Video game addiction a disorder? WHO says, yes

Lisa Pont has heard plenty of skepticism about video game addiction and whether it's truly a medical condition that should be classified as a disease, as the World Health Organization plans to officially do in a couple of months.

"Some people think it trivializes other diseases. People think, 'Oh my God, how can you get addicted to gaming? Just put [the controller]down,' or like, 'Please, then anything can be a disease,'" says Pont, a social worker at the Centre for Addiction and Mental Health in Toronto.

"But I've been seeing people coming to CAMH for treatment for almost 10 years, so whether it was an official diagnosis or not, we could observe people were having problems with [video games] and we needed to respond to those problems.I don't think we're 100 per cent all in agreement on what the conceptualization of it is, but there are definite themes and phenomenon that seem to be consistent."

The WHO has said it will include "gaming disorder" in a June update to its International Classification of Diseases (ICD), defining it as a pattern of behaviour "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."

A diagnosis would recognize "significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months."

A CAMH study released in 2016 estimated 13 per cent of Ontario students or almost 123,000 kids have experienced symptoms of a "video gaming problem," which was up from nine per cent in 2007. About one in five boys reported having "problematic symptoms" linked to their video gaming.

The WHO has been studying the issue since 2014, while the American Psychiatric Association has flagged "internet gaming disorder" for further study and consideration in its Diagnostic and Statistical Manual of Mental Disorders (DSM) since 2013, but has not yet moved forward with it. They are two of the main groups the medical community in Canada looks to for guidance on diagnosing and treating patients.

I get a call at least once every two weeks from a parent who says, 'I can't get him off his computer,' or 'I can't get him off his cellphone becauseall he wants to do is play these games.-Prof. JeffreyDerevensky

Prof. Jeffrey Derevensky, director of the International Centre for Youth Gambling at McGill University, consulted with the WHO in preparing the upcoming ICD-11 release and says video game addiction is "clearly a growing problem."

"It may not have the same prevalence as some other disorders but ... I get a call at least once every two weeks from a parent who says, 'I can't get him off his computer,' or 'I can't get him off his cellphone because all he wants to do is play these games,'" Derevensky says.

"There've been a number of instances where individuals have actually committed suicide because they weren't able to have access to their computer for gaming."

He suspects the DSM will eventually include video game addiction as well, although the process to update the guidelines moves slowly. The last update in 2013 was 14 years in the making.

A coalition of video game organizations, including the Entertainment Software Association of Canada, has called on the WHO to abandon its plans to add gaming disorder to the ICD.

"The WHO's process lacks transparency, is deeply flawed, and lacks objective scientific support. We urge this process to be halted," reads a statement from the group, which adds "the educational, therapeutic, and recreational value of games is well-established and recognized."

Calgary native Cameron Adair is a reformed gaming addict who has turned his recovery into a full-time business, Gamequitters.com, which offers a how-to ebook and one-on-one coaching along with free resources. The 29-year-old's work to help others break the cycle of addiction was recognized last year by CAMH, which included Adair on a list of Canadian "difference makers" in mental health. Adair believes the spotlight the WHO is putting on video game addiction will be crucial in legitimizing the issue and getting more help for young people.

"There's a lot of resistance around this being an addiction and I think that comes from just a lot of misinformation," Adair says.

"I get emails from parents every single day who say they have taken the Xbox away and now their kid is threatening to commit suicide. We need to be sensitive that there's people out there struggling. They're losing relationships, they're failing out of college, they're losing their families and their kids. This is a significant thing and if they want support, let's give it to them."

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Adair sees to the rise of lucrative competitive video gaming, called esports, as "a coming storm." He notes that excessive game playing led to his dropping out of high school, and that was before elite players were being treated like celebrities online.

Pont says there's a lot of confusion about how to get help for a video game addiction but a good starting point is speaking to a family doctor. Among the treatment options in Ontario are counselling at CAMH, and an in-patient video game and internet dependency program at Hotel-Dieu Grace in Windsor, Ont.

She says it's also worth considering that in many cases, video game addiction may be "a symptom of underlying issues."

"For most people, where there's addiction there's something they are trying to soothe. Whether it's a clinical issue like depression or even other issues like relationship conflict or poor self-esteem, there's almost always underlying issues."