When José Antonio Hita Ruiz was a teenager, his home life wasn’t all that great. His father was an alcoholic, his mother worked too much. In middle school, he was bullied and his grades suffered, so he dropped out. While his friends left his hometown one by one to study at a nearby university, Hita turned even more to video games as an escape, often spending up to 16 hours a day playing strategy games and simulators at his mom’s place.

“There was a point where I was completely alone,” he tells me over Google Hangouts.

Now 24, Hita is doing much better. He’s doing volunteer work for local nonprofits near Naples, Italy. During our chat, I hear sounds typical of the youth hostel where he’s staying — animated chatter, pots clanking.

Three years ago, though, Hita was at his lowest point. He was having suicidal thoughts. To numb his pain and lessen his feelings of isolation, he kept turning back to video games. He had an emotional breakdown and committed himself for a night to a psychiatric ward near his mom’s house. Left with a terrible choice — end his life, or quit gaming — Hita chose the latter. He decided it was time to lay down his controller.

Years later, he was still puzzled about his addiction. Video games had never even come up when he reached out for professional help in the past, and yet he saw them as the key to his problems. He couldn’t be the only one, right? So Hita signed up for an online forum called Game Quitters where he could share his own story. Lo and behold, there were thousands of people like him.

“I wasn’t even playing with other people; it was just me and the same few games, again and again,” Hita tells me. “Some people may misinterpret if I say ‘like a drug.’ But in my experience, it was like a drug.”

“In my experience, it was like a drug.”

The specifics may vary, but Hita’s story shares a common thread with those of thousands of other video game addicts: an unhealthy relationship with video games.

In the 30 years since gaming consoles became affordable, video games have become more than a simple distraction or hobby. About 2 billion people worldwide play video games. That number is rising even more quickly than expected, in large part because more people are simply getting access to games. Many of these players are at risk of becoming addicted. The national Bureau of Labor Statistics found that, between 2003 and 2016, the amount of time we spend on video games a day rose by 50 percent — from 10 to 15 minutes. It may not sound like much, but it’s a big leap if you consider that it’s a national average.

In fact, most people might not realize the huge role gaming plays in many people’s lives. It has become an increasingly popular way for people to interact, to socialize, and to even make a living in some cases. Gaming no longer means playing alone in your parent’s basement — it has become a truly social activity,  a way to stay in touch with friends, or for some the only meaningful social interaction in their entire day. It’s even grown into a career path. Professional gamers compete in international tournaments with prize pools of up to $11 million.

Because games are now so widespread, accessible and designed to keep people playing for longer, they can overtake people’s lives — sometimes in unhealthy ways. Hobbies can become obsessions, which can turn into addiction, in which video games has such a strong hold on a person that they find the habit impossible to break.

I Just Can’t Quit You

Cameron Adair has a story pretty similar to Hita’s. He had been addicted to video games since he was five, he says. That was a big factor for why he dropped out of high school when he was 15 — that, and the shock of seeing his best friend being put into a rehab center against his will. “And it just rocked me,” he tells me. “For me, I’ve always been big on helping people who want help.”

But here, their stories diverge. After finding that there was practically no place online where he could discuss his addiction, Adair founded Game Quitters, the self-proclaimed world’s largest support community for video game addiction.

Game Quitters is an online peer support community where like-minded people can share their stories and find solace in the fact that they are not the only ones with their addiction. The forum of almost 2,000 registered users from 92 countries is full of accounts of experiences like Jose’s and Adair’s, tips on how to curb your addiction, and members’ daily journal entries. The average member is a 24-year-old man (94 percent of Game Quitter users are men, Adair says), whose lives have been negatively affected in some way by video games. Some have gotten bad grades in school, had rough breakups, or developed eating disorders — all because they couldn’t quit gaming.

Like with any addiction, admitting you have a problem isn’t easy. And it’s even harder when professionals can’t decide what to call your problem in the first place. Earlier this year, the World Health Organization (WHO) made a bold step towards settling the debate, announcing it will recognize what it refers to as “gaming disorder.” It’s a “pattern of behavior” characterized by gaming that “takes precedence over other interests and daily activities” and is impossible to control.

It’s the first time video game addiction has been officially recognized as a disorder. But there are still plenty of American psychologists who don’t think gaming disorder has a place in any diagnostic manual. The American Psychiatric Association (APA), which sets the criteria for diagnosable disorders in the U.S., listed “Internet Gaming Disorder” as a “condition for further study” in 2013 — the APA wants to see further proof before it decides to make it officially a disorder by including it in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Skeptical psychologists think the WHO rushed its definition of “gaming disorder,” arguing that there’s not enough evidence yet to single it out as a distinct condition. Others think gaming disorder simply isn’t a separate disorder. “Undoubtedly some people overdo games just as they overdo food, sex, work, dance, etc., but there’s no real rationale for an independent gaming disorder diagnosis,” Chris Ferguson, a psychology professor at Stetson University in Florida tells Gizmodo.

