Gaming and Mental Health: Therapy or Addiction?

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Third of three parts

Video Games are part of our Lives

Video games are here to stay and, to a certain degree, essential, there is no debate in that.

Since the 1980s, video games have become an increasingly important part of the entertainment industry, there’s even debates if they are actually an artform, (the author personally agrees).

Economically speaking, video games are a hundred billion dollar industry ranking only behind broadcast and televesion in the US markets.

As discoveries in science and health improve, so do uncovering impending health crises, and devising solutions to abate it.

There will always be a stigma in health issues not just in mental health crises.

In a 2013 study by Eric J. Nestler, MD, PhD, about the cellular basis of addiction, it stated that addiction is a brain disorder characterized by compulsive engagement in rewarding stimuli despite adverse consequences. Regardless of the involvement of a number of psychosocial factors, a biological process—one that is induced by repeated exposure to an addictive stimulus—is the core pathology that drives the development and maintenance of an addiction.
Is excessive video gaming considered addiction or is it therapeutic? The debate has been polarized. | Image from Unsplash.

But with further progress, science and evidence will eventually break off that stigma, and will move forward to identifying and providing better for patients that society used to neglect or label wrongly: from drug use and abuse patients, veterans with trauma, obese binge eaters, to people dying of heartbreaks.

With improved diagnostics there is now a better understanding of these health matters and no longer will people become confused of whether a person is actually just a sick-pain in the ass or is actually sick of a disease.

The steps to relieve patients of this malady are steps toward a better society. Those who are against the International Healthcare authorities’ move to consider video game addiction as a disease entity have valid worries such as stigmatization or lack of sufficient literature and treatment options.

It could warrant the conservative and less tech savvy people to demonize gaming and rid their children, partners, and friends of that playstation controller, but a much more pressing concern are for those who actually need legitimate help but were discovered too late.

In fact, gaming addiction has become a significant public health concern in Asian countries like South Korea, with their governments going so far as to enact public policies and laws to target the problem.

In 2011, the South Korean government implemented a law, known as the Shutdown law or the Cinderella Law, which prohibits children under the age of 16 from playing online video games between the hours of 12:00 a.m. to 6:00 a.m.

However, as of 2014, the law was amended and now children under the age of 16 can play after midnight if they have permission from their parents.

The ultimate goal is not to put handcuffs in gaming but to create a safe space for everyone who engage in it, to make sure that everyone gets to enjoy video games without fear of the risks of its adverse effects. Much like alcohol, eating sweets, sex and other recreational stuff. There will always be hazards but that does not mean we just stop them altogether.

Ready Patient One: Video games as therapy

On the other side of the spectrum, video games as therapy is actually a developing thing and is currently being researched.

While there are video games centering around themes of conquering depression and anxiety, like the platforming game Celeste, and exploring schizophrenic themes like the dark fantasy action game Hellblade: Senua’s Sacrifice, there are actually steps done by Health experts to integrate Video games and it’s ideas into medicine.

Virtual reality therapy which has been used as an experimental treatment for Post-Traumatic Stress Disorder (PTSD) is apparently effective.

A 2015 study by James Lake published on Science direct on the integrative management of PTSD on military personnel found that combined multisensory exposure and virtual reality graded exposure therapy (VRGET) reported significant reductions in severity of PTSD symptoms in active duty combatants who had failed to respond to other forms of exposure therapy.

A 2017 study by Michelle Colder Carras and co-authors published in Frontiers of Psychiatry, tackled on the potentials for commercial video games as therapy, where they addressed that more research must be done in the field due to its promise.

A more recent study in 2019 by Debra Boeldt and co-authors reviewed and re-explored the concepts of using Virtual Reality as exposure therapy treatment for anxiety disorders, in which they state that Incorporating VR in therapy can increase the ease, acceptability, and effectiveness of treatment for anxiety.

Perhaps the best example would be Akili Interactive, an actual biotech company recognized and recently approved (2020) by the United States Food and Drug Administration as a pioneer in using their video games as prescription treatment to pediatric patients with ADHD.

Their video game, named EndeavorRx showed improved objective measures of attention in children with Attention Deficit / Hyperactivity Disorder.

Their clinical evidence, written by Prof Scott H Kollins, PhD and co-authors was published in the Lancet on 24 February 2020.

After four weeks of EndeavorRx treatment, one-third of children no longer had a measurable attention deficit on at least one measure of objective attention.

Furthermore, about half of parents saw a clinically meaningful change in their child’s day-to-day impairments after one month of treatment with EndeavorRx; this increased to 68% after a second month of treatment.

While this is great progress indeed, and pretty soon, further developments on this matter will pop up globally, note that this is actually not as simple as booting up DoTA 2 and say you are getting your daily dose of vitamins.

But with video games getting used for medicine, it does give some kind of merit to those who actually feel therapeutic effects from video games (like the author did).

Video Games: Moving Forward

It is an understatement to say that mental health illnesses as well as non-pathological negative dispositions such as fear and anxiety have risen in the background of the current CoviD-19 pandemic, and people are trying to cope inside their homes while scrounging for ways to survive.

For some, it’s engaging in creativity, study, cooking and/or exercise.

Of course there are also those who play video games and it’s absolutely not a small demographic.

Since much of the world’s population is quarantined due to the pandemic, video game playing and other Internet use has grown greatly, a March 2020 report by Video Game Chronicle stated that on Steam alone, the main digital storefront for personal computer video games saw over 23 million concurrent players in a day surpassing all previous records.

This just means that the topic of video game addiction and video game therapy as well as overall mental health is as important and significant now more than ever.

The author, for one, feels like he should re-download Skyrim again.

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