IamA Former Video Game Addict and Therapist who helps Gamers, Young Men, and Parents Improve Mental Health and Find Balance around Technology. I'm here to Answer Your Questions about Men’s Mental Health, Technology, and Parenting around Technology...

What is the difference between "video game addiction" as a standalone condition, versus it being a symptom of other issues like depression or adhd?

In my eyes, "Video Game Addiction" (I really like that you put this in quotes) is most often the symptom of something else. The way I put it, Video Game Addiction isn't a problem, it's a solution that someone has found for their problem. For me, that thing was anxiety, shame, and a crippling fear of failure. For many others they may be understimulated, bored, lonely, disconnected, etc. Video games legitimately meet and solve for these needs in the short-term:

-They are extremely stimulating
-It's very easy to connect with other people who are playing and create community
-They can give a sense of achievement or competence
-They are easy to focus on, often times at the exclusion of other things
-They provide an instant and accessible way to use your time

All of these things are a huge part of why video games are great. That experience gets tainted if it is feeding or covering up some kind of underlying challenge. By addressing the underlying challenge, people can get back to a place that they are purely enjoying the experience of playing again.

This is appropro only of the concept of video games and mental health, but playing an MMO did genuinely allow me to isolate, define, and understand a part of me that needed attention in a specific way and provide that attention. It has been an interesting and enlightening experience.

Right. Video games can be a tool for growth.

One thing I always tell people is that I have no regrets over the time I spent playing. I learned so much. If I were to give a TED talk it would be:

How Video Game Addiction Taught Me Confidence, Accountability, and Growth

But it allowed me to procrastinate my dreams for decades. I certainly have regrets; had I not had video games I never would have reached the level of disinterest and procrastination I reached. I only started working towards my dreams in my 30s.

So be careful not to go overboard with the positive aspects of videogames in your spiel. There's a lot of people looking for excuses to rationalize their addiction.

EDIT: Not that I think you weren't balancing it correctly. Just expressing some thoughts.

Agreed.

The best time to start finding balance with your video game use was yesterday. The second best time is right now.

Despite not having regret, I truly believe anyone should try to act the moment that they know their gaming is out of balance. It's just easier if you start sooner, and I don't think getting deeper into it brings benefit.

I’m actually curious about this. I am in therapy for other problems but one thing I have struggled with my whole life was video games. I always used it as an escape and everything you wrote resonates with me. At 31, I have done a lot better in prioritizing taking care of responsibilities; chores, exercise, work (never had an issue with this. More personal hygiene and self care). I’m having a tough time dealing with anxiety. For example, today I exercised, kept within my calories, did laundry, showered + skin and teeth care. Yet, I feel anxious and I want to use video games as an escape for some relief. It’s hard to not feel like anxiety controls me. Any advice or things that helped you? I enjoy video games but even with exercising for the day I still feel anxious. I need to go the store and buy veggies/fruits/dinners for the week and I have work tomorrow but my mind wants to go back to video games right now and have fun. I told myself I will do it tomorrow as I need a break lol. Even though I feel like I got a good deal done, my anxiety is not satisfied. The more I expand, the more my mind wants to go back to old comforts like video games. It is hard separating my enjoyment of it and escaping from my anxiety.

First, I feel damn proud for you. That isn't easy, and it's made even harder by carrying anxiety while doing it.

I'm extremely tempted to write out an entire essay worth of information on managing anxiety because I feel for you. In short, anxiety is like an over-protective friend that doesn't want you to stop thinking or acting until you've created absolute certainty. When you give into the anxiety, you teach your mind that your anxiety was necessary, and that you need to continue giving in so that you can feel relief and be safe. Instead of writing you an essay, I'm going to recommend reading 'The Happiness Trap' by Russ Harris. It does a really good job of breaking down the process of leaving that cycle.

Why speak of video games as "great"? Wouldn't it always be the case that one could stop playing completely and do things that actually serve their life goals?

I think this is a valid way to live your life; in pursuit of the next goal. If that is the case, video games likely are not a good use of your time.

My way of thinking of things involves using your values to drive your life. In this way of thinking, someone who values socializing, growth, skill mastery, and adventure could definitely play video games in a way that is serving them and the life they want to live.

Do you still play video games?

Video games are great, and no one will ever be able to convince me otherwise! Up until about a year and a half ago, I was still playing video games regularly. I still play on occasion, however recently I've been much more focused on other things that I enjoy (LoZ: Tears of the Kingdom is on my play list right now).

I'm a firm believer that balance is the right path for most people when it comes to video games, not abstinence. That said, a lot of modern video games are designed to keep people playing which makes finding balance a challenge. It has to be done intentionally, and with a good understanding of your mind and the strategies companies are using to keep you playing.

Thanks for the answer. I agree completely. I was very addicted to Everquest while in school. I still play games but refuse to touch the MMORPG genre because I know the affect it will have on me

Yeah, I love MMO's, but I know I cannot play them in a balanced way. I'm hungry for the purple items, and that hunger does not get satisfied.

If someone is recovering from a gaming addiction, do you normally recommend them staying away like with alcohol or other drug addiction or is it healthy to just moderate because it's not physically additive like those are?

This really varies from person to person, however with most people, I end up suggesting an approach that eventually involves moderation.