Politicians who draw links between video games and violence only makes things worse. After the February school shooting at Marjory Stoneman Douglas High School in Parkland, Florida, President Donald Trump met with video game executives and members of Congress. “I’m hearing more and more people say the level of violence on video games is really shaping young people’s thoughts,” he told Florida’s attorney general Pam Bondi as quoted by TIME, despite overwhelming evidence to the contrary.

Mental health professionals are already helping gamers with their addiction, whether it’s a coping mechanism for something else or not.

Image Credit: Nintendo/Victor Tangermann

A Way Out

Despite the controversy around how to define video game addiction, clinicians are coming up with ways to treat it. Some of these treatments are ways of dealing with addiction in general, while others are targeted specifically for an addiction to video games.

Often, where there’s a patient in treatment for addiction, there’s cognitive behavioral therapy (CBT). “Cognitive behavioral therapy is one of the most effective treatments for addictions,” says Stephanie Sarkis, author and therapist specializing in ADHD and anxiety treatment in Tampa, Florida.

CBT is a form of psychotherapy that examines the patient’s entire mental state, instead of focusing in on one particular disorder. A clinician gives a patient a psychological assessment and helps them learn new skills to deal with negative thinking. Sarkis recommends to get an evaluation for this kind of treatment when “it’s really hard for you to have the best quality of life that you would like.” In other words, when your addiction is starting to negatively affect you.

Could Game Quitters offer something similar? Sarkis was optimistic. “There’s universality — you find out you’re not the only one experiencing an issue, and I think that’s very healing and cathartic.”

But a sense of solidarity isn’t a replacement for the help of an actual clinician. And for self-professed gaming addicts, access to that kind of professional treatment isn’t a guarantee. The fact is, very few therapists are trained and equipped to talk about video game addiction at all. “I advocate for people to seek professional support all the time,” Adair says. “That’s a bit of a challenge for me personally, because I also know that there is a huge gap in the amount of professional services available.”

There’s a new trend to treat gaming addiction, too: private clinics that provide patients with a way to “detox” for a while. One of the biggest names in video game addiction treatment, called reSTART, has four locations across Washington state. It offers intensive programs that last from eight weeks to a whole 24 months for people with “problematic technology use” between the ages of 14 and 30 in which people can learn to understand their unhealthy relationship with digital media and find ways to overcome it in the long term. Programs focus on withdrawing access to technology — a brochure mentions a “tech-limited apartment setting” for example — and introducing accountability by building support groups of friends and family around them.

In practice, reSTART’s programs often involve video game addicts living in apartments together without TVs, computers or smartphones over the span of a couple of months. They mostly learn how to live their lives independently — a lesson that many video game addicts hadn’t had to learn yet. “Paying my own bills, go to things on time, go make my own food. Things like that. Those are all things that I’ve never fully accomplished,” a reSTART patient called Kevin tells VICE News.

But these private clinics aren’t an option for all video game addicts. Treatment programs tend to be extremely expensive —a 45-day rehabilitation program at a reSTART clinic, for example, costs a whopping $26,000.

The Future of Gaming Addiction

A growing pile of evidence or a groundswell of community support, might not be enough to convince the professional psychology community that the condition is real. It might just take time. It took the APA 16 years after the first issue of the DSM, in 1952, to officially recognize Attention Deficit Hyperactivity Disorder (ADHD), even though the condition was first mentioned by a British pediatrician in 1902.

But the longer we wait to recognize gaming addiction, the farther we are from finding effective, and accessible treatment for it.

So for now, online peer support groups like Game Quitters, plus a smattering of therapists well-versed in the topic, will have to do their best to support those for whom obsession has morphed into addiction.

But there are still plenty of hurdles to overcome. One we can start on now: de-stigmatizing it. “Improving the quality of conversation around addiction can actually help break the stigma of gaming,” Adair says.

Fear or shame for speaking out about an addiction can inhibit the thousands of people for whom video games have negatively impacted their lives from reaching out for help. But to listen to them, we  — and the professional mental health community — have to take them seriously, take their condition seriously.

“If you want to change, you have to know that there’s a whole community of people that have gone through the same situation as you,” Jose says. “It’s about knowing your options. After all, it’s your time and your life.”

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Video Game Addiction Is Real And Professionals Aren’t Prepared To Help