The withdrawal made Brett want to die. The 12-year-old had only been cut off for a few hours, and his mind was already wandering to a dark and dangerous place. Looking out the window of his family's three-story home in Wassenaar, a suburb of the Hague, in the Netherlands, the American transplant imagined swan-diving out of his room and falling to the ground below, with his skull cracking open against the pavement. A grim death, sure, but at the time he felt anything had to be better than not being allowed to play Counter-Strike.
Brett's father had retrofit a metal lock on his Celeron computer to prevent his son from gaming. When it was locked, the Celeron's data cable was disconnected from its hard drive so it couldn't turn on, preventing Brett from gunning down digital assailants. Half an hour after Brett was mulling suicide, however, a friend called him on the phone and invited him to come over and game. Brett, nearly at his psychological brink, was relieved.
"I remember thinking, It's probably very unnatural for someone to go from thinking about killing themselves to enjoying themselves in the span of 30 minutes," the now 23-year-old told me ten years later.
However strange, that incident was a mere prelude to the depths that Brett would sink with his burgeoning video game addiction—an affliction that has plagued his health and his familial relationships and stunted his adult life.
Brett's addiction reached its first fever pitch in 2007, when he was in the tenth grade and living in Marin, California. He was so focused on World of Warcraft that he stopped bathing or brushing his teeth regularly. He rarely got more than a few hours of sleep because he'd stay up all night dungeon-crawling. He was clocking up to 40 hours a week on video games on top of going through the motions during the day at school. It got so bad his teacher ordered him out of class because he looked like one of the monsters he'd savaged the previous night. He failed all of his classes that trimester.
Brett was playing so many hours of video games the seams between reality and virtual reality started to break down, once causing him to attempt a World of Warcraft–style teleportation move at a bus stop.
By summer break, his parents had had enough. At 3 AM one June morning, Brett was pulled out of bed by two strangers who would escort him to a six-week "wilderness camp" rehab program called Second Nature in Bend, Oregon. He kept company with teenage alcoholics and drug addicts. Over Skype, I asked Brett what he talked about on the way to his first rehab program.
"I talked mostly about video games," he said. "I talked about figuring out that I was never going to find happiness by being the best World of Warcraft player in the world."
Seven years, two rehab programs, and more than $100,000 worth of addiction-treatment bills later, Brett still games more than 65 hours a week.
Brett isn't alone in his struggle with gaming. Over the past decade, we've seen several tragic stories of addicted gamers make international headlines. Seungseob Lee, a boiler repairman in South Korea, played StarCraft for more than 50 consecutive hours at an internet café before suffering a fatal heart attack. In China, a man named Xu Yan died after playing an online game persistently for two weeks. And in America, a woman named Rebecca Christie was sentenced to 25 years in prison after she allowed her daughter to starve to death while Christie was preoccupied with World of Warcraft.
Experts estimate that more than 3 million Americans between eight and 18 could be suffering from video game dependency. And medical authorities are finally noticing. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders recently christened the phenomenon as "internet gaming disorder." The DSM warns that such "persistent and recurrent online activity results in clinically significant impairment or distress," adding that certain neural pathways are triggered just like a drug addicts' would be when ingesting their substance of choice. To put that comparison in perspective, there could be about 1 million more diagnosable dependent gamers in America than coke addicts.
The DSM notes that this condition is entering the sphere of mainstream mental health disorders, but there isn't a good medical model for diagnosing it yet. Dr. Douglas Gentile, one of the world's leading experts on adolescent media addiction, believes that you can measure video game dependency the same way you measure other psychological conditions. Experts combine cues from gambling addicts and substance abusers to diagnose destructive gamers. The disorder even manifests in addiction signifiers such as tolerance, withdrawal, a loss of control, and harm to social or academic pursuits. But Gentile understands the skeptics. He began his research on media addiction in 1999 "largely trying to show that it was wrong."
"I was absolutely sure that video game addiction couldn't be a real thing," he said. Instead, he was converted and is now passionate about attracting attention to pathological gaming.
"I wanted to shut out real life totally. I just wanted to climb in the game and stay there." —Patricia, a 69-year-old gaming addict in recovery
There is no "typical" gaming addict. Lurking on various online fora, I encountered Scott, 41-year-old former alcoholic whose gateway game was online gambling. From there, he obsessively played strategy and puzzle games until, after relapsing multiple times and separating from his wife, he found an online 12-step group for dependent gamers. On Reddit, I met a 21-year-old who listed 27 console games and hundreds of flash games he played obsessively. He recently "sobered up" at a rehabilitating boarding school and stays clean with an online support group devoted to game abusers.
Then there was Patricia, a 69-year-old recovered World of Warcraft addict, AA member, and cancer survivor. For years, Patricia gamed for between eight and 12 hours a day, at first on top of her job at a library. "I wanted to shut out real life totally. I just wanted to climb in the game and stay there," she said. She poured herself into a character named Patria, the same name she bears on the online video game addict support group Computer Gaming Addicts Anonymous (CGAA). She skipped out on Christmas dinners, her grandchildren's visits, and romantic excursions with her aging husband. When Patricia sobered up in 2011, she experienced intense withdrawal symptoms similar to those of cocaine: sleeplessness, anxiety, and hallucinations.
