Last week China announced strict limits on how long kids can play online video games. No games Monday through Thursday, and no more than three hours of gaming on weekends. Gaming companies will be responsible for enforcing these restrictions, by kicking players off when an hour is up, and using facial recognition software to make sure they’re not logging in as someone else.
I imagine parents across China are breathing a collective sigh of relief. As a mother of four, I know I would. I’m tired of trying to limit my kids’ video game time. Tired of peeking over their shoulder to see if it’s Fortnite instead of fractions. Minecraft instead of arts and crafts. League of Legends instead of League of Nations.
I admit to once (or twice) sneaking outside and peering through the window to catch my kid in the act. And then what? Lots of yelling about how they need to focus, get things done and prioritize. All of which has an impact for, oh, maybe 15 minutes before they’re back at it again.
As a psychiatrist, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University, and author of the new book “Dopamine Nation: Finding Balance in the Age of Indulgence,” I’m also concerned about the very real risk of video game addiction, also known as gaming disorder. Gaming disorder has been embraced by the World Health Organization and defined in the 11th Revision of the International Classification of Diseases as “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”
A patient of mine, a young man in his early 20s raised here in the Bay Area by loving and competent parents, developed just such an addiction. He started playing video games in middle school, progressed to several hours a day in high school, and by the time he was in college, was staying up every night all night gaming. He fell further and further behind in his classes, and by the time his parents were called to school to rescue him, he was suicidal.
Here’s the important thing: After he stopped video games for a month, his mood got better. He decided to continue to abstain for several months after that, and his mood continued to improve. When he ultimately went back to playing video games, he was able to do so without slipping back into compulsive overuse, by putting barriers between himself and video games, what I call self-binding strategies. For example, he restricted himself to playing no more than two hours of video games per day, no more than three days per week. Sound familiar? He also got two separate laptops, one for gaming and one for school, to limit the temptation to game while he was supposed to be studying, a nice way to reduce cue-induced craving.
This young man is not alone. Although data on rates of video game addiction are hard to come by, according to a Pew Research Center survey, 41 percent of boys and 11 percent of girls ages 13 to 17 say they spend too much time playing video games. And it’s no wonder. These games and the devices that deliver them are engineered to be addictive. They are wildly reinforcing, causing dopamine, the brain’s reward neurotransmitter, to be released in the brain’s reward pathway. Giving young people unrestricted access to video games is not so different from giving them a pack of cigarettes and saying, “Smoke these, but don’t get hooked.” While it’s true that some won’t get hooked with simple exposure, many will, especially those who already have risk factors for addiction: a family history of addiction, co-occurring mental illness, the absence of alternative, more adaptive rewards such as fresh air, nature and a supportive social network.
Even without any of these risk factors, simple exposure to addictive drugs can lead to addiction, especially in a world where every online activity becomes a test of willpower as the AI algorithms are constantly feeding us images, alerts and notifications tempting us to play again and again and again.
It’s not just our children’s mental health that is being compromised. Data show that in the last 15 years, younger men (21 to 30) have been leaving the workforce at higher rates than older men or women. What are they doing? Playing video games.
China’s approach to this problem is unimaginable in the United States. Some might call it a terrifying exhibition of authoritarianism. Yet I am convinced, based on my research and that of others, that parents alone will be unable to curb their kids’ video game use. We need help, and the tech companies who make these games, and the schools where kids spend most of their time, are well poised to help us. Here are just a few ideas. The government could incentivize the companies that make video games to build in restrictions for minors and penalize them if they don’t. Tech companies could create a laptop that allows kids to do schoolwork but nothing else. Schools could create tech free spaces and tech free lessons so some dedicated learning involves no screens at all.
But I’m a psychiatrist, not an engineer. Here’s a call to all those bright young minds in the Bay Area that led this tech revolution. Use your collective ingenuity to help all of us engage with this technology in a way that enhances rather than harms our lives.
Anna Lembke, MD, is a professor of psychiatry and addiction medicine at Stanford University and author of the New York Times bestseller “Dopamine Nation: Finding Balance in the Age of Indulgence”(Dutton Penguin Random House, August 2021).