It can be really helpful to have some time away from gaming completely. If the person is willing, we'll create a plan that involves spending a few weeks away from games completely, then returning to games in a way that allows them balance (as defined by them). This helps break up some of the habits and patterns that existed before, and many people find themselves appreciating video games more after returning. That within itself makes it worth it for many. One client told me:

"I'm playing less, but I'm playing better and I'm enjoying it more. It feels like I was trying to eat chocolate cake for all of my meals, and expecting to not feel miserable and get sick of it. Now I eat my veggies, then I enjoy my cake, and that cake tastes so much better."

I am… not in a good place right now health or balance wise.

But I really like the way my therapist framed this concept in terms of efficiency. When you have a balanced life, you simply get more out of the things you enjoy, even if it means spending less time with them. It’s simply more efficient.

I imagine this might help some people because boy howdy do strategy gamers love optimization and efficiency.

RIGHT? More EPM (Enjoyment per minute, of course).

You mention ToTK... will your approach be to enjoy the game for the main story experience or be a completionist?

I'm asking mainly because I'm currently a casual gamer with limited time, and will play something like ToTK over the course of the next 2 years or so, and that will likely be my only gaming that I will do.

From a personal perspective, I've always loved video games, and it was a definite motivating factor for me to pursue a technical career. The interesting side-effect to working in tech all day, and I have done everything from game and web development to infrastructure engineering, is that the last thing I usually want to do when I'm done working is be in front of any kind of screen.

Here is another neat thing; I'm approaching the game in a different way than I have every approached gaming. I've always played for the sake of completion or achievement, and I'm playing now for the sake of exploration and enjoyment. It's been so fun to just hop on, enjoy exploring for whatever time I'm willing to give, then hop off. I don't feel the pressure to complete the game or do everything optimally.

My choice to approach it this way actually came from a discussion with one of my clients about the game. Sometimes (oftentimes, TBH), my clients teach me.

Not sure if you're done here yet or not, but:

I love that you mention the way many games are designed to keep you playing as long as possible, not just by providing a fun experience but by actively manipulating the players. Do you see any way to end or at least discourage this trend in AAA gaming? Do you think this is something that could, or even should, be addressed through legislation, or will this just be a permanent feature of poorly-regulated capitalism?

I tend to have a bias towards optimism, however in this situation, I think it's unrealistic to count on legislation to address this in the near future.

I do think accountability for game companies is important, and in an ideal world, that is what I would like to see. I think it's wise to try to push for that, while also pushing for gamers and consumers to have a better understanding of what's going on so that they can make informed choices and vote with their dollars/time.

But do you just think this way because you have a "sunk cost", in the same way a person who has been persuaded to buy a $1000 phone will then try and convince their friends to do the same?

As a videogame enthusiast, what are the negative sides, how do videogames impact a person's attention span, their ability to interact in a non-mediated way with other people, their motivation, their ability to think outside the box?

Had you spoken to me 5-years ago, I would not have believed that video games had a significant impact on attention span, motivation, and thinking. Having experienced how differently my brain works on the other side, then seeing the same thing in my clients, I'm now certain that all of these are impacted by excessive video game use. It's important to know that when used in balance, video games can actually positively impact the mind in a lot of ways, and excess is really what makes the poison.

When I was in the depths of it and playing upwards of 16-hours per day, everyday tasks were PAINFULLY boring. To my partner's dismay, a simple task like going to the grocery store seemed like the biggest chore. In addition, I had a hard time reading anything longer than a paragraph, and anything that didn't have step-by-step instructions was hard for me to get started on.
Part of my process of finding balance involved spending a few weeks away from gaming. Life circumstances at the time made that an easy and obvious choice. It was striking to me that when I returned, I could go to the grocery store and actually enjoy it. Things like focus and operationalizing the challenges in my life took more deliberate effort, but also improved.

What is considered a video game addiction? What conditions have to be met to distinguish between a regular person who plays them in their free time vs. an addict?

Often times when I get asked this question, people are hoping for a specific amount of hours. Especially in the age of Esports and games that take 100's of hours to complete, the amount of time that someone can play and still be healthy really varies. Instead of looking at hours, it is best to look at how it impacts the person.

There are two metrics that I use:

-Your video game use is starting to cause other issues. For instance, my playing was causing me to fail school, socially isolate, and even caused me a repetitive stress injury in my wrist that still impacts me to this day.

-You're functioning well in your life, but you're playing video games despite them not being very fun anymore and wanting to do other things. Outside of the basic things needed to function, gaming is the only priority.

Are there any published studies about the effects of exposure to videogames/internet media with young adults and teens?

Were your parents right and was your relationship with video games unhealthy?

My parents were most definitely correct, but the more they tried to convince me, the worse it got. Underneath my video game use was a lot of shame. Not only did I not feel that shame when I played games, I felt proud because I was pretty good at them. The more they pushed on me, the more shame I felt, and the more I wanted to play.

Research is growing. South Korea has been doing great research for a long time, and HealthyGamer is doing some excellent work right now. One important thing to point out is that with balanced use, video games actually can be BENEFICIAL! It's the lack of balance that causes challenges.

Here is a really solid Meta-Analysis that was pre-pandemic. My anecdotal experience is that a lot of this has increased post-pandemic, however science moves slowly:

https://pubmed.ncbi.nlm.nih.gov/33028074/

What type of limitations do you set for yourself in order to maintain that balance?

What steps should I take as a parent of a young child to prevent him having an unhealthy relationship with video games?

