SIOUX CITY | After playing the online computer game StarCraft for nearly 50 hours at an internet cafe in 2005, a South Korean man in his late 20s died of heart failure due to exhaustion and dehydration.
Just two years ago, a Taiwanese man in his 30s met a similar fate after playing video games for three straight days.
Although these are extreme cases of video game addiction or gaming disorder, the signs, symptoms and consequences can be severe, according to Andrew Gerodias, a licensed mental health counselor and certified alcohol and drug counselor at Jackson Recovery Centers.
For two years, Gerodias has been working with patients who have a process addiction, a form of addiction where a person becomes addicted to a rewarding behavior that doesn't involve an addictive substance. Video gaming falls under this category, along with gambling, sex and eating.
"Individuals have spent upwards of $10,000 on a parent's credit card for a mobile game, in particular, Clash of Clans. It can really go across just about all the different areas of electronic gaming," said Gerodias, who recalled that students were skipping class to play World of Warcraft when he was in college.
Last month, the World Health Organization (WHO) added "gaming disorder" to its list of mental health conditions. In the beta draft of its 11th International Classification of Diseases (ICD-11), the WHO defines gaming disorder as "a pattern of persistent or recurrent" gaming behavior that takes precedence over other life interests and daily activities and results in "significant impairment in personal, family, social, educational, occupational or other important areas of functioning."
"After this announcement, I think more people are going to be worried about it and watching it more often. Games are now becoming more accessible. It's not just at home. It's in the schools. It's during downtime," said Gerodias, an avid gamer himself, who cautioned that just because a person spends time playing video games, it doesn't mean he or she has an addiction.
While avid gamers of any age could develop an unhealthy attachment to video games, as with substance abuse, Gerodias said an addiction is more likely to take hold between the ages of 12 and 25 when the brain is developing. That's why Jackson Recovery Centers is reaching out to local colleges to show school staff what video game addiction looks like.
"I've only had one adult at this point come in for services for video game addiction. The reasoning for it was the risk of losing a relationship," Gerodias said. "If there's more awareness of it, possibly there will be more people seeking services."
Gerodias said some mobile games give players access to new levels for just a couple of bucks. When money enters the equation, he said a video game addiction can become very similar to a gambling addiction.
"Some of the early studies are finding that it is very similar (to gambling). You're just continuing to enforce the reward center. As you're doing that, you're blazing this trail in your brain that says, 'If I get X, I'm going to feel this good,'" he explained. "When you first start playing the game, you get levels up very quickly. They are giving you those rewards very easily, but then things continue to get more and more difficult and you have to put more time into it and more effort into it. That is what makes the game so addicting."
Geordias said the bulk of his patients are high school students brought to Jackson's River Hills Recovery Center for evaluation by parents who feel they are spending too much time gaming. He said parents also cite falling grades as a concern.
Other signs of gaming addiction include loss of the sense of the passage of time, isolation, lack of concentration, obsessive thoughts about gaming, committing illegal acts (stealing to get your video game fix), and emotional or behavioral disturbances (blowing up when someone walks in front of the TV while gaming or chucking a controller against the wall in frustration). Gerodias said people who are addicted to gaming even complain of physical aches and fail to maintain proper dietary, sleep and hygiene habits in their quest to conquer "just one more level."
The key to treating a video game addiction, according to Geordias, is identifying why the patient plays video games in the first place. He said some people play video games to socialize, while other seek accomplishment or game mastery. After learning the reason for the gaming behavior, Gerodias said he suggests new activities or hobbies. He said working alongside parents to set healthy boundaries and goals is very important.
"Ultimately, same as any other addiction, we have to go and break through that denial factor, have that level of acceptance and find alternatives for it," he said.