Video game addiction seeks acceptance

Josh Caney used to sneak out at night to get his fix. The next day would be dominated by thoughts of how to get his next one. Early on, it was just a fun way to pass the time, but as it took over more of his life it developed into what he now refers to as an addiction. But the Surrey resident’s problem wasn’t alcohol or psychoactive substances. For him, the drug that ruled his life was video games.

Starting at the age of 15, Caney played games “addictively” for two years. While his parents slept, he would sneak out to a local Internet café for all-night sessions in front of a flickering screen, arriving home exhausted just before they woke. But when his parents bought a computer for the family, his addiction hit the big time. Now he didn’t have to go out anymore. And he didn’t.

“Sometimes I sat on the computer for 20 hours a day, just playing those games,” Caney told the Georgia Straight by phone.

Now 21 years old and having overcome his fixation, Caney is one of a growing number of people who claim to have been video-game addicts.

Caney’s particular poison was World of Warcraft, a massively multiplayer on-line role-playing game set in a medieval fantasy world. Players create their own character and interact with one another. Caney would skip school for days at a time to play the game.

“That one really got me,” he said. “When WoW came out, I think in the first year that I had it I spent about 150 days out of the year on it. I would go upstairs, eat dinner in three minutes, run downstairs, and sit in front of the computer all night. I would sit there on the computer until 3 in the morning and then wake up as early as I could to play the game all day again.”

But it wasn’t just the amount of time he spent playing the game that was a problem. Caney believes the game changed the way he behaved.

“My parents would call me upstairs for dinner, and I would get pissed off at them,” he said. “I wanted just to game. It was nothing towards my parents.”

Caney is certain that what he experienced was addiction, but some experts aren’t so sure.

Joti Samra, a Vancouver-based clinical psychologist and addictions expert, is one of those people.

“I have a pretty strong opinion that I don’t see video-game addiction as being an addiction in the sense of the true definition,” Samra told the Straight by phone. “Right now, the word addiction is actually not a mental-health or psychiatric term. So when the average person uses the term addiction, what they’re really talking about is abuse and dependence.”

Samra noted that mental-health professionals refer to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders to diagnose mental illnesses. The DSM recognizes substance abuse and dependence as mental disorders, but not video-game addiction.

A new, fifth edition of the DSM is scheduled to be published in 2013. A DSM-5 working group has proposed the creation of an “addiction and related disorders” category but hasn’t recommended that video-game addiction be listed as a behavioural addiction.

Samra believes that excessive gaming can be a symptom of other illnesses, such as depression or obsessive-compulsive personality disorder.

“If you look at the DSM, the language is historically used around substances, like alcohol,” Samra explained. “There are two features where we think of addiction in that context, where they have control and they develop a dependence, where there’s the psychological dependence, but there’s also the physiological dependence that you can clearly measure. You can take a look at someone’s tolerance.”

As an example, Samra described someone who starts drinking one year, and gradually increases their intake in subsequent years. Eventually the person develops an increased physical tolerance to the substance, requiring more to get the same effect as before.

“And if we look at those kinds of features really being at the heart of abuse, dependence, and addiction, video-game behaviour doesn’t meet that same criteria,” Samra said.

But across the border, another psychologist takes an opposing view.

“Absolutely, there’s no doubt about it at all,” Hilarie Cash told the Straight by phone of the existence of video-game addiction.

Cash has been working with video-game addicts since the mid 1990s, which was when Internet gaming started to become popular.

In the years since, she’s seen the problem become increasingly common. In 2009, after being fed up with not having a proper treatment facility to send patients to, she and a partner founded reSTART, an Internet and video-game addictions clinic in Fall City, just outside of Seattle.

“It [gaming] rewires the brain in profound ways,” Cash stated. “All addictions basically light up similar areas of the brain. It’s known as the ”˜reward pathway’, and when you don’t stimulate that part of the brain after doing it for so long, you go into withdrawal.”

According to Cash, the unpredictability of reward, or what she called “intermittent reinforcement”, keeps gamers hooked. Cash puts her patients on a “media fast” and has them partake in art, exercise, and therapy sessions. A minimum stay of 45 days at the clinic “allows the brain to get out of this withdrawal and rewire itself to get back to normal”, she said.

Cash doesn’t dispute Samra’s view that video-game dependence may be associated with other behavioural issues, but she firmly believes that video-game addiction is its own illness.

“That doesn’t mean that there might not be depression or OCD [present along with video-game addiction],” she said. “But just like with any other addiction, if you don’t recognize the addiction for what it is and address it in and of itself, then you’re unlikely to get to the root of all of the other problems too.”

Cash doesn’t feel enough attention is being paid to what she calls a “very real issue”. But she is confident that with more time and research, video-game addiction will eventually make it into the DSM and become widely accepted as a true addiction.