There was a meme that changed me life. I can't seem to find it when I search for it but it was:

-Playing Video Games
-Start to think about all of the stuff I need to get done
-Playing Video Games *STRESFULLY*

Seeing this meme hurt a little bit too much. My parents had tried to convince me to get everything done before I play games, and I was especially resistant to that idea because I felt like it reinforced the idea that I had a problem. Because of this meme, I became motivated to give that a try. My thought was, "I don't know if this will matter, but I want to see what it feels like to play video games without having worry in the back of my head." I promised myself that for a week, I could play as many video games as I wanted after I had taken care of all of my responsibilities for the day. Some days, this meant I had 2 hours, some days it was more like 10-15. Unsurprisingly, video games were SO MUCH MORE FUN. To this day, I follow that rule, but with an added bit. Two pronged question:

-Do you have any other responsibilities that you need to take care of today?
-Is there anything else that I would like to do in order to take care of myself, or that I would feel more fulfilled by at the moment?

If the answer to both of those questions is no, then I'll play video games.

With regards to a young child, you can really help teach the skills of balance early. Some tips I have include:

-Make sure to always show understanding for wanting to play games/use technology. No parent has ever succeeded in convincing their child that they should play less.
-Use the 'Yes, and' approach. For example, "Yes, I know you want to play more, and I want to make sure you're healthy. Once you do (insert x healthy things here), you can have some more time to play."
-Recruit your kid in discussions about how much time they believe to be healthy for them

What are certain processes/boundaries parents should implement for their children?

One of the things that makes this so challenging is that there isn't one specific set of boundaries or processes that works for every family and every kid. I have a lot of empathy for parents who are trying to set boundaries in the technology age, because there just isn't a simple answer.

Two rules of thumb when it comes to boundaries:

-If it is causing a problem for your child whether that be socially, physically, mentally, or academically, it needs to be addressed.
-Boundaries should be set from a place of understanding, compassion, and discipline, not from a place of punishment. In addition, boundaries should be set beforehand. Below is a sample of some of the language I guide parents to use to take steps towards this:

“We know that you enjoy playing games because it gives you time with your friends and

it’s just plain fun for you. We like to see you happy and we want you to have that. We

also care about you want want to make sure you're healthy. Let's talk about how you can play games in a way that's healthy."

From there, you discuss what healthy technology use looks like, and agree to what will happen if those limits are broken.

If you want more in depth information on this, my guide has a more complete run-down.

I wish we had access to this exact information 15 years ago!!! We had issues w my son's gaming and made mistakes. We had no support to properly deal w gaming limits!!

I wish so, too. One thing that I came to realize was that it wasn't my parent's fault; there just was not very good guidance on how to approach games and technology.

Please, if you're able to, share this with any people in your life who you feel could use it now!

What’s been your biggest challenge as it comes to talking to men about underlying (or sometimes overt) misogyny?

I love this question, by the way.

Honestly, the biggest challenge is that by the time that I'm speaking to the person, their interactions have created a self-fulfilling prophecy that can be hard to challenge because of how invalidating it feels. I have to ride the line between legitimately understanding their experience, accepting them where they are at, and challenging unhelpful beliefs around women.

For many men, there is a lot of anxiety, hurt, and self-doubt underneath misogyny. One common belief is, "Women only date ultra powerful and ultra attractive men." This gets reinforced over and over again because of how this causes them to interact with the opposite sex, and the responses they get as a result of interacting that way.

Generally, my go to has been to show a lot of understanding, and to get people to try interacting differently and see what happens. I've had a surprising amount of success with that.

Thanks for this answer! I’ve definitely seen others have that negative self fulfilling prophecy before and it’s honestly just sad because it makes you think about their ultra low self worth.

If you have some more time check out r/menslib. I was a lot more involved in the community a few years back, and their conversations are fantastic.

I most certainly will! I wasn't aware that this subreddit existed.

Would you by chance have any connection with any of the moderators?

What are some tips for cutting down on gaming time? I find myself primarily using gaming as a form of escapism and playing more than I'd like during stressful times in my life, or as a way to procrastinate to avoid doing something that is stressing me out.

I usually play competitive games like League of Legends that are very easy to play hours of since the individual games are relatively short. Thanks for doing an AMA and offering your perspective!

LoL is my most played game of all time and will always have a special place in my heart. For a lot of reasons, this game is hard to put down and balance.

Before I give some specific tips, one thing that I would advocate for is seeking some mental health support to help deal with stress.

That said, I have three thoughts that I've seen be really helpful for myself or others:
1. Understand that your rank in League is not based on how many games you play, but how well you play. If you're taking care of your body, taking care of your mind, and meeting your needs, you will have higher quality games. This will help you play better, and also help you actually enjoy it more.

1. Commit to not playing games until you've attended to the other important areas of your life. In this way, games become a reward instead of an escape. One of my favorite ways to do this is to allow yourself to play as much video games as you want as long as you've done one thing for your health, attended to any work/school must do's, and have done one thing to attend to your social wellbeing.

2. Break the stress cycle. Gamers are really smart, and really good at finding efficient ways of dealing with things, stress included. As far as your brain is concerned, if you're stressed and play a video game, the stress goes away. If video games can instantly take away stress, why wouldn't your brain want to do that? Your brain then gets trained to play video games in order to instantly manage the stress with very minimal physical effort needed. Breaking this cycle involves understanding this, and choosing to intentionally approach the stressful thing head on. I would say to myself, "I know it would be easier to play video games, and it makes sense that you want to go do that. At the same time, I know I'll feel better and enjoy the game more if I do the stressful thing first."

