An estimated 3.3 million people in the United States have obsessive-compulsive disorder, approximately 2.3 percent of the population.

Over 100 million people in the U.S. are gamers, a number that only grows each year as new platforms and increasingly accessible technology emerge.

I sit in the overlap between those two worlds. I am a female gamer living with OCD.

I grew up unaware that my behavior was different from other people's, which can be common in people with OCD. I developed neurological issues early on in childhood, but lacked an environment with proper parental supervision, so the behavioral "quirks" typifying my condition largely went unnoticed. It is only in retrospect that I can see how early my symptoms first appeared.

It started shortly after my father bought me my first console, the Sega Genesis, at age 8. My first two games were Aladdin and Sonic the Hedgehog 2 and, in the midst of an otherwise cheerless childhood, they quickly became my only friends.

Like many people with OCD, I grew up unaware that my behavior was different

As I retreated into a fantasy world, obsession set in. The fixations started out harmless and small, but grew more focused over time. One of my early memories is of Aladdin, a game that had shiny red gems scattered throughout its levels. I spent countless hours collecting every one, refusing to spend them even as I reached the holding limit.

I was similarly meticulous with the Sonic the Hedgehog games, memorizing level layouts and starting the game over if I so much as hit a single "baddie." By the time Sonic 3D Blast rolled around, I was collecting all the rings in every level, beating the game without losing a single one.

My playing took on multiple layers of precision. Within each game there came another game, one I played with myself. As it widened the chasm of escape, within these layers I could drive myself even further away from reality.

And it didn't get any better as I got older.

Despite the growing strength of my symptoms over the years, it was hard to figure out I had a problem. My knowledge of OCD was shaped mostly by TV and movies, and from what I understood, it involved a lot of counting. As far as I knew, I was healthy.

In reality my behavior was far from normal. I obsessed over social interactions until I couldn't sleep. My nightly prayer rituals would last up to an hour. I ate food in meticulously calculated rotations. To me, these were just personality traits. Without a proper plumbline to guide my mental health, I could not see that my thoughts and habits were insular, hyper-focused and obsessive.

My experience isn't universal, but as I reach out to other people with OCD, I'm finding we have some traits in common. Many of us come from fundamentalist religious backgrounds and were nurtured in an environment that facilitated constant fear and an emphasis on order, creating a state of hypervigilance that damaged our developing brains. Many of us have an enormous sense of dread when it comes to the unknown and have a habit of forcing a situation to resolution even at our own expense. Uncertainty brings with it dread.

That fear of the unknown often plays into an obsession with numbers and order. For me, evenly numbered items or sets of items are pleasant and comforting, because they feel "complete." They are not open-ended. There is finality. Sure, that's a lot to read into a four-piece mug set from Fiestaware. But to an OCD person, it provides a sense of routine that they otherwise do not have. For a child, it can be the only sense of stability they get in a world where they otherwise have no control.

Video games have changed since I was a child

As an adult I've found other outlets for the manifestations of my OCD. Raised as I was on commercial images of domesticity, I turned to decorating and entertaining to satisfy my need for visual order. My brain finds it pleasant to coordinate color and function, and it's one of the positive outlets for my condition. Hosting parties suits me well. My compulsivity has been channeled into a restrained spontaneity that most of my friends find charming. In some ways I've been able to use my disorder to my advantage.

But one area where there still sits equal potential for growth or disaster is video games.

Video games have changed since I was a child. Whereas developers once extended the life of their games by making them difficult and challenging (hi, Mega Man), these days most AAA titles have padded out their content with collectibles, minigames and side quests that generally amount to little more than busy work.

In some instances, they are distractions that undermine the tone of the game and trivialize its themes. In Alice: Madness Returns, players track down four different collectibles, one set of which reveals Alice's memories, effectively gamifying her trauma as they dangle the question of sexual assault like a carrot in front of the player's nose. In Far Cry 4, the player runs around spinning Mani Wheels for positive karma, a self-serving task that in benefiting the player undermines the very concept of karma itself.

Collectibles aren't all bad. As technology has improved, the virtual worlds we inhabit are becoming more interesting and sometimes almost too beautiful to leave. It makes sense that we want excuses to spend more time in them.

I've put collectibles in games where there were none. In Fallout 3 I hoarded every last Nuka Quantum in the Capital Wastelands and tracked down every single rare weapon and item. I did the same in Fallout: New Vegas, nabbing the last Sunset Sarsaparilla cap long after I'd earned my Pew Pew laser rifle.

I took 5,000 screenshots during my first run-through of Skyrim, and wrote an entire blog documenting the acquisition of each Daedric weapon and unique piece of armor and weaponry. Somehow I find value in the ritual, even as I'm aware the relief I feel at acquisition is merely symptomatic of my disease. The most satisfying game I play is often the one I play with myself, just as in my youth.

