Addiction to electronic games (online, offline): is it a disease?

Video games can have several benefits for cognitive development and even for learning other languages. However, its excess can be bad.

Recently, the World Health Organization (WHO) included addiction to games in the International Classification of Diseases, the ICD, which gained an update in June 2018.

The problem is called ” Gaming Disorder” , something like “Game Disorder” in free translation, but it has been called by the Brazilian press as an addiction to electronic games.

As much as it is fun, playing too many video games and with an exacerbated fixation can have serious health consequences. Understand more about this problem in the following text!



Addiction to games is a disorder characterized by the presence of problematic behavioral patterns in relation to gambling habits , that is, the patient spends many hours playing, in an almost unrestrained manner.

Fun becomes a disease when the patient has difficulties to stop playing and when he gives excessive priority to games, which take precedence over other interests in everyday life.

In addition, it becomes a problem when there is an increase in the intensity of gambling even after the games have had negative consequences for the patient’s life.

To explain it more easily, let’s use the fictional example of João, a student in the administration course who loves to spend his free time playing World of Warcraft (WoW), an MMORPG (“ Massively Multiplayer Online Role-Playing Game ” or “ Online role-playing game, very successful.

João has several responsibilities and several other interests in his life. He’s got college, his girlfriend and he’s looking for an internship. After being turned down at a company, João starts to spend more and more hours in front of the computer screen playing WoW.

Family and friends begin to notice that he only talks about the game. The achievements he had, the enemies he faced and the items he managed seem to excite him more than the college itself and, in time, João gives up even looking for the internship he had been dreaming about until a while ago.

A few weeks pass and João’s interest in the MMORPG does not seem to diminish, but only to increase. He no longer eats dinner with his family at the table, as he is playing an important game, so he asks to leave the leftovers.

When they interrupt João in the middle of the game, he is irritated to the point of losing his temper. He swears, yells and mistreats the people around him who try to show him that maybe he is having a problem. He doesn’t seem to want to hear anyone.

João goes to sleep very late and changes the day for the night because of the game. Stop attending college classes and go out with friends. Over time, he doesn’t want to know any more or to go out with his own girlfriend, who can no longer bear to hear about the game.

After a big fight with his girlfriend, he realizes that he may have a problem and decides to stop or, at least, reduce the amount of time he stays in front of the computer playing games, but he can’t. He decides to sit down to play just an hour or two, and when he sees it, he spent the entire morning killing enemies and collecting items.

This is how the game becomes a problem. It is a narrative very similar to that of a drug user, it is true, but it is important to note that, despite the similarities, the mechanisms by which addiction to games occurs are different from those of addiction to psychoactive substances.

While a drug, such as cocaine, has direct effects on the brain, blocking the reuptake of neurotransmitters such as dopamine, games activate a very similar reward system, with the difference that there is an absence of a substance acting directly on the brain.

However, this is not a “less worse” addiction. If it disturbs your life and causes a decrease in the quality of life, it must be treated and deserves all the attention and seriousness that an alcoholism would receive, for example.

Understand more about the mechanisms of addiction (addiction) in games in topic X.

Is addiction to electronic games a disease?

-Yeah . Addiction to electronic games has been officially considered a disease since June 2018, when ICD-11 was launched by the World Health Organization (WHO).

But in order to understand this answer better, we first need to know what the ICD is. It is, in fact, a kind of “catalog” of diseases that serves to help the doctor to keep up to date on the main health problems that affect human beings.

Its real name is much bigger than what we are used to: “International Statistical Classification of Diseases and Related Health Problems”. To make our lives easier, we simply call it the International Classification of Diseases, or ICD.

Now, to understand a little better why the addiction to electronic games entered the ICD and how important this step is, we talked to Dr. Emerson Rodrigues Barbosa, psychiatrist and Clinical Director of the Paraná Psychiatric Institute.

“The categorization of disorders, diseases and their subdivisions serves mainly to facilitate communication between health professionals and interested institutions.”

The doctor explained that, in the case of addiction to electronic games, for example, if a doctor in Sweden writes about a case coded as ‘ICD11: 6C51.0’, he will be understood anywhere in the world. In this way, it is easier to estimate the prevalence of the disorder and to seek more effective methods of treatment.

As for the addiction to electronic games themselves, the doctor says: “both behaviors are pleasurable in some way, and this activates our reward system, making the user always seek more and more of that pleasure regardless of the negative consequences that this can bring. ”

And despite being a great player, Dr. Emerson is categorical:

“If the video game can disrupt your life as well as alcohol or other drugs, why couldn’t it also be considered an addiction?”


