Sunday, November 17, 2013

Is Video Game Addiction for Real?

For the moment, it appears that I'm an "expert" on Internet addiction to video games:  Candy Crush and Angry Birds in particular.  I had a great time as a guest on Antonio Mora's show Consider This on Friday night, when I was interviewed with Time Magazine reporter Eliana Docterman.  We were the final segment, a lighter-side close to the 10 pm news, and it aired around 10:50 pm.  A driver came to pick me up, someone was at the studio to do hair and makeup, a studio man to rig me up to a microphone and earpiece, and there were  a half-dozen calls with producers in New York to discuss what topics I was and wasn't able to discuss, plus a few calls for "Is the driver there? Are you on your way? Are you at the studio? 5 more minutes, 2 more minutes..." I'm sure it would have been even more fun if I'd been on the set in New York, but it was pretty good from the remote studio in Baltimore, even with my stage fright.

 I felt like a celebrity for an hour there, and I felt like I could discuss the topic, but I did not feel like an expert on internet addiction.  What really helped was when the producer told me that the host thought he was addicted to a phone game (brickbuilder) -- I said he should mention that and it would be a great springboard for discussing what makes something an addiction. When the show finished airing, Antonio said to me, "You know, I do think I was addicted. I played it all the time, in the elevator, every chance I got."  I asked him how he finally quit and he told me that his Blackberry was upgraded to a new model and he would have had to carry an old Blackberry just to play.  Plus, he had mastered the game and it was no longer challenging.  An addiction?  That's like an alcoholic saying they stopped drinking because the liquor store next door closed and it was too much effort to drive to the one down the street.

I'll say what I said on the show: according to the APA, the jury is still out on whether internet gaming is an "addiction" --- it's been placed in a category under conditions warranting further research and experience.  We banter the term "addiction" about freely, as a joke, and so when 35% of gamers polled say they are "addicted" we don't know what that means.  In studies of young Asian males, there is some evidence that those with problems with gaming have pathways in the brain that light up in similar patterns to those addicted to drugs (or so says the APA).

Often, people play phone games because they are fun!  It's a form of entertainment, and some people  have trouble stopping when they are doing fun things.  That doesn't make it an illness or a disorder.  Something is a problem when it's a problem.  That's what I said on TV, I may have said other things as well.

 Behavioral addictions, such as Candy Crush, do not have the obvious biological underpinnings of an addiction to alcohol or narcotics or other drugs where there are physical signs which accompany the withdrawal of a substance the body is dependent upon -- changes in heart rate, sweating, diarrhea, elevated body temperature, or even seizures.  But we've come to include other, non-biological areas of dyscontrol as addictions -- such as gambling -- so why not video games?  It may be hard to figure out who can't stop and who won't stop.  In terms of problems, these games are often not a "problem" for the players, but for the people around them.  Teenage boys in particular like to play video games for hours on end, and their parents may be troubled by this -- if the teen stops other activities to play, such as going to school, getting acceptable grades, or making expected progress towards life goals, then it may well be a problem worthy of attention, whether that attention entails removing the game from the phone, or removing the phone from the kid, or seeing a therapist....well, I'll stop there.

I'm not much for DSM criteria.  If you have a behavior you can't control and it's interfering with your ability to live a productive or healthy life, then get help.  Throwing a disorder into the DSM seems to do a few things: first, it gives the problem some credibility so insurers will pay for it's treatment (a good thing), and second, it relieves part of the responsibility of the individual to control that behavior (maybe, sort of) because they have a 'disorder,' and that may not be a good thing.  It may call attention to a problem so that people will know there is help available, but we don't want everyone who deviates from the norm to be labeled as disordered. 
If your a normal-weight person who is addicted to chocolate, and 'has to have a candy bar every night' but is otherwise well nourished, then enjoy your candy bar, call it an addiction if you like for fun, but it's not a disorder.

If you think you're addicted to Candy Crush, here are a few things to ask yourself.  Are you missing work or deadlines at work because you are playing, in such a way that it has focused some negative consequence upon you -- such as being fired, a demotion, a write-up, the loss of grant because you didn't get the proposal in on time, or the wrath of your boss?  Is your partner more then momentarily annoyed because playing has interfered with your activities in the relationship or around the home?  If you've been divorced only because you've given your life to Candy Crush, you have a problem.  Do you enjoy it?  If you're playing a game that doesn't give you pleasure, rethink this.  And if you decided you do have a problem, remember you can always delete the App.   


Jeremy Wexler said...

Hey. I tend to agree. Not sure everything needs to be called an addiction. There was a great interview with Marty Klein on Dan Savages Podcast a few months ago about sex addiction. Klein had written a piece saying -- broad strokes -- that he doesn't believe in sex addiction but thinks people don't want to claim the sexuality they desire because of sex negativity in the culture. Also may not be particularly happy in other areas of their lives. Not sure I agree. But it was interesting in relation to gaming addiction. Here's my blog post about it
and here's a link to Klein's piece.

Joel Hassman, MD said...

thanks for noting what goes on before and behind the cameras. Motivates me NOT to be on these shows, telling you what you can or cannot talk about, scripting how to direct the conversation.

Gee, is truth and frankness thrown out the front door when you walk into these talk show rooms!?

Dinah said...

Jeremy, thank you for the links.

Joel, there wasn't anything sleezy about this -- it was a fluff piece on Candy Crush, they told me what they might ask and told them what I was and wasn't comfortable discussing, and they tailored their questions to what I could comfortably answer. At no point did they tell me what to say or what not to say (though I did tell them what I was comfortable discussing). On all news shows when there is a guest, there is always coordination with the guest-- sometimes the guest even writes the questions. It's a TV show, not a sting operation, and it doesn't make anyone feel good if they have experts on to ask questions that the expert can't or won't address-- the host looks dumb, the experts won't come back, the producer looks dumb.

60 minutes or investigative journalism shows or political shows with adversaries, or political debates -- well maybe then they want to catch you off guard.

But Candy Crush? A few minutes of fluff to end the show with.

Anonymous said...

I can't imagine having to see a therapist to stop playing candy crush. It would be a whole lot cheaper to buy 5 more lives for a dollar or delete the app. I like playing it, but I can't imagine my life revolving around it - it's just not that interesting.


jesse said...

I'm not starting Candy Crush. Shrink Rap is addictive enough...