Can video games be addictive? It’s an interesting question. Considering that I’ve just spent the last few posts arguing that understanding the basal ganglia can provide a strategy for creating motivation and, in particular, inducing habit, it’s a question I can’t really avoid. Though I mean well, could greater insight into the brain processes underlying motivational processes help unscrupulous game designers enthrall millions of youth into automaton like existence addicted to crack-like video games? Well, I don’t think video game designers need my help in that regard. A quick google and you’ll get a cache full of worry about the threat of video game addiction to youth (apparently no one is worried about the middle-aged women with credit cards who pump billions into Zynga’s coffers). Though reading these pages can sometimes feel like you’ve stepped into a 2012 alternative version of Reefer Madness—for example, listed among the potential symptoms of video game addiction on the Wiki page is “standing in the middle of nowhere looking into space for a considerable amount of time”—the question nonetheless merits examination.
So the basal ganglia are, in fact, the brain structures most frequently implicated in addiction. In particular, addiction is believed to arise from drugs of abuse ‘hijacking’ the dopamine reward system and causing compulsive drug seeking vis-a-vis the basal ganglia: motivation run amuck and sorely misguided. So on the various web sites promoting the idea of video game addiction, you will frequently encounter as evidence the observation that video games release dopamine. Thus, 2 + 2 = video game addiction. Is this true? Despite the appearance of countless studies cited on these pages, there is actually only one straight-forward study of whether video games release dopamine (Nature. 1998 May 21;393(6682):266-8): yes, they do. The rest of the apparent citations are simply to other popular media stories citing other popular media stories citing other popular media stories ad infinitum. Not one byte of it counting as evidence, unless merely saying something often enough makes it true.
Nonetheless, in this case it is true: video games do release dopamine. Could this induce addiction? Actually, dopamine is released all the time. If you could do it in a PET scan machine, I guarantee you would see dopamine released during ping-pong. You’d probably spike a little dopamine at the grocery store when you unexpectedly find cat food on sale. There’s a good chance that solving a math problem releases dopamine. You release dopamine every time you have a meal. In fact, if you did not release dopamine, you would die. Literally. In Parkinson’s disease, it is the progressive death of dopamine cells that gradually debilitates and eventually immobilizes its sufferers. Lack of dopamine is a serious and tragic disease. Dopamine is involved not only in reward, but in motor movement and learning of many sorts. It modulates attention, energizes behavior and sharpens focus. This is why so many college students are nipping Adderall; it releases dopamine—it’s speed. And it is addictive. And yet, our brains release dopamine constantly. Why are we not addicted to everything?
Because releasing dopamine is an essential and extremely ancient evolutionary mechanism that arose to allow organisms to adapt to their environment. Not only people, monkeys, cats and dogs, but worms and flies. . . almost any multicellular organism you can think of use dopamine. It is old old old. It is there to help us. The problem with drugs of abuse is that they crank the system to 11 on a dial of 10. Basically, addictive drugs plug the whole 110V system into a 220V outlet. Things fry. Not good. So what about video games? Can they do the same thing? Over crank the system? Consider this: about 90% of kids play video games, millions of them daily. What would happen if 90% of all kids in the United States smoked crack several times a week, many of them daily? Think about it.
We live in an alarmist society, one fond of medicalizing everything. Everything can be addictive now. Not only drugs, but sex, exercise, video games, shopping, gambling, shop-lifting, facebook, crossword puzzles. It reminds me of the adage “if all you have is a hammer, everything looks like a nail.” Addiction seems to be our social hammer. From the Wiki page: “The most effective treatments seem to be, as with addictions or dependencies, a combination of psychopharmacology, psychotherapy and twelve-step programs.” Really? Symptoms include: “Players may play many hours per day, having late baths and regarding personal hygiene as a waste of time. (Previously construed as a symptom of childhood). Or: individuals may “play at work.” (Alternatively viewed as a symptom of a dull job and/or poor supervision). Many studies cite the excessive amount of time, often hours a day, that young people spend playing video games. How is this different from spending, on average, 6 hours a day watching television, a staple of childhood for several decades?
There is no doubt that some people, kids and adults alike, retreat into the world of video games, sometimes obsessively and to their detriment. And I certainly do not mean to make light of this. If it were my son or daughter, I would not find it amusing but deeply worrying. But I am not sure casting it as an addiction, pathologizing and medicalizing it, helps much at all. Again from Wiki: “Ferguson, Coulson and Barnett  in a meta-analytic review of the research, concluded that the evidence suggests that video game addiction arises out of other mental health problems, rather than causing them.” Which is to say that a deeply withdrawn child who plays video games for hours to the exclusion of friends and other activities may, in fact, have other problems. Other problems it would be important to recognize and treat.
Do kids spend too much time playing video games, even kids without mental health problems? Perhaps, but then as has been pointed out repeatedly, many people obtain satisfaction in the world of video games they cannot obtain in the real world. Just like television. And movies. And books. Perhaps the question could be asked whether video games release too much dopamine and are addicting. But why, in a sense, does the world we provide children, adolescents and many adults not provide sufficient dopamine stimulation to get them addicted to activities in the real world? Is our world that dull? Do we infantalize youth, leaving them without meaningful challenge and opportunities? Does a culture of passive consumption induce a mind-numbing ennui from which video games offer respite?
The world becomes interesting and engaging when you have the skills to engage it and to make it interesting and challenging. As a tool for building motivational scaffolding, video games provide an opportunity for adults and educators to help children and adolescents acquire skills that can transform the way they see and engage the real world around them. We should not lose sight of that amidst the spectacle of supposed video game addiction. And maybe, just maybe, if we don’t like when people turn away from society in an endless array of so-called addictions, we might take a look at the society against which they choose to turn their backs.