Despite being relatively new in the medical field, the WHO, at ICD-11, divided the addiction to electronic games into 3 different categories, related to the “modality” of play: online, offline and unspecified. Understand:

Addiction to predominantly online games

The characteristics of addiction to online games are almost the same as other types, namely:

  • Difficulty in controlling game habits (frequency, intensity, duration, start and finish);
  • Increasing priority given to the game, that is, the game becomes more important to the player than other daily activities, such as bathing, eating and relating to other people;
  • Insistence and accentuation of gambling habits, although they have generated negative consequences for the patient’s life.

What differentiates this type from the others is the game mode, that is, in this case, the patient plays online. The particular problem with online games is that, under these conditions, there is no possibility to interrupt the game, as it takes place in real time for several players at the same time.

This characteristic (of the game in real time) is often used by the patient to justify the fact that he plays uninterruptedly, after all, the other players depend on him to win the game and there is no possibility to pause the game.

It is worth mentioning that, as the name suggests, addiction to predominantly online games does not mean that the patient only plays online games, but that the main modality played by the patient is online games.

Addiction to predominantly offline games

Addiction to offline games is very similar to addiction to online games, with the difference that the games are private, that is, the patient plays alone, in his own time and without the interaction of other players.

The main characteristics are the same, that is, difficulty in controlling habits, accentuated priority given to the game and insistence and accentuation of the game habits, although they have brought negative consequences.

In the case of offline games, the patient does not necessarily have a fixation for a specific game, but it can happen for several. The patient, for example, has a large library of games and feels an almost uncontrollable need to reach the end of everyone, to win all the available trophies, to “platinum” all games.

Unspecified game addiction

Unspecified game addiction concerns patients who have a mixed type of addiction. That is, play online and offline. The main characteristics remain the same, that is:

  • Difficulty in controlling habits;
  • Increasing priority given to the game;
  • Insistence and accentuation of gambling habits, despite negative consequences.


It is not yet known exactly what causes the addiction to electronic games itself, although there are risk factors that can make a person more or less prone to develop this type of addiction.

The main reason for this is due to the fact that it is not because a person is excessively exposed to games that he has a problem , as in the case of some psychoactive drugs, since there are many people who play every day and do not have the disorder.

However, the main bet and explanation for this behavioral deviation is due to our brain, more specifically to the area responsible for the control and regulation of emotions: the limbic system.

The Limbic System

The limbic system is an area of ​​the mammalian brain responsible for controlling emotions and social behaviors. It was very important for the development of the human species, as it functions as a kind of “reward center”.

When we eat something very caloric like, for example, a chocolate, the limbic system releases neurotransmitters that give us the feeling of reward, among them the main being dopamine, which, in turn, gives us the feeling of pleasure, well- being and euphoria.

This system was very important for the development of mammals, as it helps animals to know what actions or not to take, what behaviors it should repeat.

For example, the caveman, when eating a super caloric fruit, was rewarded by the brain with dopamine, and he ate that fruit again, which would feed him and not let him go hungry.

Nowadays, the limbic system started to be manipulated in several ways, both by the consumption of drugs and by the consumption of super calorie foods or games.

When we play, we go through stressful situations, we have to use skill and logical reasoning to solve the problems that the games pose to us. When we win, our limbic system gives us that sense of reward as well.

It turns out that some people, for genetic or environmental reasons, begin to present a dysregulation in the limbic system, causing this reward system to cause a greater release of dopamine in the body.

In these people, then, the habit of gambling is rewarded by the brain, and the more the person plays, the better they will feel, causing them to develop problems such as addiction.

Risk factors

Although it is not known exactly what causes the addiction to games, it is possible to delimit some risk factors, based on the cases that have already occurred. They are divided into biological, psychological, social and the game itself. Understand:

Biological factors

Some people have a type of neuronal genetic predisposition that makes them more susceptible to developing some type of addiction.

In such cases, the addiction could happen both with games and with alcohol or other substance. Unfortunately, it is not possible to know whether or not the person has this predisposition until the problem occurs.

Children and adolescents are at a greater risk of developing the disorder, because in the growth phase the neurological mechanisms linked to the brain’s reward center are still being developed, which may increase the difficulty of controlling or refusing the pleasurable stimuli provided by the game.

Psychological factors

Some psychological factors can make a person more prone to develop some disorder related to games, such as:

  • Difficulty in self-control;
  • Impulsivity;
  • Excessive shyness;
  • Low self-esteem;
  • Mental disorders, such as depression and anxiety.

Social factors

Several social factors can have an impact and increase the chances of developing addiction to games. Are they:

  • Social isolation;
  • Lack of limits on the use of games;
  • Bullying;
  • Excessive pressure at school or work.

