Is Video Gaming the End-Boss of Digital Addictions?

Once a hobby just for nerds, video games have become as mainstream as alcohol. Whether they are—or will become—as addictive is hotly debated by experts. And as their popularity continues to soar, that debate carries a growing sense of urgency.

Modern games, which retail for around $60, are made with one goal in mind: keeping people entertained for hours—which can then be further monetized through subscriptions and expansions. But with Hollywood-sized budgets (sci-fi shooter Halo 4 was built on a budget of $100 million and made $220 million on the first day of its release) to throw behind writing, graphics, testing and even psychological expertise to maximize fun, critics—including many parents—say that video games hold the attention all too well. Some gamers are losing productivity, relationships and even their lives, and programs for pathological video-game play are springing up all over the world.

The games provide players with a rush in the head from winning with no tangible consequence for losing—and you get to keep playing as many times as you want.

A World of Warcraft (WoW) player in Texas told The Fix about losing his marriage and career to the game. A professional trucker, he sustained a back injury on the job in 2001 that immobilized him; he sought ways to distract himself during his time at home between surgeries. Because of his military-related PTSD, he dislikes sitting with an idle mind, and WoW—with its massive fantastical world and giant community of fellow players—was his distraction of choice. "From that day forward I was either at the computer playing WoW, sleeping or in the bathroom,” he recalls.

Years later, he was still at it. “Fast forward to 2007—you know that meme of the Redditor guy with his sad-looking wife looking at him from the doorway?” he says. “That was the everyday scene at my house. Wife bored, frustrated and horny, me at the computer doing my best to ignore her.” She finally gave him an ultimatum—get off the computer or get out. He packed his bags and left his wife and daughter that night.

Some gamers have even lost their lives. Today's online digital landscapes drove one Chinese man to play for 27 days straight, subsisting only on instant noodles in an Internet cafe, until he died from cardiac arrest. A Taiwanese man, 23-year-old Chen Rong-yu, passed away after a 23-hour League of Legends bender, the rigid arms of his corpse still reaching for the mouse and keyboard.

But the DSM-5—the bible of the mental-health industry due out in May—declined to classify problem video gaming as an addiction, instead placing Internet pathologies in a “needs more research” sidebar. An official diagnosis of digitally fueled problems like video gaming could help spark the serious attention that many psychiatrists, who angrily lobbied their colleagues in charge of the DSM revision, say they deserve.

The US gamer population stands at 211 million—more than two-thirds of the population. According to the Journal of Psychiatric Research, about 3%—or 6.3 million—play at a “pathological” level. And it’s not just teenage boys anymore. “The average age of the most frequent game purchaser is 35. Forty-seven percent of all game players are women,” claims the Entertainment Software Association, the industry’s lobbying group that has successfully resisted regulatory crackdowns in the face of much negative publicity. “In fact, boys age 17 or younger are now 18% of players.” The Nielsen Company, a consumer behavior information firm, corroborates these numbers, reasoning that women have flooded this market as smartphones—and the casual games on them—become increasingly prolific.

Health experts, however, are still mainly fretting over how video gaming affects young males. After all, the “hardcore gamer” stereotype is that of a socially awkward or outcast teenage boy. The violence of these games (rather than their potential addictiveness) often returns to the forefront of public awareness following a mass shooting committed by a young male who also happens to play video games—most recently the Newtown, CT, killer Adam Lanza, who is said to have been immersed in the popular military shooter, Call of Duty.

But now, with the next generation of even more realistic and compelling gaming consoles just over the horizon, the fear is growing that video games will impair the mental health and social development of the next generation of males. Hilarie Cash, co-CEO of video-game rehab center reSTART, in Fall City, Wash., says that her clients are almost all males between ages 18 and 28; female gamers tend to play puzzle or social games, she says, and “manage” their gaming habits better.

So what’s all the excitement about? The games provide players with a rush in the head from winning with no tangible consequence for losing—and you get to keep playing as many times as you want. Outsmarting a legion of monstrous orc invaders feels more rewarding on your tenth try, as you finally develop the requisite skills to overcome everything the game throws at you. Brain scans show that victory feels very good indeed, activating the brain’s dopamine-producing pleasure pathways that are the center of addiction. And a Stanford MRI study found that video games light up men's brains more intensely than those of women.

The DSM-5 followed this science, but only so far. “There is currently insufficient research to definitively conclude that video game overuse is an addiction,” it reads, “but symptoms of time usage and social dysfunction/disruption appear in patterns similar to that of other addictive disorders.”

These “dependence-like behaviors” are amplified when other players are involved, especially in the case of massively multiplayer online roleplaying games (MMORPGs), with sometimes millions of players competing or collaborating as denizens of a digital fantasy world. “When you can interact with others it becomes much more addictive. You get to be part of a community,” Cash says. “The social component really carries you into deep immersion.” World of Warcraft, with 9.6 million global players, is the most popular—and immersive—of them all. You can hold a wedding or a vigil for a player who passed away—or, if you're in the opposing faction, raid these gatherings in a surprise attack.