that helps provide resources and support for people struggling with their mental health. The American Psychiatric Association has an article with information on the potential negative consequences of excessive internet gaming. It also describes the proposed symptoms outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
Local and online communities may also be available for individuals to discuss their experiences and seek advice from others facing similar challenges. As a result, individuals can build social connections and learn more about effective coping methods. As internet gaming disorder involves behavioral addictions, local centers that treat addiction may be potential resources for support and treatment.
Please see our Get Help Now page for more immediate resources.
Research
Recent research has sought to understand the cognitive and neural mechanisms behind internet gaming disorder. One study discovered that internet game playing might be linked to changes in the size of certain parts of the brain. Specifically, playing online games was linked with decreased white matter density in brain areas involving decision-making, behaviors, and emotions. In addition, video game playing was connected with an increased dopamine release.
One study investigated the factors that may increase or decrease the risk of IGD. The researchers reviewed several studies published online and found 34 factors that may be changed to potentially affect internet gaming disorder. These factors include how much time a person spends gaming, their level of loneliness, and the quality of their relationships with peers. The study concluded that more research is needed, especially on how environmental factors (such as school engagement) might impact IGD.
Another study reviewed several trials to determine the effectiveness of various options for treating gaming disorder. The researchers looked at seven trials from multiple databases that tested five treatments: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). The study found that all modalities, except tDCS, positively affected gaming disorder, but more well-designed trials would benefit more reliable findings.
Statistics
Below are several key statistics on internet gaming disorder:
- The prevalence of IGD varies widely worldwide due to different diagnostic approaches. In the general population, less than 1% to almost 58% of people may have internet gaming disorder.
- Studies have shown that the occurrence of internet gaming disorder is markedly higher in teenage boys compared to girls (19.2% compared to 7.8%).
- One study found that, among students diagnosed with internet gaming disorder, around 22% had moderate to severe depressive symptoms, and around 11% showed signs of severe anxiety.
- According to one study, more than 50% of people with IGD who seek treatment do so by personally searching for support, while over 30% are referred by other healthcare providers.
These statistics may highlight the impact of internet gaming disorder and the growing awareness and efforts to manage it effectively.