Why is it men appear more likely to become addicted to video games? I as a woman love video games but I would say that I've never played them enough (despite playing a lot in my youth) to make my parents concerned about me being addicted. Even when they were up against me playing as much as I could through a new Mario game, for example.

There are a lot of reasons why this may be the case including but not limited to:
-Men are much less likely to seek help for challenges and much more likely to turn to external solutions to internal challenges
-While more and more females are playing video games, gaming culture and social gaming is much more normalized among males
-Male brain development, particularly in the frontal lobe which is responsible for impulse control, is significantly slower than in females
-Males may have more brain activity in the mesocorticolimbic center from video game use, the region of the brain associated with reward Reference

why cant i get addicted to stuff that makes money?

If you think about it, the stuff that is easy to become addicted to often involve trading time for almost immediate pleasure, and doing so with the least amount of physical effort possible. Your brain is very efficient, so if it has found a way to get pleasure with small amounts of energy, it wants to keep doing it.

If you think about the things that make money, they often involve spending time, tolerating and sitting through discomfort, waiting, then receiving the reward of payment.

From the point of view of your brain, why would your brain want to do that when it could simply play a video game and experience the same sense of reward and achievement?

Hi! This is a very interesting topic for me, and so I have a few questions for you:

• How would you rate HealthyGamerGG's youtube channel in terms of his information and tips? To me it seems like a good channel with the host having a past situation similar to yours but it's always hard to judge the quality of a medical/mental health communicator.

• What would you say to a young child to get him on a balanced life with technology before any addiction happens? It seems like it's very difficult in today's world for a young influenceable mind to not stick to their phone like everyone else is doing.

• In the same vein, what would you say to someone who is deeply addicted and not concerned about its effect on their life?

• Have you seen a link between social isolation and time past on technology (watching videos, playing video games or simply doom scrolling on phone)? Also, how can someone gain back their lost social life when they spent their development years not socializing?

Thank you and sorry for all the questions!

• Dr. K and HealthyGamer are great. His information is extremely solid, and he truly understands mental health, finding balance in technology use, and mental wellbeing. Also you're right; we have remarkably similar histories. I have a feeling many other people share our story, and that this is simply the nature of growing up in the era of competitive gaming.
• I would start by talking about how awesome technology and games are and understanding why they want to use it so much. Why? Because it's true! I would then tell them that I want them to keep enjoying it, and that I want them to be healthy, too. I would empathize with the fact that their friends maybe don't have the same limits, and would set limits nonetheless. As much as possible, I would recruit them to help determine what is healthy and what those limits should be.
• I would say that this person has become hopeless, and understand what has caused them to feel so hopeless. I wouldn't try to convince them that they should stop playing games, or that they need to stop playing games. In fact, I would probably say, "If life has become this miserable, it makes sense to me that gaming is how you want to spend your time. Can you help me understand what has been making life so miserable?"
• Most certainly. One thing to note is that video games are also a great social activity in balance. During the pandemic, gamers THRIVED. At the same time, while socializing through video games is legitimate, it isn't a replacement to face-to-face communication. Without face-to-face communication, social skills atrophy. There is good news though: 1. Social skills return with practice 2. Social skills are, in fact, a skill. Thus, they can be learned. There is no way around this; it will take confronting the anxiety of socializing, and then needing to practice. I recommend choosing some kind of IRL activity that is engaging, enjoyable, or useful to you. This way you have a task to focus on while socializing which can take some of the pressure off.

Thank you for asking so many thoughtful questions; that's what I'm here for! Please subscribe to my youtube and pop in to ask any other questions you may have during stream.

What’s the threshold for considering yourself to be addicted to video games?

If I play 10 hours on a Saturday and then only about 3 hours during the rest of the week is that being addicted? What if it’s 3 hours a day most days after work? How does splitting video game genres work in calculating addiction? Like if I play grand strategy games by myself but shooters with friends are those two different things?

I would think it was somewhat like any addiction. Does it dominate your life, do you prioritize gaming over relationships, do you find it to be something you cannot control.

I say "somewhat" because many people have very healthy social interactions with gaming associates and form lasting and meaningful relationships. When those people are also friends that you encounter socially, I don't see how that is any different than going bowling or whatever.

You're absolutely correct. Here is my response from another commentor:

Often times when I get asked this question, people are hoping for a specific amount of hours. Especially in the age of Esports and games that take 100's of hours to complete, the amount of time that someone can play and still be healthy really varies. Instead of looking at hours, it is best to look at how it impacts the person.

There are two metrics that I use:

-Your video game use is starting to cause other issues. For instance, my playing was causing me to fail school, socially isolate, and even caused me a repetitive stress injury in my wrist that still impacts me to this day.

-You're functioning well in your life, but you're playing video games despite them not being very fun anymore and wanting to do other things. Outside of the basic things needed to function, gaming is the only priority.

How can I support a family member in the throes of untreated gaming addiction?

It’s an incredibly sensitive topic, this person is an adult living with parents that can’t really control their behaviour/choices.

Thanks for doing this, it’s a fascinating topic that hits close to home.

You're asking the right question here. You're right; your support needs to be mindful of the fact that the person is an adult who cannot be controlled. That said, their parents do have the ability to set boundaries with accountability and compassion and may benefit from what my course has to offer in terms of teaching those skills.

