Concern about addiction to video games, social media or smartphones seems everywhere at the moment, with a growing noise that goes beyond any moral panic. But in addition to Apple investors and former executives of Google and Facebook, the most intriguing communication on these issues has come from a global health body!
In December 2017, almost five years after the US introduced the diagnosis of Internet Gaming Disorder, the World Health Organisation (WHO) agreed to include the diagnosis of Gaming Disorder in the next edition of the International Classification of Diseases (ICD); the manual of health problems that almost defines what is or isn’t a medical problem, and whether treatment might be offered. Gaming Disorder focusses on any negative impact of the gaming, over a period of a year, and this helps to distinguish it from enthusiastic gaming where the positives dwarf any long-term concerns. Many gamers will no doubt receive this development with shock and anger, feeling again that they are stigmatised. Yet it was also in December that a parent contacted me and requested help regarding their son’s gaming, even though it involved travelling almost 100 miles to get support. Anything that could increase wider and local support and reduce such a burden must have value?
But let’s scroll back a moment. Over the last century, our health services developed so much that many disorders listed by the WHO are now treatable. The challenge to health services today is that many of them are also preventable, and that problems stem from how we live. Our struggles to sleep well, eat well, keep fit and stave off loneliness have serious implications for our future health and life chances. Many of these aspects of living contribute to obesity and a lack of exercise, which in turn contributes to the development of conditions like Type II Diabetes; treating diabetes costs the NHS £1.5 million an hour…an extraordinary fact almost worth listing on the side of a bus…
So anything that interferes with our biological needs – good food, diet, physical activity – and psychological health – good friends and relationships and a sense of purpose to your life – does need to be taken seriously; it is no joke to understand that sleep may be more important to you than even a good diet and exercise, and that is exactly what that Netflix boxset might take from you.
Although many things can disrupt our ability to meet our biological needs, gaming is particular in that it can involve large amounts of time, such as 16 hours a day, over long periods of time – months or years. What complicates the matter now is that the opportunity to earn or win large sums through playing many hours a day as a professional gamer, or YouTuber. Some gamers are very much in the world of the superstars, and we are only at the start of the era of the super gamers. So what may sometimes pass as an addiction, is really entrepreneurial activity, focussed on succeeding in the digital economy; something else that we have yet to address – 21st Century careers advice.
Gamers are quite right to point out though that there are many other online activities that can have such a disruptive impact on your sleep, health and even work. Nowadays, in the frantic attempt to get and keep your attention, devices and platforms are gamifying as much as possible, which whilst driving the digital economy, risks exhausting and making unproductive its constituents. When Sean Parker or Tristan Harris sound the alarm bell in response to these trends, it is time to take them seriously.
So who is going to help us remember that we are not machines with inexhaustible batteries and must respect our biological realities, and not least our minds and feelings? Well, in the UK there were very welcome and heartening references in the recent Government Green (Strategy) Paper on Internet Safety to digital well-being. The shift from focussing on safety alone, or even digital resilience (strengthening the abilities to cope with online risks) to a focus on well-being is really promising, as it contains the seeds of how to live well in the digital age.
But we must also be grateful to those who helped the WHO include Gaming Disorder into its manual of diseases. Not because of the focus on gamers, and those that lose control of their use, but because it will advance the digital maturity of our health services. This will afford those that get lost within the digital world, or are harmed by it (through, say, bullying or exploitation) the chance of better informed assessments and better chances of recovering what has been lost or damaged. We have so much to learn, not least about immersion as much as we do addiction.
We should be grateful to the gamers that have immersed themselves in the digital world, sometimes to their own cost, for highlighting some of the pitfalls. And we must work together to make sure we enjoy all of the opportunities of the digital age, but in a way that does not neglect our biology and humanity. Perhaps surprisingly, in this respect, when industry loses its way, the WHO turns out to be one of our best allies.