Gaming disorder is officially a thing. Here’s what that means.

Gaming disorder, which basically boils down to video game addiction, was officially recognized by the World Health Organization Saturday.

After a year and a half of deliberation on the new revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), which included gaming disorder in its 2017 draft, all 194 member states of the WHO agreed to adopt ICD-11. The new revision goes into effect Jan. 1, 2022.

So what exactly is gaming disorder? It sits in the subcategory in ICD-11 called “Disorders due to substance use or addictive behaviors” alongside alcoholism, gambling addiction, and, curiously, a section devoted to harmful cannabis use dependence.

Here’s the definition in full:

Gaming disorder is characterized by a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline, manifested by:

1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);

2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and

3. continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

The pattern of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.

There are many people that play video games to an extent that feels like they meet some of these descriptors, but it’s important to remember that this is a deeper issue than just playing video games a lot.

What is and isn’t a gaming disorder

As Dr. John Jiao pointed out in a helpful Twitter thread Saturday about gaming disorder (which he refers to as VGA) , it’s not about hours put into games. It’s about when gaming gets in the way of other, important aspects of life for a long period of time.

There are a lot of hot takes out there today about the new video game addiction disorder. Let’s make one thing clear:

VGA is not about # of hours played. It’s when gaming takes precedence over health, hygiene, relationships, finances, etc.

Gaming itself is not a disorder.

— John Jiao, MD (@JohnJiao) May 25, 2019

Tons of people who play video games take time off from work to play a new release, spend the night inside to play rather than go see friends, or even (on particularly intense occasions) skip a meal because they’re so mentally locked in to a game. These aren’t problematic on their own, but if they happen again and again and again over 12 months, then gaming disorder may be a fit diagnosis.

So for instance, if your job is to stream video games and you play 12hrs/day but pay your bills, hang out with friends, have relationships, there’s no disorder.

If you play 4 hours a day but it causes you to abandon your family, gets you fired from work, etc, that’s disorder.

— John Jiao, MD (@JohnJiao) May 25, 2019

As Jiao points out, there are people who play games for a living, such as esports professionals, streamers, or even just intense hobbyists like hardcore MMO raiders, speedrunners, or completionists. They’re people who can play single games for hours and hours, but if they still maintain a pretty healthy life outside of that, they don’t have gaming disorder.

The importance of gaming disorder as an identifiable and diagnosable problem boils down to treatment. If there are people that fit these descriptions and don’t really have any underlying disorders, it’s much easier for them to get insurance to pay for therapy if this is a recognized thing. That can be a huge help to people who are struggling.

Why might we need an official diagnosis, you ask?

Because otherwise people with real, legitimate video game addiction can often have trouble with insurance paying for their therapy, especially if they don’t fit any other diagnosis (not clinically depressed, for example).

— John Jiao, MD (@JohnJiao) May 25, 2019

There’s no saying gaming disorder can’t go hand-in-hand with other issues such as depression, which is something I’ve written about in my own experience with addiction and World of Warcraft.

Plenty of gamers hear “gaming disorder” and turn up their noses or get defensive of their hobby, but they likely haven’t experienced the kind of self-destructive dependence on gaming that I and others have experienced. 

If the inclusion of gaming disorder in ICD-11 allows more people to recognize and get treatment for this kind of behavior, that’s a net positive for the world.

Problems with gaming disorder diagnoses

Of course, there are valid criticisms of the WHO’s description of gaming disorder, as mental health and gaming organization Take This points out. While Jiao’s thread provides some helpful context to the definition of the disorder, those details are not in the official diagnostic guide.

The definition is rather ambiguous and there’s a lot that can be extrapolated from it. Streamers and esports pros have to start somewhere, and while amateurs aren’t making a living off of gaming at the moment, they still have to put in that time and effort to get to that level. Their time spent playing could fit within the description of gaming disorder.

The lack of details in the gaming disorder definition makes me question my own relationship with it. When I was in middle school and high school, I certainly fit within the diagnosis of gaming disorder at times. Do I still fit that diagnosis even though I don’t game like I used to?

Or how about the few days I took off from work for a little stay-cation a couple years ago when I played Diablo 3 for roughly 15 hours every day for three and a half days straight, forgetting to eat and completely neglecting everything else in my life? Would that fit in the part that says “the required duration may be shortened if all diagnostic requirements are met and symptoms are severe”?

Perhaps some additional information on gaming disorder and some more concrete details would strengthen its definition.

Still, its inclusion in the ICD-11 is a step forward for people who need help. Does it need work? Yes. But what doesn’t?