Many of us belong to the generation referred to by Oxford Dictionary as Digital Immigrants, or people “born or brought up before the widespread use of digital technology.” In their article,  Digital Natives and Digital Immigrants, Wang, Meyers and Sundaram state, “digital natives are the new generation of young people born into the digital age, while ‘digital immigrants’ are those who learnt to use computers at some stage during their adult life. Whereas digital natives are assumed to be inherently technology-savvy, digital immigrants are usually assumed to have some difficulty with information technology.[1]

While technology has changed the way we learn, work, research, communicate and even practice medicine, our multifaceted relationship with screens is  complex and, as with many other behaviors, can be subject to abuse.

In 2018, WHO (World Health Organization) officially included Gaming Disorder[2] as a mental health condition in their latest edition of International Classification of Diseases (ICD).

Gaming is one of the fastest growing industries and has gained popularity not only for recreational use but also for its uses in many employment fields, as a marketing device, and as an official and lucrative sport.

At least one person in two-thirds of American households plays online video games, according to the Entertainment Software Association[3], with approximately 160 million American adults playing internet-based games. These games require prowess and skill and are highly competitive.  Consequently, this seemingly  limitless, often free, source of entertainment can be habit-forming.

Advancement in gaming technology has led to heightened realism and therefore an increased sense of immersion for players.  The growth of gaming marketing within television, social media and online advertisements has made it increasingly difficult for many to detach from the world of gaming even when they are not actively playing.

As technology continues to evolve in all facets of  our daily life we will almost inevitably see a rise in technological disorders.

Gaming Disorder

Problematic gaming is a behavioral issue that refers to a pattern of persistent and frequent gaming despite negative consequences occurring within work, study, relationships, and finances.

Recent studies have found that while gaming disorder affects a small percentage of the people who play video games, anyone who engages in online gaming should be aware of the time spent, whether they prioritize gaming over other daily activities, and any subsequent changes in their physical or psychological health related to their gaming patterns[4].

Gaming disorder is defined in the 11th Revision of the International Classification of Diseases (ICD-11) 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 interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”[5]

Although anyone can suffer from a gaming disorder, it is statistically more frequent in adult males even though adolescents and children appear to be the most active gamers. Research indicates that just fewer than 50% of adults play video games across devices. The American Psychiatric Association (APA) state that, “adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving, and negative impacts on health among the gaming population, compared to females.”[6]

Symptoms of problematic gaming include:

  • Difficulty controlling gaming behaviors, including duration, frequency, and intensity
  • Prioritization given to gaming over other areas of life
  • Continuation of gaming despite negative consequences
  • Preoccupation with gaming
  • Withdrawal symptoms, including sadness, anxiety, irritability, when unable to game
  • An increase in tolerance, which results in the gamer needing to spend more time gaming or “winning” in order to achieve satisfaction
  • Numerous unsuccessful attempts to quit gaming or reduce time spent gaming
  • Loss of interest in previous hobbies due to gaming
  • Deception of loved ones about the amount of time spent gaming
  • Use of gaming to relieve negative emotions
  • Loss of a job or relationship due to gaming
  • Sleep deficit and physical exhaustion

Demonstrating  five or more of these symptoms within a year, with a habit-forming pattern of sufficient severity, warrants a diagnosis of gaming disorder.

Problematic gaming is largely considered an impulse control disorder, meaning that a sufferer struggles to control their urges to game and is likely to experience withdrawal symptoms if unable to play. Those with gaming disorder commonly have an established routine involving a dependency on playing games with an increase of frequency and duration in order to satisfy cravings.

Our extensive daily use of technology, especially our mobile phones, can make the avoidance of triggers particularly challenging. Treatment is key to help users manage their emotions and behaviors towards gaming.  Therapy will help gamers acknowledge the negative impact their gaming habit is having on their life, allow them to work towards abstinence and reduction, and help them find techniques to direct their urges into more positive and creative behaviors.

There is ongoing debate over whether the games themselves are to blame for habit forming tendencies or if gaming is a symptom of other mental health conditions[7]. After all, gaming is fun and provides a welcome distraction and an escape for those suffering with depression, anger, anxiety or self-esteem issues.


In 2013, the American Psychiatric Association (APA) classified Internet Gaming Disorder (IGD) as, “a condition warranting more clinical research ahead of formalizing it as a mental disorder. Proposed as a behavioral addiction, IGD shares many similarities in both physical and psychosocial manifestations with substance use disorder, including cerebral changes on functional magnetic resonance imaging (fMRI).[8]

Dr Richard Graham, a specialist within technology-based disorders at the Nightingale Hospital in London, has publicly welcomed the decision for WHO to classify problematic gaming as an official mental health disorder.[9] Its classification creates a significant opportunity for more specialist services and treatments. According to Dr Graham, there is a difference between being a high-level user of technology and being dependent on it – although it is not so easy to establish which is the case unless you are an experienced diagnostic.

For those concerned about their loved one’s gaming habits there are now many treatment options available. Withholding technology is not the answer in a world that is increasingly reliant upon it. Education is crucial, and the key is to introduce healthy gaming patterns early in life and establish skills to maintain a positive relationship with online games.

Originally published at:


[1] Wang, Qian et al. “Digital Natives Und Digital Immigrants”. WIRTSCHAFTSINFORMATIK, vol 55, no. 6, 2013, pp. 409-420. Springer Science And Business Media LLC, doi:10.1007/s11576-013-0390-2. Accessed 12 Nov 2020.

[2] “Addictive Behaviours: Gaming Disorder”. Who.Int, 2018,

[3] Parekh M.D., M.P.H., Ranna. “Internet Gaming”. Psychiatry.Org, 2018,

[4] Feng, Wendy et al. “Internet Gaming Disorder: Trends In Prevalence 1998–2016”. Addictive Behaviors, vol 75, 2017, pp. 17-24. Elsevier BV, doi:10.1016/j.addbeh.2017.06.010. Accessed 9 Nov 2020.

[5] “Addictive Behaviours: Gaming Disorder”. Who.Int, 2018,

[6] Chen, Kevin H. et al. “Internet Gaming Disorder: An Emergent Health Issue For Men”. American Journal Of Men’s Health, vol 12, no. 4, 2018, pp. 1151-1159. SAGE Publications, doi:10.1177/1557988318766950. Accessed 9 Nov 2020.

[7] Mehroof, Mehwash, and Mark D. Griffiths. “Online Gaming Addiction: The Role Of Sensation Seeking, Self-Control, Neuroticism, Aggression, State Anxiety, And Trait Anxiety”. Cyberpsychology, Behavior, And Social Networking, vol 13, no. 3, 2010, pp. 313-316. Mary Ann Liebert Inc, doi:10.1089/cyber.2009.0229. Accessed 9 Nov 2020.

[8] Chen, Kevin H. et al. “Internet Gaming Disorder: An Emergent Health Issue For Men”. American Journal Of Men’s Health, vol 12, no. 4, 2018, pp. 1151-1159. SAGE Publications, doi:10.1177/1557988318766950. Accessed 9 Nov 2020.

[9] Moss, Rachel. “This Is What Happens In Britain’s First Technology Addiction Clinic”. Huffpost UK, 2015,