As human beings, we all have certain needs: a sense of control, a challenge, identity, social contact and so forth. Video games, more than any other form of media, provide players with ways to fulfill all those needs. But, for players with a history of personal trauma, games can work as an unhealthy substitute that prevents them from addressing deeply ingrained issues.
In severe cases, this can escalate to a full-blown gaming addiction, according to Dr. Alok Kanojia, aka “Dr. K”, a Harvard-educated psychiatrist and instructor at Harvard Medical School who practices out of McLean Hospital.
Dr. K, who hosts a successful Twitch channel where he’s interviewed some of the biggest streamers on the platform, is one of the co-founders of Healthy Gamer, an organization dedicated to improving mental health among gamers.
But before that, he was a textbook example of the very people he’s now helping. Dr. K nearly flunked out of college and was placed on academic probation. In fact, he barely graduated with a 2.5 GPA because gaming went from being a passion to a stumbling block.
“I struggled a lot with video game addiction in high school and college,” Dr. K told In The Know.
Dr. K traced his own addiction back to a difficult upbringing. He was a precocious student who skipped a grade ahead and, as a result, he performed poorly in sports against older and larger kids, who ridiculed and bullied him.
Academically, Dr. K found his early coursework dull and uninteresting. He’d finish his worksheets far ahead of schedule and when he asked his teacher for something else to do, he’d be left to twiddle his thumbs for 40 more minutes until class was over.
For the young Dr. K, gaming offered him things that real life didn’t. It allowed him to compete in a way that sports didn’t, served an escape from social isolation and challenged him when school didn’t. Unfortunately, it also became a crutch that was inadequate for helping him through life.
“School got harder, but I didn’t really learn how to apply myself,” Dr. K said. “So, I started doing bad in school and the worse things got, the more I needed to game to help me feel better.”
He recounted one time in college where he was so anxious about bombing his Spanish final, he skipped it altogether and coped by playing video games.
After college, Dr. K went on a “journey to find himself.” He spent some time in India studying to become a monk but eventually went on to study neuroscience, which led him to psychiatry.
During his time as a student in Harvard Medical School, two things became apparent to him: video game addiction is a very prevalent problem (Dr. K spoke with over 300 gamers struggling with it in the course of just two years) and none of the people at the forefront of psychiatry (typically in their 50s to 70s) knew what to make of it.
“People didn’t really know much about it,” he said. “No one even considered it an issue.”
Indeed, video game addiction is something that not even health experts are entirely certain about yet. But, if any activity can cause problems with work, school, relationships or any other aspect of day-to-day life, it is certainly a cause for concern.
“The short answer is that if it causes a problem, it is a problem,” Dr. K said. “The real dividing line between a healthy passion and an addiction or a real problem is impairment of function.”
Games can be a great way to relieve stress, but, “when you’re doing ‘stress relief’ for 12 hours a day for six days a week because you’re going nowhere in life and the thought of applying for a job is overwhelming, that’s when it becomes an addiction,” Dr. K said.
While Dr. K acknowledges that gaming addiction is complex and can’t be neatly categorized alongside other officially recognized addictions, the hundreds of gamers he’s spoken with have led him to believe it’s very much real.
“I think it’s actually quite severe in the United States and people didn’t seem to know about it,” Dr. K said. “So that’s why we started Healthy Gamer because what I heard from these gamers was ‘yeah, I’ll go see a psychiatrist or therapist but after one session they’ll diagnose me with depression, give me medication and send me out the door.’ The mental health professionals aren’t aware enough to ask about video game addiction or how it affects people.”
Game addiction, Dr. K explained, doesn’t have a genetic or familial component such as substance abuse. It also doesn’t have the chemical component that substances have, which can trigger parts of your brain and make you lose control.
This is what Healthy Gamer seeks to address. Prospective clients can sign up with coaches — all trained and certified by Dr. K himself — who will walk them through a plan to break their gaming addiction.
Notably, Healthy Gamer coaches don’t have to be licensed medical professionals. This is because the goal of Healthy Gamer isn’t to diagnose or treat a medical condition. In fact, Dr. K made it very clear that anyone seeking those things should be consulting with trained psychiatrists and therapists.
Rather, Healthy Gamer is a peer support group like Alcoholics Anonymous. Dr. K noticed some troubling patterns among the people he spoke with who professed a gaming addiction — many of them were victims of bullying. Rough childhoods shaped by abusive or overbearing parents are “remarkably common.”
Healthy Gamer’s coaches share this lived experience. A licensed medical professional is able to treat patients, but they won’t necessarily have that lived experience component. Studies have shown that peer recovery groups have much promise in sustaining a long-term lifestyle free of addiction.
This is also where Dr. K’s experience with yoga, meditation and traditional Indian medicine comes into play. Video games aren’t inherently bad or physically addictive, which is why concepts like Ayurvedic mental health and meditation can help gamers enjoy their hobby without being controlled by it.
In fact, Dr. K said many of Healthy Gamer’s clients are professional gamers and content creators who struggle with the blurred lines that come with video games being both a form of work and play.
“Finding balance as opposed to, ‘is it illness or not illness?'” Dr. K said. “I think Eastern medicine and some of those principles are actually far better suited for ‘video game addiction’ because it’s not black and white.”
Dr. K made his name by streaming live interviews with dozens of Twitch’s most prominent streamers, including a talk with Byron “Reckful” Bernstein, who tragically died from suicide in July after struggling for years with depression and bipolar disorder. Days after Reckful’s death, streamer Ohlana also died from suicide.
In a tearful tribute, Dr. K noted that Reckful’s passing has sparked renewed awareness for mental health and cyberbullying in the streaming community.
With Healthy Gamer, Twitch’s resident psychiatrist is fighting to make sure that their deaths will be remembered, but never repeated.
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