Video games have evolved into an integral part of the lives of many individuals; they are a new form of media, akin to books, films, and music, with the capacity to shape the experiences and interests of both children and adults alike. Amid this gaming boom, it is crucial to recognise that video games, like any other form of media, come with both positive and negative aspects. Here, Lee Hawker-Lecesne, MBPsS, clinical director at The Cabin, looks at how gaming offers a host of benefits when approached with structure and balance, but how it can become a problem when it interferes with life engagement and diminishes baseline dopamine levels.

Recent statistics reflect the growing influence of video games in society

• In 2022, the overall UK video game consumer market valuation reached an astounding £7.05 billion, marking a 17% increase from the pre-pandemic era.
• A staggering 88% of young adults, aged 16–24, engage in video games, with 29% participating in online gaming with strangers.
• Among children aged 7–18, more than two-thirds (68%) possess their own gaming consoles, and an additional 9% enjoy consistent access to one.
• Sony’s PlayStation 5 (PS5) emerged as the most sought-after console of 2022, with 800,000 units shipped.
• Sales of digital games in the UK witnessed a significant rise, with an additional one million units sold between 2021 and 2022, totaling 62 million.
• Gaming accessories for consoles saw remarkable sales, reaching 9.3 million units, vastly surpassing gaming PCs, which accounted for 2.3 million units.

Positives and negatives of gaming

While gaming can bring joy, create a sense of community, and offer competitive opportunities in the world of esports, overindulgence in gaming can lead to the desensitisation of the brain’s dopamine receptors, a phenomenon known as “redlining”. This redlining can result in frustration and aggression, often unrelated to the violence in games but rather connected to the feeling of incompetence. Gamers may continue to play out of habit, even if they find the experience less enjoyable.

Lee Hawker-Lecesne, MBPsS, clinical director at The Cabin, Asia’s most respected rehab, which has successfully treated over 5,000 inpatients, says: “It’s essential to acknowledge that not all gaming is problematic, and the distinction between passion and compulsion can be quite fine. With the introduction of gaming disorder as a recognised condition, there’s a risk of oversimplifying a complex issue. Drawing from our direct experience working with teenagers exhibiting excessive gaming habits, it’s evident that many struggle with self-regulation, leading to overindulgence. These individuals can benefit from implementing self-regulation strategies, which can help them strike a balance while still enjoying their gaming experiences.”

Gaming disorder diagnosis

However, in more extreme cases of excessive gaming, it’s important to recognise that some individuals turn to video games as a means of seeking relief from their pain. This pain may encompass physical, emotional, or mental suffering. In our experience, those who are likely to receive a gaming disorder diagnosis often have an underlying trauma or mental health challenge at the core of their struggles. Overindulgence and self-regulation issues tend to compound these underlying problems. In such cases, video games serve as coping mechanisms or a form of self-medication. Viewing game design as the sole cause of problematic gaming behaviours is overly simplistic and can divert attention from the deeper issues that underlie extreme cases, which people may be concerned about.

Warning signs: behavioural signs that a young person’s gaming has become problematic

• Irritable behaviour
• Aggression
• Rage when game time is limited
• Deceit about actual playtime
• Apathy towards responsibilities
• A strong desire to play games
• Late nights
• Disrupted sleep patterns
• Declining physical health

Tips for gamers and families seeking practical guidance

For gamers

• Limit gaming to a maximum of four days a week to improve performance and create space for other activities in life.
• Aim for gaming sessions of 2–3 hours at most, with breaks in between.

For concerned parents

• Take the time to understand your child’s favourite games and engage with them to foster a better relationship.
• Avoid extreme viewpoints in video games. Acknowledge that games, when played excessively, can have negative consequences, but they are not inherently harmful.

Lee says, “There exists a fundamental dilemma with debates over excessive gaming from a parent’s or loved one’s perspective. From an avid gamer perspective, they believe that games make them happy. More games equal more happiness. From the concerned adult’s perspective, they are worried that gaming is addictive and causes the young person to be aggressive or to disengage from their lives, so they think gaming will result in unhappiness. Both sides of the debate believe they are thinking about what’s best for the gamer’s well-being but disagree on how gaming affects it. The other obvious thing that they disagree with is the amount of gaming that is acceptable before it’s considered overplaying.”

Safe vs unsafe

Recent studies suggest that playing video games for approximately one hour per day can enhance one’s well-being, but this effect diminishes for those who play over three hours daily. The ideal gaming balance suggests sessions of 2–3 hours, no more than four days a week, for optimal performance and enjoyment. For children under 12, it is recommended that they play under 10 hours per week with age-appropriate content.

It’s important to recognise that individual motivation heavily influences how games are played as gamers seek to fulfil specific needs, which might be more easily satisfied in games than in real life. Game design can vary significantly, with some games employing tactics that encourage excessive play while others do not. The phenomenon of variable reward loops, akin to those found in gambling, can keep players engaged. However, overplaying can negatively impact both well-being and in-game performance, leading to frustration and disconnection from real life. Using video games as an escape from underlying mental health issues is not an effective coping mechanism; it masks the problem and may exacerbate it. Addressing the root issue is crucial for long-term well-being.

The Cabin’s programme addresses problematic behaviours associated with excessive gaming and the core issue of self-regulation. It identifies the missing piece of the puzzle that can lead to lasting behavioural changes. The critical question that arises is when casual gaming transforms into a gaming disorder. This transition is not quantified by a specific number of hours played. It depends on the extent to which gaming disrupts daily life and the opportunity cost involved. The Cabin’s approach involves educating and inspiring gamers to play intelligently by speaking from their perspective. The team at The Cabin consists of gamers who understand the gaming world from the inside. The programme extends to esports, with performance coaches working with top esports teams, helping players improve their real-life well-being and gaming habits.