The best thing you can do to support them is to provide understanding, respect, thoughtfulness, and accountability/autonomy. A mentor of mine, David Burns, has two sets of skills for doing this:

1. The Five Secrets of Effective Communication
2. Sitting with Open hands

The five secrets are really just the basic skills needed to communicate well, and sitting with open hands is the skill of allowing people the space to choose to come to you instead of trying to force them to speak. I'll give examples of both below:

Five Secrets: "Hey, I know that everyone has been on your case about how much you've been playing games, and I think that we've been unfair to be making those assumptions. I know you enjoy it a lot, and I don't think we've been taking the time to listen which I'd imagine has been frustrating, and has caused you to feel shutdown and criticized. I feel sad seeing how this has affected you, and I think I've put the fact that I'm worried about you in the way of actually listening and understanding you. I care about you a lot and know that you have a lot to offer the world.

Sitting with Open Hands: I would like to understand more about how you think and feel about video games, as well as what it has been like to have everyone on top of you about it. I would love to speak now if you're willing, and if not, I want you to know that I'm always here to talk.

Thank you for being a support to the people you care about.

Do you think video games themselves are addicting by their nature or is it more a problem where certain people don't know how to cope with real life issues and video games are just too effective as an escape from reality?

Would learning to deal with those issues reduce a person's reliance on video games as a coping method and thus make games less "addicting" or should video game addicts quit gaming altogether to avoid a risk of "relapse"?

I would say a little bit of column A and a little bit of column B.

Last year I went on a trip to Germany. I was on a train next to a stranger and started to make conversation. He asked me what I do for work, and I told him. He replied, "Oh, I'm your enemy!" It turned out, he was studying computer science and game development. He further explained, "My course work is literally about how to make games as addicting as possible, because that is what employers are wanting."

I want to be careful here; I'm not saying game companies are evil, and I'm not saying that video games are some kind of poison. What I am saying is that naturally, video game developers want you to play more, and they're getting extremely good at it. If you have some kind of underlying need that is being met by playing games, this makes it much more likely that you will play to the point of excess. On top of this, it creates a need to set limits or utilize tools outside of the game to maintain balance. One thing I started doing for myself is setting an alarm that goes off every hour. When it goes off, I'll stop to stretch, attend to how I'm feeling, and ask myself if this is how I want to keep using my time.

I'm a huge believer in addressing the underlying issue, then taking steps to use games in a balanced way. I really recommend trying to take at least a two week period away from games for which you are doing other engaging and enjoyable things, then bringing the games back in with some guidelines around them.

On occasion, I'll run into someone who truly can't seem to find that balance. Really with all the people that I've worked with, this has been only a couple of people.

Do you not find anything problematic with game developers and corporations designing these games to be addictive that are then marketed and pushed to children?

I most definitely find this to be problematic. I also believe that it has made a lot of games less fun, despite it being easier to want to spend more time on them. It's a brutal cycle where companies benefit from getting people to play more, people do play more because of these changes, and companies are then reinforced to keep doing it.

I think the solution is a mix of better informed gamers, and advocacy/regulation towards game/app producers.

Any significant impact on sexual behavior from a lot of gaming?

This is not something that I've looked into at this point, although now I'm curious.

I'll put it on my list of things to learn more about. If you're willing to share, could you tell me more about what is leading you to ask?

I started saying "poggers" in the bedroom as a joke to mess with my partner, and now I can't stop.

You can take the man away from the memes, but you can't take the meme out of the man. I laughed out loud.

How much of parents whining about their kid being addicted to video games would actually qualify as addiction? What are the differences between addiction, and just liking to do it a lot?

I relate to this question so heavily.

It really is relative, and for many parents, there is a huge gap in understanding. They grew up in the era of Nintendo and Arcades where you could actually play a game for 5-minutes and get a meaningful amount of enjoyment. One of the discussions I have with parents frequently is how different modern games are (and also, the reason why their child can't simply pause to do what is demanded of them in a given moment).

I really have empathy for both sides. The solution often involves me understanding why parents are concerned and having a hard time, then parents understanding why their child is spending so much time playing. Sometimes, I don't even need to give any additional guidance after that; the mutual understanding is enough.

As someone who grew up before video games, is it similar to when your parents interrupted you while you were reading a book, watching a good TV show, or listening to an album?

Is that some way parents can relate?

It is definitely like that, except with added pressure. Because most games are online these days, you're letting a team of actual humans (often times, your friends) down by leaving. In addition, while it may not seem like a big deal, so many people are playing to win.

I would say the best way for parents to relate is directly to ask their kids:

"Hey, I can tell that it really bothers you when I interrupt you while playing, can you help me understand what bothers you about it?"

What are your thoughts on Dr. K?

Dr. K and HealthyGamer are both absolutely wonderful. I'm in huge admiration of him and what he has done, and we share a lot of the same view points with regards to approaching excessive video game use. My approach is more secular and clinically based due to my experience and training, however lands on a lot of the same conclusions.

A question that will help give us a good insight about you and the addiction, when did you start (what year and what age) and how long would you say it lasted till (year). What were your favourite games over the years and how many hours do you spend daily or weekly gaming then and now?

Also curious do you buy in game purchases if so what was your largest?

I'm surprised I've never been asked this before.

I was basically born with a controller in my hand. As young as I can remember, I had been playing games like Punch out!, Legend of Zelda, and Battletoads on the NES.

