- As with other forms of addiction, the “hallmark” sign of video game addiction is experiencing negative consequences, problems, or impairments in important areas of life
- Over time, excessive gaming can cause the brain to develop a tolerance as it gets used to regular dopamine hits from video games
- While there are some available treatments for a gaming disorder, there is still research that needs to be done to establish which types of therapy are most effective
Most of us equate video games as a relatively harmless and enjoyable pastime but for some, video games can become problematic in similar ways as drugs and alcohol. Gaming disorder is a newly recognized form of addiction that affects up to 10% of the population.
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Understanding gaming addiction
Video games have increased in popularity since the early ’80s to become a multi-billion dollar a year business. For most, video games can be enjoyed recreationally, even for long periods of time, without it affecting our day-to-day lives. For others, video games become an all-consuming part of their lives and can cause them to neglect some of their real-world responsibilities, causing problems in their daily life, work, and relationships. 
Gaming addiction isn’t formally recognized in the DSM-5, the manual used for diagnosed conditions including behavioral and substance addiction, but it was recognized as a disorder by the World Health Organization in 2018.  This decision was made because of a growing amount of research that suggests that it is a type of behavioral addiction that can cause significant problems similar to those observed in other addictive disorders.
Research has also shown that video games activate the release of the chemical dopamine in the brain, which is closely linked to addiction. When people spend a lot of time playing video games, they may be forming addiction pathways in the brain that make it much more difficult to control their behavior.  Some people who struggle with anxiety, stress, depression, or other forms of mental health issues may be more at risk for developing an addiction to video games or internet gaming disorder. 
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Warning signs of video game addiction
There are some telltale signs of gaming addiction, both physical and psychological, that help identify if an issue exists. It is important to note that someone may spend a lot of time gaming due to other factors, such as stress or boredom, and may use it as a coping mechanism to help with co-occurring mental disorders. This means that not everyone who spends a lot of time playing video games has an addiction.
- A pattern of excessive gaming (i.e. spending a lot of time playing video games)
- Loss of control over video games (i.e. being unable to cut back or stop)
- Prioritizing video games over other important responsibilities, relationships, and priorities
- Experiencing negative consequences because of excessive video game use (i.e. relationship conflicts, work problems, decreased social skills, etc.)
- Not cutting back or stopping video gaming after experiencing negative consequences or impairments
As with other forms of addiction, the “hallmark” sign of video game addiction is experiencing negative consequences, problems, or impairments in important areas of life. Some of the consequences that people with gaming disorder may notice include: 
- Conflict in relationships because of time spent playing video games
- Health problems related to being sedentary or giving up other active hobbies
- Neck and back problems resulting from excessive gaming
- Poor sleep, hygiene, or eating habits because of excessive use of video games
- Becoming moody, irritable, or angry because of video games
- Neglecting work or school work because of excessive gaming
- Experiencing negative changes in mood or other withdrawal symptoms when unable to play video games
- Trouble focusing, concentrating, and remembering things because of excessive gaming
- Social isolation resulting from spending too much time gaming
- Not being able to enjoy or get fulfillment from offline or real-life activities
Why is gaming addictive?
There are several reasons a person may develop a behavioral addiction, both physical and psychological. The same is true with gaming addiction, though the most widely accepted causes are to do with brain chemicals and emotional influences.
Brain chemical imbalance
When we engage with a behavior or activity we enjoy, the brain releases a chemical known as dopamine which interacts with the limbic reward system responsible for controlling pleasure and reward. Over time, excessive gaming can cause the brain to develop a tolerance as it gets used to regular dopamine hits from video games. Once a tolerance has formed, the person playing video games will develop a dependence on them to feel good or normal.
This dopamine imbalance can cause people to play solo or online games compulsively and the cycle can often not be broken without treatment or therapy. People who suffer from anxiety, depression, or other mental health problems may have existing brain chemical imbalances that make them more vulnerable to the mood-boosting effects of video games.  Video games can also affect the limbic regions of the brain which help to r solve problems and perform other mental tasks, so it is possible that excessive video gaming could negatively impact cognitive functioning.
Emotional & social influences
People who have one kind of addiction are more likely to develop other addictions, so video game addiction and other substance use disorders often co-occur. People may use gaming to escape their negative emotions or mental health issues, such as anxiety or depression, and may feel unable to cope with the real world outside.
Vulnerable people may come to rely on reward structures built in for completing in-game achievements. Obtaining these achievements can boost self-esteem and temporarily ease underlying feelings of sadness, loneliness, or low self-esteem.
Because of the increasing popularity of online gaming, some gamers may rely almost exclusively on video games for social interaction. Video games may not provide the same high-quality interactions as people experience when seeing friends in person or doing other activities together.
Treatment and therapy for gaming addiction
Treating a video game addiction is carried out in much the same way as other behavioral addictions such as sex, pornography, and social media. Currently, the DSM 5 does not recognize video game addiction as a diagnosable condition, although this may change in the future. While there are some available treatments for a gaming disorder, there is still research that needs to be done to establish which types of therapy are most effective. 
There are some therapists and treatment centers that can provide help for people who feel they are struggling with gaming disorder, or have a video game addiction. Many of these are treatments that are commonly used to treat other types of addiction, including substance use disorders, alcohol use disorders, or gambling disorders.
Cognitive behavioural therapy (CBT)
CBT is a common form of therapy that helps people identify problematic thoughts that are linked to certain behaviors, as well as encouraging them to behave in ways that align with their goals.
For those suffering from gaming addiction, it is used to identify triggers and other behavior patterns that may compromise sobriety and lead to relapse, helping them to gain control over gaming. It is also commonly used for those suffering from co-occurring disorders like anxiety, depression, and other mental health conditions.
Dialectical behavior therapy (DBT)
DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from contemplative meditative practice. DBT teaches skills like emotion regulation, assertive communication, and distress tolerance, which can be useful for those in gaming addiction recovery to help them avoid scenarios where temptation to play games may occur.
Family therapy can be useful to identify any underlying issues in the home that may be causing a person to seek out video games as a way of escaping. It can be especially useful for those with younger children and teens who are displaying signs of video game addiction. In family therapy, underlying issues can be addressed and parents can also receive targeted support in how to set healthy limits around technology use.
Individual therapy may also be an option for people who are interested in getting help for a video game addiction. Because many people who struggle with this issue have underlying issues related to depression, anxiety, or loneliness, therapy can often help to address these issues and teach healthier methods of coping.
Self-help and group therapy
Group therapy allows individuals with gaming addictions to share their experiences in a judgment-free environment with peers who have shared similar issues. This can be extremely helpful for individuals who feel isolated by their addiction and can lead to healthy support networks. In many instances, self-help groups are offered for free in communities around the US.
Gaming disorder has been recognized by the World Health Organization but has not been recognized by the DSM-5 as a diagnosable condition. Despite this, there are many people who report feeling addicted to video games, and a growing number of treatment options are available to those seeking help.