Is Online Gaming Addictive?
The headline was terrifying: “Man dies in Taiwan after 3-day online gaming binge.” According to the story, published on CNN in 2015, a customer at an Internet café died of cardiac arrest, likely caused by over-exhaustion and cold temperatures after gaming for hours.
Though such tragedies are rare, public health officials have long expressed concern about the potential harms of online gaming. Some clinicians think the activity can become an addiction, similar to gambling. Others disagree, pointing out that there’s no evidence that gaming itself is addictive. In fact, some clinicians even use online gaming as a tool to connect with clients in therapy sessions.
Does it make sense to put online gaming in the same category as addictive substances like alcohol and nicotine? The answer remains murky.
Your Brain On Gaming
At any moment, different chemicals are active inside your brain. When you’re online gaming, two major influences acting on your brain are the chemicals dopamine and cortisol. Dopamine is one of our brain’s “feel-good” chemicals. Whenever you play video games you enjoy, you get a surge of dopamine, which makes you want to keep going. It’s such a good feeling that you want to experience it more and more, which leads you to spend more time gaming. And that’s a problem, because the next time around you’ll need to play a little longer just to get the same amount of dopamine, explains Larry Rosen, PhD, Professor Emeritus and Past Chair of the Psychology Department at California State University, Dominguez Hills, in a 2024 video.
On the flip side is cortisol, a stress hormone that helps us respond to potential danger. “In small quantities, cortisol’s a good thing,” says Rosen. “But in large quantities, cortisol’s not good for you.” When we’re anxious about a big exam, for instance, our cortisol spikes. We might sweat and feel our hearts racing. The desire to banish those unpleasant symptoms can steer us toward behaviors such as online gaming or checking our “likes” on social media. “You want to get rid of the cortisol and enhance the dopamine,” Rosen says.
Rosen and other clinicians are concerned that the interaction of these chemicals can encourage us to alter our behavior, possibly leading to an addiction. But as of yet, the U.S. doesn’t recognize excessive gaming as an official diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), published in 2022 by the American Psychiatric Association, lists Internet Gaming Disorder (IGD) as a potential diagnosis needing further exploration. Symptoms include preoccupation with gaming, negative feelings when gaming is taken away, and needing to spend more time gaming to feel satisfied.
Research suggests some concern is warranted. For instance, in China, a 2022 study of students ages 12-19 found that 4.6% met the criteria for IGD. Those with IGD gamed more and had worse academic performance than those without it. They also gave up other activities in favor of gaming.
“Addiction” is a Loaded Term
Although online games affect our brain chemistry and can influence our behavior, some researchers hesitate to label gaming as addictive.
In a 2021 video, research psychologist Rachel Kowert says there’s no evidence yet to suggest games are inherently addictive or problematic. “Many researchers believe that the problematic use of games is more likely a coping mechanism for something else entirely, such as underlying depression, anxiety, or stress,” she says.
Ariel Landrum, a California-based licensed marriage and family therapist, agrees. “We need further literature to talk about whether the disorder, the mental health condition, actually has to do with the game. Or is utilizing gaming a symptom of another mental health condition?”
When someone is spending a lot of time gaming, Landrum says, there’s usually another mental health condition present. If a person is depressed and has difficulty trusting others, for example, it makes sense that they would gravitate toward online gaming. In that space, “I have instant connection. I have control over the entire environment. I’m the one making my decisions. And I get a feedback loop of success,” she says.
If the same person could meet those emotional needs in another way, they probably wouldn’t need the game so much, Landrum says. “If you remove the game, and you replace it with something else that also brings satisfaction, like a sense of community, we wouldn’t say you’re addicted to community.”
Labeling children and teenagers as addicted to gaming can lead to shaming and stigma, and it doesn’t solve the underlying problem, Landrum says. Instead, when evaluating whether a person is gaming excessively, she tries to determine what purpose the game is serving. For a client who has trouble communicating, the game might be a safe space where they won’t have to try and read social cues. Or, say, it could be a place where a gamer is able to use their chosen gender identity without fear of discrimination. If the gaming is purposeful and doesn’t interfere with the needs of daily living — sleeping, eating, showering, and the like — Landrum doesn’t consider it problematic.
Experts may never agree on how online gaming impacts our brains. But the immersive worlds of digital gaming are almost certainly here to stay. Approaching the activity with curiosity, awareness, and an open mind is likely to be a winning strategy.