Understanding Gaming Disorder

Video games are fun. They are a great release and way to pass time. While most gamers spend a couple of hours a day playing video games, some spend significantly more. Most of us have a healthy relationship with video games. We play for a little bit to de-stress or to hang out with friends, and then we go to work, bed, or wherever else we are expected to be. Sure, we have all had those moments where you look at your watch, and you realize it is six in the morning and you have been playing a game all night long. It happens, and it is not a problem if it happens occasionally. But what if it is happening every night? And what if you start calling off work because you need to get to the next level? And what if you keep telling your spouse “20 more minutes” on your anniversary until it is too late to go out for your anniversary dinner? Well, for a small percentage of the population, this is their reality. They have Gaming Disorder (GD), which is video game addiction.

Gaming Disorder was adopted at the World Health Assembly in May, 2019, as a diagnosis in the 11th edition of the International Classification of Diseases (ICD-11). The International Classification of Diseases is how we, in the medical field, code medical diagnoses. So what exactly is gaming disorder? According to the ICD 11:

Gaming disorder is characterized by a pattern of persistent or recurrent gaming behavior, which may be online or offline, manifested by impaired control over gaming, increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences. (World Health Organization [WHO], 2022).

To be considered for this diagnosis, the behavior must persist over a period of 12 months. It can be continuous or recurrent.

Gaming disorder can have a significant impact on a person’s personal life. It can impact their job status and their relationships. People who have gaming disorder are often craving playing video games when they are not playing. They may make attempts to limit game play unsuccessfully. It is not uncommon for GD to occur with other disorders, such as substance abuse, mood disorders, anxiety, obsessive-compulsive disorder, etc.

Studies show that males tend to have longer gaming sessions and suffer more from gaming disorder than females (Stevens, Dorstyn, Delfabbro, & King, 2020). Gaming disorders in adolescents may lead to problems such as antisocial behavior, anger control issues, emotional distress, and lower self-esteem, whereas, in adults, more anxiety and depressive symptoms are seen (WHO, 2022). Adults with gaming disorder may miss work and ultimately lose their job, they may get behind on tasks, and their relationships may suffer. Adolescents with gaming disorder may have altered sleep patterns, and their grades may start to slip.

Addiction and the brain

Gaming disorder is an addiction disorder. When someone plays video games, which is the addictive stimulus in this case, the reward pathway releases dopamine. Addictive stimuli cause the reward pathway to be flooded with dopamine. In return, they want to feel that sensation more and more, which is what can eventually lead to addiction. Dopamine is a neurotransmitter that makes us feel good. Many things can lead to the release of dopamine, so you don’t have to fear that everyone playing video games is going to get addicted. It is estimated that somewhere between 1.7% and 10% of the US population is addicted to gaming (Cleveland Clinic, n.d.).

People at risk for video game addiction often exhibit the same characteristics of someone at risk for other types of addiction. Impulsivity and lack of self-control can be risk factors (Rho, et al., 2018). A person with anxiety and pursuit of desired appetitive goals can also be risk factors (Rho, et al., 2018).

Additionally, Rho et al. (2018) found that many people with GD play at home, use a PC rather than mobile device, are more likely to be game club members, and have few to no social relationships and are more isolated.

Signs and symptoms of GD

Just like with other forms of addiction, it is possible to never know that someone is addicted to video games. However, if you pay really close attention, you will see the signs and symptoms, though they will often be denied. People suffering from GD may start to have poor performance in work or school. They may stop taking care of their household responsibilities. They may stop doing things they used to love to do and replace those things with gaming. You may notice a decline in their personal hygiene. They may lie about what they are doing or how much time they are spending playing games. They may be more tired than usual due to late nights. They may be short tempered or on edge. They may also tell you they can stop whenever they want, however, when attempting to stop, they cannot.

How to treat GD

If someone thinks they are addicted to gaming, they can start by talking to their provider who can then refer them for appropriate treatment. Often, people with addiction disorders have underlying problems that also need to be addressed, such as anxiety and/or depression. Addiction psychologists and counselors can also be helpful when it comes to beating an addiction. Cognitive Behavioral Therapy (CBT) has been shown to be effective in treating GD. CBT is a form of psychotherapy that focuses on modifying negative behaviors, thoughts, and emotions by talking through and gaining a better understanding of them, and then challenging and replacing those thoughts and behaviors.

As previously stated, video games are fun. They also are not inherently bad. There are many well documented benefits to playing video games. That said, we must keep in mind that even good things, in abundance, can become bad. The same is true of video games. When gaming becomes a necessity and life is out of balance because of it, there is a problem that needs to be addressed and treated. Addiction is serious, and it is a disorder of the brain. It is often out of the person’s control. As a community, we need to be supportive of those who are dealing with this type of addiction and guide them to get the help they need.

Resources for Gaming Disorder





Cleveland Clinic. (n.d.). Video game addiction. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23124-video-game-addiction

Rho, M’J., Lee, H., Lee T.H., Cho, H., Jung, D.J., Kim, D.J., & Choi, I.Y. (2018). Risk factors for internet gaming disorder: Psychological factors and internet gaming characteristics. International Journal of Environmental Research and Public Health, 15(1). DOI10.3390/ijerph15010040

Stevens, M. W.R., Dorstyn, G., Delfabbo, P.H., & King, D.L. (2020). Global prevalence of gaming disorder: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 55(6), 553-568.

World Health Organization. (2022). 6C51 gaming disorder. ICD-11 for mortality and morbidity statistics. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1448597234

By Alicia Shields

Hi. I am Alicia. I am a Registered Nurse and Humanitarian. My experience is in leadership, trauma, and prehospital. I have traveled the world doing humanitarian work. In my spare time, I like playing video games, especially with my kids. I started playing video games as a child and find it to be a great way to unwind. Two of my favorites are Borderlands and Bulletstorm. Слава Україні!

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