But just as Patricia rematerialized, her AA recovery partner and husband of 43 years contracted a fatal illness. Patricia took care of him until the end.
"I regret so much," she said. "I wasted all our time together. We could have been doing all kinds of things, but I was just gaming."
"What can I say?" she adds. "I was an addict, and I didn't know it."
Brett's addiction started in 1995, when his grandmother gave his older brother a Sega Genesis for Christmas. Covetous of his brother's console, Brett was consumed by the side-scrolling punch-'em-out game Streets of Rage and the classic Sonic the Hedgehog. His father, an engineer, picked up a 400 MHZ Celeron on the cheap a few years later, which enabled a years-long StarCraft obsession. Even though his mother limited his "screen time," Brett would fixate on gaming strategies to whittle away time between the end of one gaming session and the beginning of the next.
In 2003, when his father was offered a job in the Netherlands, Brett wasn't so nervous about deserting his friends or his childhood home. "I had bought a PlayStation 2 a few months before. One of my first thoughts was that I couldn't buy video games there to use with my PlayStation because they were incompatible." So Brett's focus shifted to the computer game Counter-Strike, which was one of the most popular online shooters until the blockbuster Call of Duty franchise outpaced it. Even though his Celeron could only muster a 400 by 300 screen resolution, ran at about 15 frames per second, and was entirely devoid of sound, Brett was hooked.
"It took me over a month to get my first kill in that game," he said. Despite the technological hurdles, he kept gaming until he achieved some level of skill, even a sense of mastery. The pull of Counter-Strike, he said, was that he "was able to objectively beat other people; to be quantifiably better than other people."
His parents were less enthusiastic about their son's talent for massacring digital terrorists. His father vigilantly guarded the key to the lock on Brett's computer. But if Brett couldn't play his games, he'd be at loose ends. His father remembered Brett's hostile moods and impertinent attitude, calling him a "beast." And sometimes, suicidal thoughts would cross Brett's mind when he was kept away from his digital world.
It's a terrifying prospect that video games cause depression. It's also not exactly true. Early in his research, Gentile wondered if depression was the main problem for media addicts and gaming was the symptom. Tracking 3,000 kids for three years, Gentile learned that there's a complex chicken-or-egg structure to pathological gaming and depression. People with mental health problems or attention disorders are more inclined toward escapism and, therefore, habitual gaming. But on top of that, people like Brett who game consistently from a young age will develop attention disorders and social anxiety, which cripple them in school, leading to more intense mental health problems and a stronger drive to game.
"I decided that the progression of my WoW character was more meaningful than the progression of myself in real life. It's so much more quantifiable. It's so visible. It's more entertaining than real life, it's easier than real life." —Brett
"It wasn't just the games—that would be too simple," Brett's father explained. "There's probably a more satisfactory culprit for his condition than video games themselves."
Brett's mental health only deteriorated more when he moved back to California in 2004, the year World of Warcraft was released. In California, Brett had a school-issued laptop that was lockless and without a parental admin password. An infinity of gaming became possible just as Brett realized he could play WoW instead of doing his work. "It had never occurred to me before that I could just not do homework," he said. Brett was an orc warrior named BobaBuilder; soon, he couldn't have a conversation about anything but gaming for a minute or two.
"I decided that the progression of my WoW character was more meaningful than the progression of myself in real life. It's so much more quantifiable. It's so visible. It's more entertaining than real life. It's easier than real life. It's more straightforward. And there's so much to do."
Games like World of Warcraft aren't inherently evil or even inherently habit-forming. In fact, all the addicts interviewed—they prefer to be called "addicts" regardless of their recovery status, like AA members—stressed that their game of choice was irrelevant to their gaming dependency. They latched on to a variety of games ranging from Tetris to Halo.
"It's not about the games," said the 21-year-old Conor S., a gaming addict I connected with over the internet. "It's like asking a recovered alcoholic what they used to drink. It's all about this," he said, motioning to his head over Skype.
DansNewLife, a Reddit commenter on a gaming-addiction forum, speaks from personal experience: "The addict seeks relief from distress—think of how highly motivated you are to take your hand off a hot stove. When you stop, all the bad stuff keeps rushing back... for an addict, stopping means returning to a very painful, tortured existence."
Today, Brett's working on getting his A+ Certification to be a computer technician. He's been taking Santa Barbara City College classes on and off for a years, not finishing more than a couple semesters in a row. And he's still gaming despite his stints in rehab. Over Skype, Brett excitedly listed some of the 100-plus computer game titles that recently thwarted his desire to shower for six days. He says he would have rather spent those 15 minutes gaming.
"Right now," he said, "I don't really do that much."
His father, with immeasurable dejection in his voice, added, "He is as bad today as he was when we sent him to wilderness camp. That's six or seven years of his life wasted."
Follow Cecilia on Twitter.