I would say that it started to cross the line into problematic use in middle school. I was playing Runescape at the time. Ironically, it was initially a motivator for me. My Mom promised me she would pay for a year of membership if I got above a 3.0 GPA, and this was the only time I achieved that through my middle and high school career. I ended up sneaking out of bed, ditching friends, and staying up until 1 AM on school nights at 12-years-old to grind out stats. My parents tried grounding me, limiting my game time, and taking games away. I always found a way to keep playing. After Runescape I played Maplestory, WoW, and Starcraft.

This continued and progressed all the way until I was 21-years-old. I played more WoW, League of Legends (my most played game, seriously, I would cry if I could see the time I spent), and Starcraft II. I also played a bit of Minecraft, Terraria, some single player games, and anything I could goof around on with my friends. At that time, I was playing 16-hours per day. I would wake up, grab coffee, walk straight to my computer, and only get off to grab quick meals (sometimes, literally just ingredients from the fridge). I would not get off the computer until I was CERTAIN that I would fall asleep immediately when I got off. The turning point was when I was told that I was no longer able to attend my university classes. This was the peak of my play time, and it decreased slowly from then until now.

Thankfully, I never got too far into in-game purchases. I do have quite a few LoL skins that I accrued slowly over my 11-years of playing, and spent some money in the cash shop of any game I played seriously with the justification that I was supporting development.

Hi! I've gotten into the same subject over the past 4 years and developed a passion for helping people with technology addiction. I have suffered myself and overcome it through years of work. Great to see someone that's also helping others with it. I was wondering, any opportunities to work in the field that are out there? I notice most addiction work such as social work seems to revolve around other addictions.

Welcome! I'm so happy to hear it. Just look at this thread; you're needed.

You're correct that there is not a lot of formal training, and research on technology and gaming addictions are in their infancy. The focus on other more fatal addictions like opioids, as well as the lack of DSM-5 diagnostic classification have made it less desirable to the clinical world. The way I've learned to approach things has come from my own experience, my training and background working in addictions, and the use of measurement tools in my therapy to make sure that what I'm doing is actually effective.

Healthygamer.gg is approaching this outside of the clinical world and hires new coaches frequently. I would recommend checking their jobs page. They are also advocating on the frontline to bring more attention to this need.

Outside of that, I can see that the current generation of therapists being trained is more interested in this subject area. They are pushing their professors and universities to make more information and training available, and also doing research on the topic.

Finally, people like you who are interested and experienced will continue to help further the ability to assist people with this need. Thank you.

Oh, I AM a Healthy Gamer coach. LOL! I appreciate you listing us - we do great work :) Dr. K is awesome.

I run a bunch of groups there and help people discover "what's underneath" as you posted...

But I still have a craving to assist people in a way that's more "IRL" based or where I just tell people what they need to do with their gaming/technology habits. For example, for myself, I'm doing 369 days of no random YouTube watching (YouTube is one of my biggest technology pitfalls).

If you want, I'd love to talk further about this whole subject whenever you'd like to. It's my main passion and I am currently working on a list of "Harm Reduction" strategies that worked for me and could work for others. Are you open to sending a DM?

Oh, neat!

Please do, I would love to hear more about where you're headed. If you use instagram, the instagram account listed in the post is probably the best way to reach me.

What should you do to find balance when your career revolves around gaming like myself? (Twitch partner)

Oo, that really is a very unique challenge. There is pressure to play a lot, and balance looks very different when you're a content creator.

Without knowing the specifics of your situation (which honestly, a great answer requires the specifics), I do have a few thoughts.

First, there is a little bit of a trap that I've seen content creators fall into. I hear a lot of nervousness that goes something along the lines of, "If I'm not streaming as much as possible, I'm losing out on opportunity." The hard part is that there is truth to this, and the way out of this trap involves accepting that you lose some opportunity by choosing to take care of yourself. I've worked with a few content creators who have told me that they stream more effectively and efficiently when they are taking care of themselves, and that they're able to enjoy it more. In other words, you accept that you trade some opportunity for the ability to enjoy and be more engaged in stream.

Some very clever content creators have found ways to work balance into their streaming. There are a few streamers I have watched that include their workout as the intro to their stream.

Ultimately though, that balance is very individualized. I would recommend answering the question:

"If I were to talk to a friend who was in exactly my position who I care about a lot, and to be extremely honest to them about how they are spending their time, how would I advise them to spend it?"

What games do you see people getting addicted to the most frequently?

Competitive games and MMORPGs. When I look at what both of these have in common, there is endless playability and a constant sense of the ability to achieve.

Hey Adam. Fellow LCSW and gamer here. I spent the first 7 years of my career in public schools - running video game club at a middle and high school level. A lot of the kids I had in social skills groups or did counseling with were in those clubs.

I now work at a state university as a therapist in their CAPS. I don’t see as much content related to video games - but I do see a ton of social isolation in conjunction with disturbing usage (from a time spent perspective) of social media.

With the advent of live service games (Destiny 2 being a big one) demanding time as well as social media being designed to take up a lot of time - do you think both issues can be solved in conjunction or do you think there are things unique to each platform as it relates to creating dysfunction?

Hey there! I love that; truly a wise way to integrate mental health and gaming.

Slowly but surely, I'm seeing the need to address video game/technology use being taken more and more seriously. I also am seeing and hearing from college students who are pushing for this, as well as doing research in these areas.

My approach has been to address it all as a lump sum by talking about the need to balance technology use. That said, the strategies to address the habitual components may change between video games and social media, and each person I work with gets their own specific approach based on their use patterns.