In addition, it often happens that the person is only accepted socially within the virtual environment, which can generate a very great feeling of belonging, which, depending on the time and context, can lead the person to addiction to games.

Factors of games

One of the risk factors involves the game’s own characteristics. This is a very controversial issue and it divides opinions, but it is a fact that there are games that have a greater number of addicted players than others.

If this number means that the game has more addictive characteristics or not, there is still no way to tell, as it is also a fact that games that have many cases of addiction are also the most popular games and with more players, so it is difficult to make an analysis needs the dangerousness of certain games in relation to others.

What we can say is that the environment of online games, mainly, is very inviting, as it has characteristics of a space of freedom, in which the player can be whoever he wants.


The main symptom of addiction to games is the prioritization of gambling over other activities, some of which are fundamental, such as personal hygiene, food, work, studies, social life, etc.

More palpable examples of these symptoms would be:

  • Failing to make all meals to play;
  • Eating in front of the computer or television;
  • Start to miss school and work to play;
  • Do not go out with your friends or family;
  • Stop bathing and brush your teeth to play;
  • Stay with unregulated sleep, change the day for the night or sleep very little to be able to play more;
  • In more serious cases, stop going to the bathroom to play.

In cases of addiction to games, it is very common, even, that the person even wants to perform these other activities, but that he feels he cannot. Even though she knows all the negative consequences of excessive gambling, she is unable to leave the platform.

Other quite common symptoms of addicted players are:

  • Sleep changes (or complete change of “time zone”);
  • Sadness, inaction or apathy.

In addition, it is common for the person, when abstinent, that is, when not playing, to present symptoms such as:

  • Aggressiveness;
  • Anxiety;
  • Irritability.

The time a person spends playing is also a determining factor, as people who have an addiction start to develop tolerance and, therefore, need more time exposed to the game to have the same pleasure as before.

Another thing that can happen is the compromise of personal relationships. Over time, family and friends relationships can end up wearing out. It is very common for players with addiction to become aggressive when faced with the problem and this can have several impacts on family relationships.

How is the diagnosis made?

The diagnosis of addiction to games is quite difficult to be performed and, like other disorders, the doctor responsible for this issue is usually a psychiatrist .

In these cases, the specialist will do an analysis of the main symptoms, will talk to the patient and their family members to check whether or not there is a addiction to games and whether treatment is necessary.

The World Health Organization, at ICD-11, stipulates that it is necessary for symptoms to be present in the patient’s life for at least 12 months, however, depending on their severity, it is up to the psychiatrist to diagnose the disorder or not.

Is there a cure?

As it is a relatively new problem, there is still no consensus in the scientific area to confirm the effectiveness of treatments for games disorders. It is precisely for this reason, in fact, that WHO decided to include the disorder in ICD-11.

From the moment that addiction to games is considered a mental disorder, it becomes possible to research more precisely which treatments are effective and which are not.

However, although the disease has only just been categorized, there are already clinics around the world, such as in England and South Korea, that specialize in treating this type of disorder.

Experts from these countries say, from their own experience, that treatment has faster and more effective responses with children and adolescents than with adults, but they point out that, however, everyone can achieve recovery.


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As previously said, there is still no scientifically proven treatment for addiction to games, but today, the most common is to make an adaptation of the treatment for substance use disorder or impulse disorders.

The main focuses of treatment are abstinence and psychotherapy , especially Cognitive Behavioral Therapy (CBT), with the possibility of adopting or not using medications, especially in cases where there are other psychiatric disorders that also need to be treated.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy has been shown to be quite efficient in the treatment of game disorders, as it helps the patient to assess their own habits and develop social skills outside the virtual environment, such as communication, problem solving and the management of feelings.

Ideally, at least 6 months of this type of therapy should be performed and, if there is no good evolution, the patient should be referred to the psychiatrist.

Neuropsychological rehabilitation

Another technique that has shown promise in the treatment of addiction to games is neuropsychological rehabilitation.

It is characterized by a set of practices developed between the patient and the health professional that aims to help the patient overcome obstacles to the adequate performance of their daily tasks, such as addiction to games.

Living together

Living with addictions is not easy at all, but it is necessary to understand that, at least at first, during treatment, abstinence is essential and it takes a lot of willpower to prevent a relapse.

Relapses, like any addiction, can happen. And, if they happen, remember that you have a problem, that slips happen and try to analyze what made you go back to your addiction. Better than just feeling guilty, it is looking for an explanation and working hard so that it doesn’t happen again.

It is also very important that you look for ways to organize your routine with responsibilities, rest, leisure and alternative hobbies.

