I've created a "Teen Video Game Addiction Workbook"

Below is an excerpt from a workbook I recently completed for video game addicted teens to use (in therapy). If you are interested in a copy, please feel free to contact me @cyberrecovery@gmail.com or call 855-735-HELP.

Chapter 1: Can video gaming really become an addiction?

Can video gaming really become an addiction? Although video game addiction is not yet an “official” diagnosis recognized by psychologists and psychiatrists, it is clear that children, teens, and adults can develop an addiction to gaming and to the internet.

Some teens develop a constant craving or desire to play video games, while also experiencing what is referred to as tolerance. Tolerance means that the gamer needs to spend increasing amounts of time gaming in order to feel excitement and satisfaction. It is very common for gamers to tell me: “In the early days of gaming, I only needed 1 to 2 hours to feel satisfied. Now I play games for more than 5 to 6 hours in order to have fun.”

Gamers also experience withdrawal symptoms. Here, withdrawal refers to the gamers feeling anxiety, anger, tension, irritability, and/or depression when they are not engaged in gaming (e.g., when at school or when spending time with family).

Finally, just as is the case with drug addiction, gamers experience persistent negative consequences. Negative consequences may include conflict with family, loss of friendships, neglect of school work, neglect of chores, reduction in physical activity, fatigue, and overall poor health.

Gamers are also similar to people addicted to drugs and alcohol because they can see the negative consequences of their addiction, but are unable to successfully change their behavior. In extreme cases, as has been reported in the media, some gamers have played to the point they experienced serious medical problems resulting in hospitalization and death.

Have you ever experienced craving? Yes/No/Unsure

Have you ever experienced tolerance? Yes/No/Unsure

Have you ever experienced withdrawal? Yes/No/Unsure

 Have you ever experienced negative consequences related to you gaming?  Yes/No/Unsure

Have you ever tried to stop gaming, but couldn’t control your behavior? Yes/No/Unsure

What are the signs of video game addiction for a teenager?

1)    Distorted perception of time (referred to as a “time warp”). Many teen gamers experience a slowing down of time when they are playing. When asked to estimate how long they think they have been playing, addicts tend to dramatically underestimate their gaming time.

2)    Difficulty taking a break from gaming for an extended period of time. If a teen is addicted to gaming, he can usually stop playing for a day with a minimal degree of discomfort. However, the gaming addict will find stopping gaming for 2 to 3 days extremely difficult (intense cravings and some withdrawal symptoms) and will refuse to try to stop for a week or more knowing that they will experience intense feelings of anger, depression, anxiety, and irritability.

3)    Increased time spent gaming. Another clear sign of addiction to gaming is the need to spend more and more time playing. Although there is no specific amount of time that means a teen is addicted, obviously the more a person plays the more gaming will interfere with everyday life. Teen video game addicts can easily put in 20, 30, or 40+ hours per week.

4)    Inability to stop playing or decrease time despite a desire to do so. Some teens do recognize they need to change their gaming habits due to negative consequences, particularly poor school achievement, but are unable to make changes no matter how hard they try.

5)    Playing at the first available opportunity. Teen gaming addicts try to play at every possible opportunity. Common times include waking up in the morning before school, playing immediately after school, playing immediately after dinner, or rushing through homework to get back to gaming.

6)    Becoming angry and argumentative when limits are set on gaming or when asked to stop gaming. In some cases, addicted teens react with violence when a parent sets a time limit.

7)    Arguing about the negative impact of gaming and denying there are serious negative consequences related to gaming. One clear sign of video game addiction is the refusal to recognize any negative consequences related to gaming and arguing and fighting any time an adult points out negative consequences.

8)    Choosing to play video games over going out with friends. Most addicted gamers say they are socializing with friends during game play. Although gamers do have online/”gamer” friends, these friendships do not help in the development of the social and interpersonal skills that are essential for off-line friendships. Online friendships may be satisfying, but they do not help with learning how to create and maintain “real world” relationships – especially relationships with the opposite sex!

9)    Sleep difficulties or dramatic changes in sleep schedules. The most common change in sleep patterns is staying awake into the middle of the night. If a teen has a computer or gaming console in his room, it can be extremely difficult not to engage in marathon gaming sessions. Some addicted teens set their alarm clock so they can wake up in the middle of the night and play when there guild or team is online.

10)                       Decreased interest in school, home work, and overall academic achievement. This may take the form of homework being ignored, decreased time studying for exams, lying about when homework is due, and/or lying about whether homework has been completed. Some teen gaming addicts refuse to attend school, opting instead to engage in marathon sessions during the school day.

11)                       Deterioration in academic performance. Usually a strong student (A-/ B+ average) will not go from high achievement to failing in the course of one semester. What is more likely is a gradual decrease in achievement over the course of a full academic year. Some strong students will be able to get by with less time studying. However, as the year progresses, the addicted gamer will start losing ground and will fail to integrate new material.

12)                       Becoming depressed and/or anxious when gaming is unavailable. Many teen gaming addicts say the only activity they find truly enjoyable and satisfying is gaming. Many teen gaming addicts become restless, nervous, and depressed whenever they are away from their gaming console or computer.

13)                       Thinking about video gaming when involved in other types of activities. Addicted gamers admit that they cannot think about anything other than being engaged in their favorite game, no matter what else they may be doing.

14)                       Loss of interest in activities such as sports, music, hobbies, or spending time with offline friends. A clear sign of gaming addiction is a teen that once had an interest in sports, music, or recreational hobbies and  who has withdrawn into living as an avatar in a virtual reality.

15)                       Feelings of responsibility to a guild, clan, or online team. Some addicted gamers are so concerned about fulfilling their part of a game that they neglect three-dimensional responsibilities and experience intense feelings of guilt and shame if they are unable contribute to their guild/clan or online team.

16)                       Decreased attention to personal hygiene. For some addicted gamers hygiene becomes a very low priority. When a teen is addicted to video games, personal care takes a backseat to playing. Showers decrease in frequency, often taking place several days apart. Brushing teeth and facial and hair care are also neglected. In some extreme cases addicted gamers wait too long before using the bathroom and urinate or defecate in their clothes.

17)                       Poor or irregular eating habits. For many addicted teen gamers regular meals and healthy eating are not a priority -- convenience rather than nutrition is what is most important. The addicted gamer generally tries to eat all meals during game time.

18)                       Headaches, dry eyes, and sore fingers are also part of the addicted gamer’s life.

19)                       Overall, decreased level of physical health. As physical activities are sacrificed in favor of gaming, sadly teens go through a general deterioration of physical well-being -- especially weight gain.

20)                       Reading about gaming, discussing gaming with other gamers online, or writing posts or blogs about gaming when not playing video games. Addicted gamers have great difficulty discussing any topic that is separate from the video gaming. Parents of teen video game addicts frequently complain that no matter what conversation topic they offer, their teen rejects the topic and starts talking about gaming.

21)                       Spending the majority of allowance or income from a job on gaming accessories, expansion packs, computer upgrades, and other transactions related to gaming. Some teen gaming addicts have been known to borrow or steal money from family or friends in order to obtain a new game or acquire resources needed for gaming.

22)                       Frequent gaming binges. The addicted gamer may play for seven or more hours nonstop.

23)                       Lying in order to get around time restrictions.