What are some early signs of gaming addiction you should look out for in yourself or your family?

I really want to be careful to note that seeing these signs does not necessitate panic, but instead a thoughtful and compassionate conversation. I always suggest approaching this not from the standpoint of, "You have a problem", but instead from the standpoint of, "I want you to continue to be able to enjoy games in a healthy way."

That said:

• Fantasizing about playing games while doing other things, especially enjoyable things
• Finding less enjoyment in things outside of gaming
• Starting to feel nervousness or worry around not playing
• Procrastinating in order to play games
• Playing more than you intend to or losing track of time while playing on a consistent basis
• This is an underrated one, but the more reasons your mind is giving you to convince you that you're not playing too much, the more likely it is that you've gotten out of balance.

So what’s the game you were addicted to?

I’m guessing WoW

WoW and LoL, mostly!

I was on a similar boat as you were on when I was young - spent too much time playing mmos until I dropped out of college within 4 semesters and just after spending 10 years doing home school during my high school days.

Long story short, I decided after dropping out that I wouldn't want my parents to make more effort in my life, so I decided to work in corporate, first as an intern and then 8 years later became a self taught data analyst that now dabbles in basic-intermediate coding and unofficial spokesperson during office meetings and social events.

Having said that, I have a few questions for you.

1. I got over my gaming addiction by basically just trying hard to reinforce a habit of completing more important activities and obligations and turn gaming as a form of reward for a "hard days" work. The problem is that, people (in laws and sister in particular) just won't accept the fact that gaming is my hobby and that they make an effort to make me feel uncomfortable during my gaming sessions, often gaslighting me to the point it triggers me to become defensive in my activities, which inadvertly proves them right. How do I deal with this constructively? I still have anger issues coming from my past experiences in life that I haven't yet come to terms with, so that adds to the tension everytime they do their thing while I am gaming.

2. In my years of struggle to control myself, I still cannot say I am 100% clean. There are times in my life, especially after question #1, that life just hits me harder than how I can control myself and I just say fuck it and just revert back to my old gamer self for at least a day or two to recuperate. What would be your advice to me to help me reduce this need to self destruct during difficult times?

Thank you.

I really appreciate your path, and where you're at is making sense to me.

1. There are essentially two paths forward here. The first is that you can accept that your family has a different point of view than yours, and that they will not understand that you can game in a healthy way. This is a totally acceptable way to proceed, however I prefer the next option. The second path is that you can lean in and understand more about their perspective, and empathize with whatever their perspective is. After doing that, you can try to open a dialogue that will allow them to understand what this is like for you. That might look like, "I get it now. From your point of view, it's a waste of time when I play games and you're worried that it's preventing me from living my best life. Would you be willing to hear my thoughts?"
2. This is not abnormal, and in fact, it's hyper normal. The nature of the mind is that it will fall back to patterns it has already learned, and the trick is to catch it as it starts that process. Good relapse prevention involves identifying signs that you're heading towards relapse (self destruction as you put it), having a list of the steps you know help you stay healthy, and acting on that as soon as possible. I also think you're on the right track; being able to come to mutual understanding with your family will likely be a big help. You could maybe even recruit them to gently check-in and give them language that you would need to hear in order to feel supported in identifying that you need to take action.

When parents come to you with the idea of "video games are worhtless," do you help advocate for the children to help the parents understand that its okay in moderation?

Somewhat related, I've always been very interested in the gender discrepancy in high skill gaming like esports, and it usually is explained that girls at a young age are socially conditioned to not put in the time and effort to develop those skills like boys are. I kind of wondered if helping to explain to parents that children of both genders can find value in games as long as it's done healthily would help in working toward more gender equality in that realm.

This is a critically important part of what I do. I simultaneously can understand why parents believe games are worthless, and why their children love them so much. It's absolutely essential that I help to close that gap, and in particular, help parents understand why their children love video games. A quote I throw out often is:

"If it becomes you versus your child and the videogames, everyone will lose."

I have completely banned my kids from watching YouTube after the Kids version failed to filter out questionable content. What do you see as the most troubling trend in technology at the moment for young children?

This may be unexpected, but short-form content and the tendency of apps to auto-play the next video. Especially for young minds, I believe the combination of those two things train a mind that is used to focusing in short, extremely engaging bursts.

Do you think there’s a reasonable line to be drawn in terms of kids access to screens and internet? I know how quickly things like YouTube can lead the most unsuspecting people down very dark roads. My kids are 7 and 3. How would you recommend restricting or supervising their behavior with regards to screens and internet to avoid these pitfalls?

What a thoughtful and insightful question.

When it comes to how many hours are suggested, the range will vary coming from different reputable medical and psychological sources. For this reason, I really try to stay away from hour-based guidelines and instead try to promote the idea of promoting balance and safety. A good guiding question is, "How can I teach my kids the skills necessary to use their technology in a healthy way?"

For kids age 2-5, honestly, I'd recommend that use be supervised and not self-directed.

