Gaming disorder is now an official mental health diagnosis under the World Health Organization’s new International Classification of Disease (ICD-11), released this week. Although many health professionals have recognized addictive gaming behavior for years as a serious problem, the WHO’s new classification helps legitimize the diagnosis, experts say—and is an important step in making sure patients in need get the necessary treatment.

The ICD-11 is a database of around 55,000 unique codes for injuries, diseases, and causes of death that help health professionals around the world speak a common language. With this new update, gaming disorder—which includes unhealthy behaviors involving both Internet and traditional video games—has been added to the ICD’s section on addictive disorders.

But what exactly is gaming disorder, and who is it most likely to affect? We spoke with Doug Gentile, PhD, professor of psychology at Iowa State University, to learn more.

What counts as a gaming disorder?

According to the WHO, gaming disorder is characterized by impaired control over gaming behavior; in other words, says Gentile, gamers know they should stop—to do their homework, to meet social obligations, or to get a good night’s sleep, for example—but they feel unable to.

Troublesome behavior also reaches disorder levels when gaming begins to take precedence over other interests and daily activities. With gaming disorder, this pattern continues and escalates, despite the negative consequences that occur because of it.

Another symptom of gaming disorder is lying about how much you’re gaming, Gentile says, which can damage trust with friends and family members. “These are ripples that look, at the time, like they’re small issues, but in fact, can have very serious long-term repercussions.”

The ICD-11’s new designation involves both online and offline forms of gaming. “It can include gaming on any platform—cell phones, tablets, or traditional console games,” Gentile says.

Games with an online component may have the potential to be especially addictive, he adds. In 2013, the American Psychiatric Association mentioned “Internet Gaming Disorder” in its own database of diagnoses, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but stopped short of giving it its own entry.

Finally, for gaming disorder to be diagnosed, a person’s behavior has to be significantly impairing his or her personal, family, school, or work life. Normally, this pattern has been evident for at least 12 months.

Who's at risk for gaming disorder?

It’s not clear what percentage of the population has a gaming disorder, Gentile says, but most studies suggest the number is somewhere between 1% and 10% of active game users. “That means nine out of 10 gamers can play without bringing serious damage to their lives,” he points out.

Most of the research on gaming addictions and disorders has been done on adolescents, teenagers, and young adults—but Gentile says it’s likely that disordered behavior can affect people of all ages.

“I might be surprised if teenagers weren’t a little more likely to have this problem than adults, for the same reason teenagers are more likely to be involved with other types of trouble,” he says. “But I don’t know of any data that suggests this disorder is only limited to this age.”

Research also suggests that boys and young men are much more likely than girls and young women to exhibit disordered gaming behavior. In a 2017 German study of 12- to 25-year-olds, the estimated prevalence of gaming disorder was 8.4% in males versus 2.9% in females. Because the disorder has been identified in so few girls and women, Gentile says, it’s not known whether it manifests differently than in boys and men.

Experts have wondered whether children or adults who are already depressed or anxious may be more likely to develop a gaming addiction, as a means of coping or hiding from real life. But research shows that disordered gaming behavior isn’t simply a symptom of these conditions, Gentile says.

“In fact, when kids become addicted to games, their depression increases and their anxiety increases,” he says. “And if they stop being addicted, we see the opposite pattern; their depression gets better. So it looks like the gaming can definitely feed some of these other problems.”

What to do if you or a loved one needs help

As with most mental health issues, gaming disorder affects only a small percentage of the total population. “We’re not talking about people who play games when they’re bored, or who enjoy playing games but are managing their lives just fine,” Gentile says. “As long as it’s not affecting your mental or physical health, go ahead and play.” 

“It’s about trying to understand that there is a boundary at which behavior becomes too dysfunctional,” he continues. “It’s like depression: Everyone gets sad, but there is a point at which it becomes too much and you need treatment.” 

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It’s also important to remember that excessive gaming can have other consequences, besides those directly related to mental health. It’s been associated with sleep disturbances, low fitness levels, and poor nutrition, for example, which can all have long-term physical effects.

If you do feel that you or a loved one could use some help treating a gaming addiction, Gentile recommends finding a mental health professional with experience in impulse-control disorders—especially since it may be difficult to find someone who specializes specifically in Internet or video games.

Gentile says the WHO’s new classification will likely help health care providers become better versed in treating this disorder and pave the way for more health insurance companies to provide coverage for care. “The first step toward getting people the help we need is recognizing the problem is real,” he says.

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