Video Game Addiction: How Much Is Too Much

Last month, TIME reporteCommon_Signs_of_Video_Game_Addictiond on the death of a 32-year-old Taiwanese man who suffered heart failure after an apparent three-day video game binge. Over the past several years similar stories have come to light, and as the scientific research into the effects of video games on the brain continues to increase, many parents may be wondering just how concerned they should be about video game addiction.

Though the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not definitively classify compulsive gaming as a disorder, according to Dr. Cora Breuner, a pediatrician at Seattle Children’s Hospital, this doesn’t mean that parents shouldn’t worry.

“When you look at the symptoms of pathological video game use, all of the foundational tenets of what we might consider to be addiction are there,” said Breuner. “Preoccupation, justification, tolerance, dependence, withdrawal; the similarities between this disorder and substance abuse are striking.”

Recent research seems to support this notion. Scientists in a 2011 study published in Translational Psychiatry, found that frequent gamers had an increased volume of grey matter and activity in the reward center of the brain while gaming. This is the portion of the brain that regulates dopamine output, and is also the same part of the brain that is stimulated by certain drugs and alcohol.

“Dopamine is this wonderful chemical our brain turns on when we are relaxed,” said Breuner. “But where you run into problems is when someone intentionally seeks out that sensation through a certain act or substance, to the point that it begins to negatively affect other aspects of their life.”

Who is most at risk?

According to a 2011 study in Pediatrics, boys are more likely to play video games than girls, and are also much more likely to develop symptoms of pathological video game use. Researchers also found that youths who were prone to impulsivity, had lower social competence and issues with regulating their emotions were particularly at risk.

“Some of the kids who are most at risk are those who struggle in school or other social settings,” said Breuner. “For these kids, retreating into video games where they can do all kinds of otherworldly things can be a respite from reality, and can be very appealing.”

However, Breuner also notes that what may begin as a coping mechanism, can become detrimental in the long run. The same study in Pediatrics found that youths who become compulsive gamers suffered increased levels of depression, anxiety and social problems.

Warning signs

The main aspects of addiction (preoccupation, justification, tolerance, dependence, withdrawal) can act as warning signs, but Breuner emphasizes that they likely won’t present together, or all at once.

“Parents usually know their kids better than anyone, but adolescents are going through an incredibly tumultuous period in their development and all of these transitions can make it hard to identify potential problems,” said Breuner. “If your child begins to pull away from activities and friends that they used to enjoy for the sake of gaming, or if the time they are playing seems to increase to the point that it begins to negatively affect their schoolwork, these are warning signs that can indicate a larger problem.”

Advice for parents

The American Academy of Pediatrics (AAP) advises that children get no more than two hours of non-educational screen time per day, but as Breuner notes, that’s awfully hard for most parents to accomplish.

Therefore, Breuner provides the following tips for parents and caregivers:

  • Take an honest assessment of your own behavior. Kids tend to mimic the habits of their parents. If you’re looking to reduce the time your child spends playing video games, start by reducing  the time you spend in front of a screen each day.
  • Trying to wean your children off of digital media and gaming can be difficult, especially when they aren’t provided with alternative activities. Sit down with your kids and brainstorm different things they could do instead of playing video games. Some parents have created “Boredom Lists” to help their kids pass the time. The key is to provide options.
  • Set clear limitations on how much gaming time is allowed, and stick to them. Also, be aware of how your child is spending their time outside of the home (friend’s houses, internet cafes, etc.).
  • It’s important to remember that video games aren’t necessarily good or bad. That said, every time your child is playing a video game they are doing this instead of something else, so moderation is important.