By: Peter Grinspoon, MD, Contributor
More than two-thirds of Americans play video games, also known as gaming. While gaming can be a fun distraction or hobby (and is even becoming a competitive sport on many college campuses), there are health risks that come from too much gaming. What are these harms, and what can be done about them?
Is there anything good about gaming?
Before discussing the harms of gaming, it is only fair to mention the benefits. Aside from being entertaining and a fun pastime, gaming can provide a way for people to interact with each other — a virtual community — as they work together toward completing common tasks. Our society suffers from an epidemic of loneliness, and gaming can be a vehicle to connect with others, including otherwise difficult-to-connect-with people in your life, such as kids, grandkids, or (I’ve seen this be quite helpful) with autistic children, who can have challenges with traditional modes of communication.
There is mixed research that there are some cognitive benefits to gaming, such as better control of one’s attention and improved spatial reasoning, though it isn’t entirely clear how much these benefits extend outside of the video game sphere into the real world. Finally, video games have medical applications, such as training people with degenerative diseases to improve their balance, helping adolescents with ADHD improve their thinking skills, or training surgeons on how to do technically complicated operations.
Repetitive stress injuries, or overuse injuries, are injuries that come from activities that involve repeated use of muscles and tendons, to the point that pain and inflammation develop. If these injuries are allowed to progress, numbness and weakness can develop, and permanent injury can result. Overuse injuries of the hands and arms are rampant among gamers.
One common example is carpel tunnel syndrome, which many gamers develop. Carpal tunnel syndrome, often seen in office workers, involves inflammation of a nerve in the wrist, which causes pain and numbness.
"Gamer’s thumb," which was previously called "PlayStation thumb" (or "nintendinitis" or "nintendonitis" when Nintendo was popular), occurs when the tendons that move the thumb become inflamed. The medical term for this is de Quervain’s tenosynovitis, and it can lead to swelling and limited movement. Gamers are also at risk for trigger finger, or stenosing tenosynovitis, which is when a finger gets stuck in the bent position due to chronic inflammation. Gamers can also get tennis elbow, a painful inflammation of the place where the tendon inserts into the bone on the outside of the elbow.
Gaming is also associated with obesity in teens and, plausibly, the same would be shown in adults, if studied. This is due to the obvious phenomenon that if a teen is sitting in front of a screen for hours every day, he or she isn’t getting much exercise. The obesity is also thought to be due to increased food intake while playing video games. According to a study in the Journal of Clinical Nutrition, "a single session of video game play in healthy male adolescents is associated with an increased food intake, regardless of appetite sensations." The proposed mechanisms are that either the signals that indicate satiety (fullness) get impaired, or that the mental stress involved with playing video games activates the reward centers, which leads to increased food intake.
Vision problems are common complaints of gamers. The most common vision problem is eye strain, which can lead to headaches and poor concentration. Gaming has been reported to result in seizures, leading to warnings on the packaging.
Gaming has also been associated with psychological problems. It is still an open question whether video game addiction, or internet gaming disorder (IGD), is a unique syndrome. According to the American Psychological Association, IGD is defined as experiencing at least five of the following nine criteria over a 12-month period:
- gaming preoccupation
- loss of interest in other activities
- downplaying use
- loss of relationship, educational, or career opportunities
- gaming to escape or relieve anxiety, guilt, or other negative mood states
- failure to control
- continued gaming despite psychosocial problems.
According to one study from the American Journal of Psychiatry, between 0.3% and 1.0% of Americans might have an internet gaming disorder. Treatments for this problem are a work in progress, as the disorder isn’t fully understood or agreed upon, but can include public health approaches such as education and harm reduction, stricter labeling on the packaging, as well as cognitive behavioral therapy. There are even support groups, such as Computer Gaming Addicts Anonymous, which leverage the power of group support — also helpful in the treatment of other addictions — to the realm of gaming addiction.
Gaming has also been associated with sleep deprivation, insomnia and circadian rhythm disorders, depression, aggression, and anxiety, though more studies are needed to establish the validity and the strength of these connections. There has also been concern that exposure to the extreme violence that is commonly found in video games can desensitize teens and young adults to such violence, causing emotional problems and even leading to young people committing acts of violence.
Gaming in moderation
As with many other activities that have potential benefits and harms, moderation is the key. Most of the harms that come from gaming can be improved, if not avoided altogether, by limiting the number of hours spent in front of the screen, and by engaging in healthy activities like exercising, or socializing in the real world instead of the virtual game world.
Education is an essential key to injury prevention. Gamers need to be educated on how to protect their thumbs, wrists, and elbows, their waistlines, their emotional state, their sleep, and their eyes. Simple education around taking breaks, stretching, eating healthy snacks, and resting and icing your thumb, wrist, or elbow when it starts hurting can address injuries early, before they become significant. For the eyes, gamers can try the 20-20-20 rule: every 20 minutes, try to look at something 20 feet away for 20 seconds.
In short, playing video games can be fun and a social activity when integrated into a healthy lifestyle that includes plenty of sleep, exercise, and good nutrition, rather than letting the game become your life.