ADVGD: Attention Deficit Video Game Disorder
I love games. I've played all sorts of games in my life, from all of the sports I've played to my neighborhood board game parties. I enjoy the challenge. I enjoy the creative problem-solving. I enjoy the social aspects of playing with other people, although I also love playing games by myself. But of all the games that I play, the one type that I have the most challenging relationship with is video games.
When I was a kid in the late '80s and early '90s, gaming was just starting to become part of our culture, but now more than 211 million adults play video games in the United States. That's more than half the population of the country, and so it's become easier to assume that most people you meet play some sort of video games.
Of course, a big reason that we have so many people playing video games nowadays is because of our smartphones. When you've got a mini-computer in your pocket, it really lowers that barrier to entry. No more crawling behind your TV to screw in a system that will only let you play on channel 3.
But that doesn't mean that video games are good for us, and a lot of people have been raising some red flags about video games. Some of the flags have weight, while others are more of the "Old man shakes fist at cloud" variety where people don't like how the world is changing. And I also want to be clear here that I understand that not all video games are created equally. There are some great games out there, and there are some legitimately awful games out there. Lowering that barrier to entry also lowered the bar of entry for the people creating the games as well.
But what we're interested in today is how ADHD and video games interact. With more and more research about video games going on, we're always learning new things and tossing out old ideas. There were points where people believed that video games were one of the causes of ADHD. And while some studies show a strong relationship with video games and ADHD, no research supports that it's a causal relationship. What's more likely is that video games attract people who have ADHD.
I want to start by saying that I'm not going to be saying "don't play video games" because well, they're fun, and it's okay to have activities and hobbies that aren't strictly productive. Sometimes we get this mentality that every single thing we do needs to have some overarching theme that is leading to some goal of self-improvement. This isn't to say that video games have no value at all, but that value isn't always clear cut. And when you're judging it against all the other things you could be doing, it might measure up.
It's easy to let gaming go from a fun hobby to the only thing that you do. I know that I've been at places in my life where I've had a considerably unhealthy relationship with gaming. Fortunately, I'm at a point in my life now where I can play some video games but also not have it be the be all end all of my existence. Having kids majorly shifted my priorities, and while I would like to play more games sometimes, it's usually just not in the cards for me most of the time.
One of the most surprising things for most people is how well video games can hold the attention of someone with ADHD. While other tasks might shake our interest after 15 minutes - let's be honest, I've lost interest in somethings in less than 5 minutes, but with video games, I can be glued to the screen for hours. But it isn't because I've found one thing I can focus on for hours; it's that the challenges are continually changing. And then there is what video games do best: the feedback loop.
Any task we do generally has some sort of feedback on it - sometimes, we get the feedback right away, while other times, we've already forgotten what we've done by the time we get feedback. You touch a hot stove; your nerves send pain signals to you right away - that's feedback. You decide not to mow your lawn, and your Home Owners Association sends you a letter that your yard is overgrown - also feedback, but a lot less timely.
In video games, pretty much all of your actions provide instant feedback. It's how you do things like learn the controller. You hit the B button, and your little avatar jumps on-screen - instant feedback. You hit the glowie spot on the boss's head, and it takes damage - instant feedback.
ADHD thrives with reward systems, and instant feedback is an excellent way to provide that. When you are immediately given feedback on whether you performed the correct action or not, you learn to do the right things quickly. People with ADHD can struggle to know if they are doing the right thing, and since we rarely get instant feedback in real life, it means that video games can feel like it's the only place where they can actually succeed.
Life can be hard with ADHD, we often don't know what we need to do next, but in video games, we have a clear path to getting better. We have quests to tell us where to go and what we need to do next. If we're struggling in real life, it can be all to easy to choose to turn to the virtual world where things make more sense.
This can turn into a scary cycle where people end up playing video games for all of their waking hours. When I was in high school, I could game for 8-10 hours a day during the summer because I didn't have other responsibilities - or really it was more I was just ignoring them. As an adult, there is no way I could spend that time on any one activity, let alone video games, without seriously dropping the ball elsewhere in my life. Not to mention video games tend to be a relatively sedentary activity, which is also going to have some serious health consequences.
