Is Your Son Addicted to Video Games?

Jacob was 22 when his parents brought him to see me in the office. He still lived at home and worked only a few hours a week, helping in his father’s remodeling business. His parents were concerned by Jacob’s complete lack of ambition. He had no job except for the occasional work provided by his father; no education beyond high school; no interest in further education—vocational or otherwise; and no plans for the future. He was playing video games at least 40 hours a week, the equivalent of a full-time job.  

“Tell me about your best friends,” I asked.

“I have dozens. Where do you want me to start?” he answered.

“Just tell me the first names of three of your best friends,” I replied.

“Well, there’s Jonathan,” he said.

“When did you last see Jonathan?” I asked.

“I’ve never seen Jonathan,” Jacob admitted. “He lives in Singapore. He’s in my World of Warcraft guild.”

“When’s the last time you had a friend over at your house?” I asked.

“Yeah, I see what you’re getting at. The virtual world isn’t as good as the real world, right?” Jacob said.

“Well, yes,” I said. “I do think real-world relationships are more important than relationships which exist only online or in a virtual world.” 

Jacob was spending way too much time playing video games. The games had crowded out everything else. 

“The only effective intervention in this context is complete abstinence,” I told his parents. “You have to eliminate Jacob’s access to video games. Remove the Xbox from the house,” I continued. “Destroy it or give it away. Eliminate all access to the Internet, including the cell phone.”

Jacob’s blake expression turned into an angry scowl. “That’s totally unacceptable,” he said. “I’m an adult. I’m over 18. You can’t tell me what to do! My parents can’t tell me what to do.”

“That’s right,” I replied. “You are an adult. You are free to walk out of your parents’ house. But if you leave,”—and now I glanced at the parents—“your parents are not to support you. Right now, you are living in your parents’ home, but you don’t pay rent. They pay for your food and your Internet access. If you are going to stay in their house, then you must abide by their rules.”

Scholars disagree about whether video game addiction qualifies as its own psychiatric diagnosis. But as a family doctor, I have seen firsthand that some kids—mostly boys—are truly addicted. 

Video games have been around for half a century. This year, we celebrate the 50th anniversary of Atari’s launch of Pong, the first video game to go viral. But 50 years ago, even 20 years ago, it would have been rare to find a boy who was neglecting every other aspect of his life for gaming. Now, it’s becoming common. 

Jacob’s story is extreme, but I hear about many boys—and it’s almost always boys, not girls—who are neglecting their schoolwork and social life in order to stay in their room with their door closed, headset on, controller in hand, playing their games. The games are just too good. If you invest 40+ hours to master an immersive role-playing game like RDR2, you feel like you have truly accomplished something when you have finished—something meaningful and substantial. The boys tell me that it’s way more satisfying than studying Spanish or American history.   

Some boys are at greater risk: the boy who is a loner, or socially excluded, is at greater risk of gravitating to violent video games and of becoming more aggressive, according to recent research. The link between violent video games and aggressive behavior may be controversial, but one recent study suggests that there may be an even stronger link between violent video games and cyberaggression. Even if the boy who kills enemies online in Grand Theft Auto 5 is not more likely to actually hurt people in real life, he may be more likely to engage in acts of online aggression.

As a family doctor, I’ve been concerned about boys and video games for many years. Back in 2007, I wrote a book called Boys Adrift: The Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men. Video games are one of those five factors, and video games are the factor most often implicated when a boy really falls off the track, as Jacob did. More recently, I wrote an updated second edition of Boys Adrift because things have only gotten worse. 

With my encouragement, Jacob’s parents followed my instructions. They donated the Xbox, and all the video games, to Goodwill. They removed the computer from his room. They password-protected their own computer and refused to allow their son to access it.

Four weeks later, they were back as I had requested.

“It’s unbelievable, the difference,” his dad said. “At work, for example. It used to be pulling teeth to get Jacob to help me at all, and I had to check everything he did. Now he’s showing initiative, and he does the job better than I do." 