After ages 5 and up, you can start to have more discussions about balance/safety and allow them more space to choose. The way that I think about it, you set guide rails on what type of content and how much content they are allowed to have, and as they get older, you widen the rails to give them more space. This is a constant negotiation. They are going to bump into the rails sometimes, and one of the most important things is creating a safe place for which your kids can discuss their technology use when this happens, while also having predetermined consequences for when this occurs. More specifically:

• Speak to your kids about how technology is good, but that it's also important to be healthy. Help them learn what healthy means for your family.
• Set boundaries and make them clear. Make it clear what will happen if they cross the boundary, and when it occurs, enforce it with compassion.
• Lead by example. They look to you to know what healthy technology use looks like.
• Use parental controls for younger kids. I'd recommend loosening and eventually removing them as they progress through teenage years.
• Be insistent on meeting responsibilities, then celebrating the use of technology afterwards. Show understanding when your kid wants to use technology instead, but continue to stick to the limit.
• Create an environment where your kids can feel safe talking to you about what they encounter online.

Are there particular games that are more/less addicting than others? For instance, is a person more likely to get addicted to multiplayer over singleplayer, console over mobile, or linear over sandbox?

My experience has been that competitive games and MMOs are significantly more addicting than other types of games. I see less addiction to single player games.

That said, it all depends on the person and what drives them to play on an individual basis. For instance, if someone plays to meet social needs and you find a giant Minecraft community that they feel connected with, it naturally becomes a very attractive option.

I’ve been thinking for a while that young men need community, friendly competition, and exposure to adult males they can be friendly with who aren’t authority figure over them. What are your thoughts on Bowling leagues as an avenue for helping teenage men get exposed to more people of all walks of life, and removed from the echo chambers denizens of the internet create for themselves?

I do think that any way we can meet some of those needs IRL, preferably in a physical way, is hugely beneficial. A big part of my own process involved spending a lot of time with my colleagues, my partner, and being in nature.

Do you believe that the social element of MMORPGs can create an environment of unknowing enablers in addiction?

Absolutely. One client said,

"I convinced myself that it's not a problem because I see so many people doing the same thing and seemingly living full and successful lives. That's when I realized that from their point of view, I also seemed to be living a full and successful life."

What games did you play?

My biggest three, in order of time played:

1. League of Legends
2. World of Warcraft
3. Starcraft 2

How many hours on each?

Maybe unsurprising, but I was always too afraid to look. Every once in a while, I would imagine what it must look like to see me playing from a third person perspective and it would fill me with dread. If I could see the amount of time I spent playing League of Legends in particular (there isn't a place where this is tracked), I would probably cringe viscerally.

How do you think the addiction is interlinked with the social networks people build up through these games? A lot of people turn to games not only because they're fun but also a sense of community.

You're correct, this is huge.

To this day, I still have friends that I met while playing games. It felt like I was ditching them, and similarly, I felt a lot of pressure to stay on and play with them.

Socializing in video games is a legitimate form of socialization, AND it cannot be a replacement for IRL socialization. The approach that I take is to make space for both.

In addition, realizing that my mind was trying to justify reasons to keep playing, I recognized one day that I can still be friends with the people I've met outside of the game world. I put effort into connecting to them outside of the game.

How do you prevent personal stigma from corrupting your outlook and research? The fundamental belief that relief from video games stimulates positive mental health seems folly when applied broadly as people are different.

This is an important question.

I went into my experience as a therapist assuming that other people did not work the way I did, and that my experience was not necessarily similar to the experience of other people's. I tried to take approaches used in a lot of other addictions, in particular, the promotion of abstinence.

I use measurement in my therapy to make sure what I'm doing is working (funny enough, my journey to use measurement came from my experience of playing video games). This involves asking for feedback before and after every session, then using that feedback to adjust my therapy. There are two basic things I'm looking for:
-Information on how the client is doing
-Information on how I am doing at understanding and providing what is needed

The data informs whether or not what I'm doing is working, not my personal belief system. Over time, it has become evident to me that a lot of people work similarly to me, and of course, some people don't.

What’s the difference between being addicted to playing games versus being addicted to reading books, or playing the piano, or watching tv? For me, playing games is something I get excited to do, it’s something that I can look forward to after a long day of work. I honestly think things like this make people have a negative view of gaming, even though it’s just another hobby. If anything, I’d say that playing games is more stimulating for your brain than reading books and especially watching tv. Some games are more like playing an instrument, like if you’re playing a game that requires precision and practice.

I’m not the OP, but have experience with drug addiction. When it comes down to it, these things exist on a spectrum and can sort of manifest differently for every individual— but ultimately, anyone addicted to any of the things you mentioned would be attempting to fill the same hole.

It’s a hobby until it’s the only thing you can meaningfully engage with in your life. Over time, you get more stressed out and more unhappy because literally everything else — from the simplest day-to-day tasks, to your long term goals — now begin to stop bringing you fulfillment in any way, maybe even making you feel worse. Then when finding the motivation to force yourself to do those things becomes impossible, you return back to what is now your addiction. You hate yourself and feel like a failure, but at least this is something you can do, that you sort of enjoy, and is one of the few things that makes any sense to you anymore. A kernel of reprieve. You know the addiction is ruining everything else for you, but you do it anyway because nothing else matters except making yourself feel better right now.

There’s more nuance to the discussion, for sure, but the gist is addiction is a hobby gone problematic.

Honestly, I couldn't have said it better myself.

What's your angle?

Primarily, doing what I can to contribute to a healthier and happier world.

Forgive me for being skeptical, but young men don't have many good role models these days. I will follow your work and form my own opinions. Thanks for the reply.

Your skepticism is not just forgivable, it's warranted.

Video game addict? Such bs.

Addiction to video games and addiction to other things are definitely not the same beast. I'd love to hear more about your perspective.