Creating goals and objectives, promoting other forms of self-care and personal development are also very important things to do.

It is very important that you are physically present with other people, as this contributes to your social development, in addition to being a pleasant leisure activity.

As the person with addiction to games spent a lot of time playing without paying attention to himself, it is essential that the individual seeks to take care of himself as a whole, mentally and physically.

Practicing physical activities and seeking new forms of leisure are important achievements for those who have to deal with addiction to games.

In addition, depending on the type of game addiction you have had, you may not need to abandon games as a whole. People who have already been addicted to online games, for example, after treatment, can still enjoy a game of FIFA with friends in front of the television.

What is extremely necessary is that the person is always observing himself and seeks self-knowledge. Thus, she will be able to practice self-control and evaluate what is good for you and what is not.

What is it like to have an addiction to electronic games?

It is not very difficult to find people who have had problems with games in the past. Only here in my work environment, I was able to find at least 3 people who told about their problematic experiences with video games.

The story that caught my attention the most, however, was that of a friend who I never imagined could have gone through this problem.

Designer Rafael Gonçalves, 28, told me that when he was around 21 or 22 years old, he went through a complicated situation due to the game Lineage 2, another MMORPG very popular in Brazil.

Rafael even locked up college because of the game.

“I had depression and the game ‘relieved me’, but in the end it was only making my situation worse . 

Within the universe of the game, Rafael was a well-known figure. Leader of a clan, he received requests from other players to play with them, since his character in the game was very powerful and was able to face the challenges for those at advanced levels.

The situation complicated when he started to stop going out on weekends to play. “From Friday to Sunday, don’t even leave the right room ,  he says.

“The game has always been an escape area, you know? When I had nowhere to go, I went to the games. I think that instead of setting goals in real life, it was much easier to set those goals in the game … and then I didn’t sleep, eat or drink until I reached the goal. ”

The relationship with the family, over time, has deteriorated. Constant fights with the mother and sister became part of the routine because of the problem. His relationship with his girlfriend started to deteriorate too, after all, he didn’t leave the house.

“My girlfriend at the time and current wife already lived with me at my mother’s house when the crisis hit. While I was playing, she watched TV, went out and I was there in my closed room. ”

The trigger of the crisis was when his girlfriend decided to move. Rafael received an ultimatum: he either sought treatment, or they both broke up.

This shock of reality was very great, because, until then, he didn’t think he had a problem.

“For me I had no problem, but I realized that my friends were moving away from me. I only went to seek help even when my girlfriend tried to break up with me ”

After that, Rafael talked to his family, more specifically his mother, and acknowledged that he had a problem. With her help, he started attending the psychologist. He consulted twice a week for 6 months, until he realized that his aggression and anxiety about playing had lessened.

Today, he lives a healthy and happy relationship with his mother, wife and 2 children. Contrary to what you might imagine, he did not stop playing. He developed self-control and even plays his Playstation 4 from time to time.

“What frustrated me most at the time was knowing that I was really only someone in the game world. Outside of it, I had a feeling it was worthless. I think that was why I had little desire to interact with people outside the computer. ”

Although he continues to play occasionally, after all, today he has many other responsibilities, Rafael is categorical in saying that now he only plays for fun. When I asked him about MMORPGs, he simply answered me:

“MMO? Never again ” .


The lack of adequate treatment can bring a series of complications to the life of the patient who has to live with addiction to electronic games.

There are several social, physical and psychological complications that can be felt on the skin of those who do not seek adequate treatment.

From a social point of view, for example, the patient who does not deal with the problem itself may experience:

  • Removal from friends;
  • Worsening school performance or work;
  • Loss of employment;
  • Fights with family members;
  • Relationship losses;
  • Preference for virtual life over real life.

On the other hand, from a psychological point of view, the patient may suffer from cognitive impairments. For example, when you stop sleeping to play, it will be affecting the entire circadian cycle of your body and will be more willing to suffer from stress and sleep disorders, such as insomnia .

In addition, if he is not careful, the patient may end up having difficulty regulating his own emotions.

Other problems that may arise as a result of addiction to games are:

Anxiety disorder

By staying away from the video game, the patient may start to feel more anxious. If this anxiety is not properly controlled and the patient does not learn to deal with it, it is possible that this will develop into something more serious to the point that it is necessary to start a drug treatment.


By not leaving home and having their personal relationships compromised by the vicious habit, the patient can develop depression and, in these cases, psychiatric monitoring and the use of controlled medication will also be necessary.

Sedentary lifestyle

By spending most of the day playing, the patient can put aside physical activities and develop sedentary behavior.

