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Medical experts hopeful as WHO set to list gaming addiction as psychological disorder

A person plays a smartphone game in Osaka on Aug. 10, 2018. Many of the most popular games are set up such that users must work together to defeat enemies. (Mainichi)

The World Health Organization (WHO) has defined the condition of not being able to stop playing smartphone, console or other games to the point of disrupting an individual's lifestyle as a "gaming disorder," and plans to officially label it a psychological ailment at a general assembly in May 2019.

While the move to officially label the condition as a psychological disorder is raising hopes of the expansion of treatment, as the internet has become intricately woven into our everyday lives and "esports" gaming competitions are gaining momentum worldwide, society continues to grope for methods to counter the addiction and its consequences.

"I can't go on like this," said a 14-year-old boy who lives in Kanagawa Prefecture, just south of Tokyo. While he is in his third year of junior high school, he has stopped attending classes. Since last autumn, his attendance became spotty when he began devoting most of his time to smartphone app and console video games. He stopped eating meals and washing himself, and would stay up until the wee hours of the morning playing. As he racked up missed school days his father would scold him, and he would become violent and kick the walls or doors. In July, his mother took him to a psychiatrist who diagnosed him with a gaming addiction.

"I didn't think I was sick. I just thought it might be a good idea to quit playing," he said. Since then, he became able to sleep through the night, and began attending a cram school to make up for lost time, but he said the urge to play games still remains.

The National Hospital Organization Kurihama Medical and Addiction Center in Yokosuka, Kanagawa Prefecture, where the student is receiving treatment, opened Japan's first outpatient program devoted to internet addiction in 2011. Of the patients, 90 percent cannot quit gaming, and the majority of those being treated are in their teens or 20s. According to a survey conducted by a research group under the Ministry of Health, Labor and Welfare six years ago, some 8 percent of junior and high school students across Japan appear to be addicted to the internet, which amounts to an estimated 520,000 teens.

The main treatment at the Kurihama Medical and Addiction Center consists of counseling and day care activities such as playing sports with other patients, with the aim to create an environment where they feel relaxed even when separated from gaming. Once a patient has been admitted to the center for one to two months without their smartphone, they begin to become aware that they are fine without the games.

Still, the majority of junior high and high school student patients have been brought to the facility for treatment by their parents or guardians, and center head Susumu Higuchi says, "If a relationship can't be built between the patient and the physician, then treatment can't be continued."

There are also cases of gamers who bury themselves in debt with in-game purchases of items and end up taking their own lives. There have even been cases abroad of people dying of "economy class syndrome" -- blood clots forming in veins deep in the legs -- from continuing to play a game for long periods in the same position.

One 26-year-old man in Chiba Prefecture, east of Tokyo, was involved in a university sports club, but became unable to move in the way he wanted due to an injury and instead began to lean toward gaming. He could not stop making in-game purchases, and would spend as much as 100,000 yen some months. He even took out loans from a consumer credit firm to pay for the habit.

"The game keeps being updated, and stronger opponents appear one after another," he explains. "Whenever I got a good result in the game, being accepted by the other players was rewarding." For him, it was the same feeling he got from excelling at club sports.

After continuing to repeat years at his university, he finally dropped out. He then began treatment at the Kurihama center this June. "Toward the end, I didn't play games because I wanted to, but I played with the feeling of crying out for someone to help me," he says. If the WHO recognized him as in fact having an illness, then he hopes "people will begin to understand that not being able to stop playing isn't from a lack of willpower, but the result of being sick."

"Setting standards for diagnosis and being able to recognize people as patients is meaningful," says child psychiatrist Masaru Tateno, the head of the Tokiwa child development center in the Hokkaido prefectural capital of Sapporo. "Currently, medical institutions all over are working on a trial and error basis, but perhaps effective treatment methods or medications will now be developed."

(Japanese original by Kaori Gomi and Hiroyuki Harada, Medical Welfare News Department)

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