While our virtual lives can be fun, we never want them to come at the cost of our actual lives. That can be a hard balance to create.
I also want to take a moment to address video game addiction - which has become a complicated condition. With the advent of professional gaming and streamers, who play video games and live stream what they are playing on websites like Twitch, people have full-time jobs playing video games. So while these people can be gaming for 8-10 hours a day, it isn't going to be seen the same as an addiction because they are being paid for it. To add to the confusion, the World Health Organization has added "gaming disorder" to its medical reference book while the American Psychiatry Association has not.
This means we don't have a good definition of video game addiction. Still, we can at least take pages from other addictions and define it as problematic and compulsive use of video games that results in significant impairment in your life over a prolonged period. I think that is pretty helpful there because it does help us weed out things like professional gaming - if it isn't causing impairment, it's overuse isn't so much of a problem. To be sure you could be an addict and a professional gamer, but what we're concerned with is the negative impacts on your life that video games can sometimes cause.
Before we go on, I just want to let anyone know who does think they have a problem with their gaming about a site called Game Quitters that can help you with your gaming addiction. I am not affiliated with Game Quitters in any way, and I should mention I have not personally used their service, but I have heard good things about it and would be my go-to recommendation. As of this recording, it costs $27 to sign up, but they've also got a lot of other great resources on their site. If you need some help with your gaming addiction, please go to GameQuitters.com and check them out.
Of course, video games aren't all bad, and we can learn a lot from video games. For example, we talked about feedback loops earlier, and that can help us create models for how we want to feedback loops in real life.
We'll be diving into a lot more of this next week when we look at some of the lessons we can learn from video games.
One of my favorite things about video games is how varied they are. Early I mentioned that video games tend to be a sedentary activity, but they don't have to be. I've recently started trying out Ring Fit Adventure on the Nintendo Switch - by using the motion controllers, it is a game where you fight the enemies with this like squats and crunches.
Most games aren't going to be getting you up off the couch though, but that doesn't mean they won't have value. In building games like Minecraft, you can be endlessly creative. In rhythm games, you can explore your musical talents.
There can be great social benefits to games as well. And I'm not just talking about playing multiplayer games - which also can be great for being social, but what I mean here is that video games can often give you a comfortable common ground to talk about. When I meet up with my friends, we can talk about the games we're playing. This can apply to all kinds of games and all walks of life. Before my mom passed away, I was helping her play through the entire Legend of Zelda series.
And I've got to also talk about one of the coolest things that has come out of gaming, which are games that can provide real-world innovations. The most famous of these is an online game called Foldit, where players manipulate virtual molecular structures. The objective of Foldit is to fold the structures of selected proteins as perfectly as possible - high scoring solutions are then analyzed by researchers to see if the compositions can be applied in real life.
In 2011 players helped decipher the structure of a monkey virus, which causes HIV/AIDS-like symptoms. This was a scientific problem that had been studying for 15 years but was solved within ten days of being put up on Foldit.
And because of the success of Foldit, more games like it are now being developed.
Our question then becomes, where do video games live in our lives when we have ADHD. And now we're torn because yeah, video games can have some great benefits, but we also definitely want to stay away from the addiction side of things.
For some people, the right answer to video games is to not play at all. Sure they might enjoy playing games, but they know that the allure is too much for them, and so they know they simply just need to put them down.
But some of us don't want to give up video games. While we could just tell ourselves, it's not a problem; that's not a solution. If we want to keep it from being a problem, it's better to be proactive. Video games can be part of your life, but the emphasis there is part of your life, you need to balance it with everything else and so sometimes video games are going to need to take a backseat.
I wish ADHD let me set sensible limits on playing video games, but I know I'm probably going to disregard those limits if I don't have any mechanism to enforce them. I love playing the Civilization game series, but I know that I have a real issue with the idea of just playing one more turn because that turns into me playing until 2 in the morning all too often. And finding good advice for setting limits is hard because so much information about video games is aimed at parents with kids. While I would hate it, it would be nice if my parents could still enforce my video game time limits. "But dad, I just need five more minutes to get to a save point."