Pains in the neck and spine

By staying in the same position in front of the computer or television for a long time, the patient may develop body pain.

Injuries to hands and arms

The repetitive effort of these parts of the body can result in the appearance of injuries.


Many patients who have to live with gambling addiction can end up eating poorly and develop nutritional problems.

How to prevent?

There is still no consensus in the scientific community on what would be the best way to prevent addiction to games, but there is a belief that reducing exposure to games may be a way out.

This does not mean that children should be prohibited from playing, quite the contrary. What the experts suggest is to be cautious, that is, to impose very clear limits on gambling.

The playing time, for example, will vary from person to person. For example, the child can play, but at most 2 hours in a row, so he has to do another activity, such as playing with friends, reading a book or comic book etc. The important thing is that the game does not become an obsession.

The same is true for adults, who can alternate their hours of gambling with their studies, conversations with friends or work. This type of measure is more beneficial than total abstinence, as it teaches the practice of healthy and sustainable consumption.

Common questions

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How to differentiate someone who is addicted to games from someone who just plays a lot?

It is not because a person loves to play video games that he or she necessarily has an addiction. In reality, the share of players who end up developing some disorder like addiction is very small compared to the total number of people who play daily.

However, the main symptom of someone with a problem is when the person fails to perform basic activities, such as eating, going to the bathroom or taking a shower to stay playing.

In cases where gambling is affecting an important area of ​​a person’s life, such as their physical health or their performance at school or at work, it is a good idea to seek professional help.

In addition, it is worth remembering that there are people who work playing, e-Sports players. In these cases, there will be times when the person plays more, with more focus and attention, as he is being required to play, due to a competition or tournament.

In such cases, the stage tends to pass as soon as the competition or tournament ends as well.

How can friends and family help someone who is addicted to games?

In the case of parents of children and adolescents, it is very important that there is an open dialogue about games with their children, as well as attention to perceive changes in attitude that last for a long time.

When the child or adolescent stops going out with friends, aggressive or anxious behavior can be a sign that he or she needs help.

However, it is very important to realize that there is no other issue, such as bullying or social isolation, that is affecting the child’s life. Often, in these cases, games are not necessarily the problem, but an escape valve.

In most cases, it is the family that takes the initiative to seek help, whether it be a child, teenager or adult. It is very important that the family talk a lot before trying any kind of more radical intervention.

During this conversation, try to understand the person’s side and try to make them understand yours too, always putting yourself as someone who is there to support them, not to judge them.

After this conversation, it is possible to suggest that she seek help.

Test: should you seek help?

Take the test below and check if there is a possibility that you have some degree of problems with the games and if you should seek help. Add up the points corresponding to your answer and check the result.

1 – Do you feel guilty for spending too much time playing video games?

  1. Yes [5 points]
  2. No [0 points]

2 – Are you overly irritated when the game crashes or crashes?

  1. Yes [5 points]
  2. No [0 points]

3 – Do you stop spending time with your family and friends to play?

  1. Often [10 points]
  2. I’ve done it a few times [5 points]
  3. No, games are not a priority for me [0 points]

4 – Do you delay meals or do not want to go out to eat before a match ends often?

  1. Yes [5 points]
  2. No [0 points]

5 – Did you try to decrease the habit or stop playing completely and failed?

  1. Yes [5 points]
  2. No [0 points]

6 – Did you miss any social activity that you would like to have gone to, like going out with friends, to be playing?

  1. Yes [5 points]
  2. No [0 points]

7 – Do you feel that you only talk about video games with others?

  1. Yes [5 points]
  2. No [0 points]

8 – Do you ever dream about games?

  1. Yes [5 points]
  2. No [0 points]

9 – Do people around you worry about the amount of time you spend playing?

  1. Yes [5 points]
  2. No [0 points]

10 – When you sit down to play, how long, on average, do you spend playing?

  1. From 30 minutes to 2 hours [0 points]
  2. 2 to 5 hours [5 points]
  3. 6 hours or more [10 points]

11 – Do you usually get very angry when someone interrupts you while playing?

  1. Sometimes I even curse at the person who is disturbing me. [10 points]
  2. Only if it is a very important match. [5 points]
  3. No, it’s just a game. [0 points]


From 0 to 25 points

You probably have no problems with games. Keep playing responsibly.

From 30 to 50 points

Watch out! Keep an eye on your gaming habits, as this can develop into something worse.

55 or more points

There is a high possibility that you may have a problem with games. Seek help.

Game addiction is officially a problem. Share this text with your friends and family in order to spread the information and try to help as many people as possible!

Is that you? Have you ever had a problem with games or know someone who has? Tell us in the comments!