But despite the sense of peace that order and completion can bring to an OCD person, I never find joy in carrying out these tasks, be they self-imposed or prompted by a level designer. Completing a game to 100 percent never provides happiness so much as a relief from urgency. And as game developers find new ways to psychologically herd their users toward maximum playing time, the potential for addiction only intensifies.

My game-within-a-game has taken on new depths now that I can track my game completion rate on Steam. My stack o' shame is now littered with collecting cards and other trinkets from Valve's trading system. Game achievements already inspired a sense of failure that kept me playing even when I didn't want to. That pressure is only increasing.

I never find joy in carrying out these tasks

The self-imposed obligation of this cycle can be tempting and addictive even for the neurotypical, but for those with OCD, it becomes borderline exploitative. There are games I have to avoid completely, knowing that they'd only become a chore; Hearthstone, Pokemon and World of Warcraft are just a few examples. For those with OCD, grinding isn't always a choice. To ignore the ritual it demands brings shame, panic and anxiety. At that point, it stops being entertainment.

A recent example that comes to mind is Dead Rising 3. I despise this game for a number of reasons, among them the cartoonishly offensive villains, the bizarrely archaic and obtuse level structure, and the abysmally cliche plot line.

For all that, I couldn't stop playing. The game is both a paradise and a nightmare for the OCD. The craftable weapons and vehicles are tremendously fun to use, and there are over a hundred blueprints and other collectibles scattered all over the map. But the thrill of mowing down zombies lasts for about 15 minutes and then you're left with pointless busy work and no sense of direction. I've never been so simultaneously bored and motivated in my entire life. Every time I hit play on my Steam screen I felt myself screaming internally.

But, faced with the uncertainty of tasks left unfinished and lists gone unchecked, I kept going back. After a while I felt chained to my computer. At no point was I truly entertained; the game merely occupied my time.

The next game I played, Far Cry 4, was not much better. It's designed in such a way that the player is encouraged to branch out slowly from their initial setting, opening new territory in pace with the narrative.

But the minute I got a taste of item upgrades (earned through tracking down and killing wild animals, which are sprawled all over the map), it was over. Soon I was ignoring the game's main and side quest lines in favor of exploring areas solely for the XP, destroying numerous propaganda posters and mindlessly spinning Mani Wheels solely for the satisfaction of seeing my numbers climb. Twenty-four towers, 24 outposts, four fortresses. I pushed and strove to tick the items off the lists. The sense of completion set in, but the satisfaction never did.

The data on the effects of gaming on the neuroatypical is somewhat limited; there don't appear to be extensive studies into the effect of cyclical reward incentive on those with compulsive or obsessive tendencies, save for those that delve into issue of gambling addiction, with which OCD shares many traits (primarily, the "addictive behaviors [...] associated with dysfunctional process of the reward system," according to a 2012 study).

It should also be noted that what research has been done focuses mostly on cisgender men, as they comprise the greater number of cases of pathological gambling. Nonetheless the similarities are worth exploring when discussing the more exploitative aspects of game design.

Whether or not the majority of developers take advantage of the addictive tendencies within their consumer base, many benefit from them, whether directly (in the case of monetized social media games) or indirectly (games like World of Warcraft, which subsist on monthly subscriptions as opposed to impulse mini-purchases). Some seem to even be embracing this, such as Big Fish, which was recently acquired by racetrack Churchill Downs, or BioWare, which has long profited from of the gambling-like feature of Cartel Packs in Star Wars: The Old Republic. Companies like Zynga have also long held a reputation for building their success on the manipulation of their users.

The examples are many, and they raise the ethical issue of using psychology to take advantage of the disabled. If even those without a neurological impairment can fall prey to behavioral psychology and deliberately predatory game design, what hope do the rest of us have?

I worry about a world whose future will be directed by technological exploitation. It seems exploitative that my neurological issues can be manipulated by the able-minded and those with the resources to manufacture the conditions under which I am physically unable to resist. The goal of many game designers is, after all, to get you to play games like I do.

They say that time you enjoy wasting isn't wasted time, but I didn't enjoy combing Los Santos for every last weapon blueprint, or slogging through the Kyrati jungle to spin every Mani Wheel. I did those things because I felt I had to. It didn't feel like a matter of free will. And it certainly wasn't fun.

These days I'm trying to find balance in my gaming life. I see my doctor regularly and take medication. I abandoned my pursuit of 100 percent completion on Far Cry 4 and moved onto Dying Light. It's a sandbox open-world title, but with its densely packed domiciles and tight winding staircases, and the constant threat of zombies, I'm not afforded the breezy exploration that completionism requires. My OCD is given a break.

The collectible zombie statues, the scattered weapons schematics; I hear their call but I don't feel compelled to answer. I am able on some level to concede that as a game reviewer, I no longer have the time to take games at my leisure.

It's a struggle to let go of both the compulsion and the obsession, but for my own sake I'm finding ways to move on.