When I was in college, I had a housemate that was neurotypical, and we'd play video games together sometimes. It was great, but I was also always shocked when he'd just stop when he intended to. He'd say he was going to play for an hour, and then at the end of the hour, he'd be done and go off and do the next thing he intended on doing. Meanwhile, I'd play until my eyes hurt and let myself skip on other priorities because I wasn't able to self-regulate myself to stop playing.
Part of the problem was that I didn't place any restrictions on myself on when I could and couldn't play. A crucial first step in limiting your gameplay is deciding what your limits are. I know that I tended to think that I'd be able to just put things down when I needed to. But I never defined when I needed to - and when you add time blindness to that, it often meant I had no idea how long I was playing for.
Even once you set your limits, it can be tough to follow through with your intentions. Sure I wanted to get to bed on time, but I just have this one more thing I want to do before I quit playing. Time blindness definitely plays into this, so it's a good idea to keep a clock within sight when you are playing. Timers are also crucial for maintaining awareness of how much you are playing. It is incredibly easy to lose track of how long you've been playing, and that makes it all the easier to play longer than you've been intending.
Another great alternative is just playing with someone who is neurotypical. When I was playing games with the housemate I mentioned earlier, I didn't have to worry that we'd play too long because he could set limits that he would follow. This is even easier to implement now with online games - just make sure you're choosing to play with friends who'll actually set limits and won't try and egg you on to play even longer.
Of course if those options aren't working for you, you might have to set more draconian limits on yourself. A few weeks ago, I mentioned how we can set screen limits on our phones - the same can be done with modern gaming consoles in the Parental Controls menu. On computers, you can use programs like Freedom that will lock out access to particular applications, like games, at set times - or there are ways to program your internet router to shut off for certain periods.
One of the other vital parts about limiting your gaming is being smart with what games you are choosing to play. As I said earlier in the episode, not all games are made equally, and this is especially important to keep in mind while you are choosing which games you are willing to play. I laugh when I see phone games advertised as "too addicting to put down" because I'm like, well 1. that's not true that game looks awful and 2. even if it was true why in the world would I want to play it then?
Some games are going to be more addicting than others - this is especially true of games designed for your phone. Most games on your phone are driven by ad revenue or some pay-to-win mechanic, which means that they are designed to keep you engaged and continuously coming back for more. Be wary of the games you install on your phone. This doesn't mean that console games can't be addicting; it's just that they tend not to be designed in the same way to hijack our brains.
For me, the best games are the ones that are story-driven and challenge me to think. One example of a game like this for me recently was the game Celeste, which is about a girl, Madeline, climbing a mountain. It is a relatively challenging platform game where you have to make some crazy jump to continue your way up the mountain. But while the gameplay was fun, what really held me was the story. Seeing the main character coming to terms with her anxiety and insecurity helped me come to terms with some issues I was working through on my ADHD.
All this to say, work on choosing quality games that you are going to enjoy. This will help when you are limiting your gameplay because you are actually going to feel satisfied with your gaming sessions. If we want to actually get benefits from the games we play - even if it's just relaxation - then we have to be mindful about what we're playing.
I love games, but I also love having variety in my life. If you are having trouble getting everything in your life, then you might have to look at cutting back on games. Video games can be a great way to enhance your life if you are able to have sensible limits on them, but if you find yourself falling into the hole of addiction, please take it seriously.
Today’s Top Tips
Video games engage our brain through instant feedback and making us feel successful.
Video games can be a great tool for learning and for your social life.
We want to set sensible limits on video games in our lives - not all games are created equally, so choose what you play wisely. Be wary of the games you install on your phone.
Game Addiction can be defined as problematic and compulsive use of video games that results in significant impairment in your life - if you're seeing signs of video game addiction in your life or you simply need help quitting playing so many video games I'd like to urge you to go check out GameQuitters.com
Mentioned in this Episode
Favorite Game Sound Tracks