“It wasn’t easy,” his mom said. "Not at first," she added, explaining:

Jacob didn’t talk to us at all for the first week. He would make his own meals and take them into his room. But then after about a week he started joining us for supper. And he just seemed to wake up. It was as though he had been in a fog, all those years he was playing video games. Maybe he just wasn’t getting enough sleep. Now, he actually talks at suppertime.

“He just seems smarter now. He understands better," said his dad. "He’s got a better attention span. He’s got more patience."

“What do you think?” I asked Jacob. “Do you agree?”

“No, I don’t,” Jacob replied. “I don’t feel any different. Not any smarter, that’s for sure.”

“If it were up to you, would you start playing video games again tomorrow?” I asked.

“Absolutely,” Jacob admitted. His parents sighed.

Jacob showed no insight. He had no awareness of how video gaming had displaced real-world activities in his life.

How to Tell if Your Son is a Video Game Addict

Scholars disagree about whether video game addiction qualifies as its own psychiatric diagnosis. But as a family doctor, I have seen firsthand that some kids—mostly boys—truly are addicted. What’s the difference between just spending too much time playing video games and actually being addicted to them? The Mayo Clinic suggests several key signs that your child is becoming a video game addict:

• Displacement: if video games are displacing your kid’s social life, or if the homework isn’t getting done because your kid is spending too much time playing video games, that can be a sign of video game addiction. 
• Lying: if your kid is lying to you, saying he didn’t play video games when he really did, that’s often a sign of addiction. 
• Anger/irritability: if your kid gets angry, irritable, or anxious when you put reasonable limits on video games, that could be a sign of addiction. 
• Escalation: if your kid is spending more and more time playing video games, that suggests the possibility of addiction. 

It’s important for parents to distinguish between too much time playing video games and a serious addiction. If a child is addicted to video games, then the only solution that really works, in my experience, is abstinence. That means removing the game console from the house and giving away all the games.

Tips for the Boy Who Just Needs Limits

But what if a child is spending too much time playing video games, but has not lied about it, or become angry about not being allowed to play, and has agreed to the need for limits? This kid is not truly an addict. I devote two chapters of my book, Boys Adrift, to presenting the research on this topic and to making evidence-based recommendations, but here’s a summary for the boy who needs limits but isn’t an addict: 

1. No more than 40 minutes a night on school nights playing video games, and no more than an hour a day on weekends.
2. The minutes do not roll over. If he goes three weeks without playing video games, that doesn’t mean he should be allowed to binge 7 hours on a Saturday. That’s binge-gaming, and it’s harmful. 
3. Don’t allow video games where the player is rewarded for killing. No Grand Theft Auto. No Call of Duty. This requires that parents know the content of the games their son is playing. Busy parents, of course, don’t have time to spend hours watching their son play each game. So I recommend Common Sense Media for this purpose. Just type in the name of the game, and the web page provides an accurate summary  and the age range for which the game is suitable. 

If your son is spending too much time playing video games but isn’t an addict, explain the need for limits and put the limits I recommended above in place. If you need some encouragement about how to set limits in an authoritative fashion—how to be “Just Right but not Too Hard”—then I humbly suggest my book, The Collapse of Parenting.

If your son is addicted to video games, don’t wait for him to show insight into his situation. I have seen many parents who expect their 11- or 15- or 24-year-old son to act logically on the basis of the evidence they find compelling. The parents will say: 

Look how much time video games are taking out of your life. See how your friendships have withered since you started spending 20 hours a week in front of a screen. See how tired you are all the time, except when you are playing the game!

The problem is your child may not have insight into the harms.

Don’t wait. You may be waiting months or even years. If your son is one of the millions of boys who have allowed video games to displace everything else in their life, you need to act decisively. If you don’t, who will? 

Leonard Sax MD-PhD is a practicing family physician and the author of four books for parents. More information is online at www.leonardsax.com.