Online gaming has a big influence on mental health — and not all of it is negative, contrary to popular belief

Over the years, studios and creators have launched games like Depression Quest, Sea of Solitude, Elude and Actual Sunlight that were designed to help gamers deal with or understand mental health issues

By Anu Prabhakar

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Published: Fri 16 Sep 2022, 12:12 AM

Last updated: Fri 16 Sep 2022, 12:13 AM

Video producer Mohammed (full name withheld on request) grew up in the Kingdom of Saudi Arabia playing video games such as Crash Bandicoot, Spider-Man and Prince of Persia. When he enrolled in an engineering college in India, he was affected by its intensely competitive atmosphere and soon gave up gaming as he was too used to hearing about how it was ‘bad’. “But I continued to struggle even a year after I stopped gaming,” says Mohammed, via email. “Some of my peers introduced me to intoxicants and I began to take it to cope with the stress — that was naïve on my part.”

Around this time, he also got diagnosed with depression. “My family has a history of depression and anxiety,” explains the 27-year-old. He went for therapy till the end of college in 2017 and it helped him to cope with his mental health issues. “But in 2019, my addiction and depression got worse. I quit in 2020 but I had severe withdrawal symptoms which affected my mental health. My business venture also shut down during the Covid-19 pandemic.”

But during the lockdown, he rediscovered his love for gaming — and it saved him. “I played games that were more focused on the storyline like Journey and The Last of Us Part II, which helped me process things better. My friends and I also used to get together very regularly and play multiplayer games like Call of Duty. This developed both my social skills and a healthy competitive spirit.”

Mohammed shifted to Dubai last year and is in a much better place now. He has a few theories on how gaming helped him to manage his mental health better — for instance, he talks about how in-game photography helped him to sharpen his own skills and that such creative pursuits kept him busy. “I also realised that when we are faced with a challenge in a video game, we are inclined to tackle it rather than be held back by a fear of failure. I still suffer from a lack of confidence due to depression, but I began to adopt the same mindset in real life as well and my life has improved significantly.” Games like The Last of Us Part II also helped him to develop more empathy in real life, and deal with problems in his personal relationships in a better way.

A few days later, we spoke to a Dubai-based Indian architect who uses the pseudonym James Mason online. “I had a pretty rough time in my teenage years due to family issues, insecurities and heartbreak,” the 24-year-old says, via Reddit chat. “I was definitely not in a good place mentally.”  He is going through another bad breakup right now but this time the severe heartbreak is further compounded by work pressure and the stress of applying to colleges for further education. “I have been thinking about seeking professional help, but cost is the only reason why I haven’t done so yet,” he says.

Once again, gaming helped. “Cooperative games like Call of Duty where I need to communicate with friends have helped me to deal with anxiety. I know this may sound contradictory but sometimes I play games like Elden Ring which are difficult and challenging, but also immersive — it helps me to deal with stress. And finally, I also play slow-paced games like Minecraft — I can just turn my mind off and explore or be creative.”

Young gamers like Mohammed and James who struggle with mental health issues have sought solace in gaming and their stories stand in contrast to popular perceptions about gaming, which once used to be mostly negative in nature. With new research studies somewhat tweaking its notorious reputation, therapists have begun to explore and discover the benefits of gaming and how it can even be therapeutic for some.

For instance, in July, media outlets reported on a new study conducted by a team from the Oxford’s Internet Institute, where they surveyed nearly 40,000 gamers and, according to the University of Oxford’s website, found no ‘causal link between gaming and poor mental health — whatever sort of games are being played’.

The university’s website quoted Professor Andrew K. Przybylski, OII Senior Research Fellow, as saying, “We found it really does not matter how much gamers played [in terms of their sense of well-being]. It wasn’t the quantity of gaming, but the quality that counted… if they felt they had to play, they felt worse.  If they played because they loved it, then the data did not suggest it affected their mental health. It seemed to give them a strong positive feeling,” and added that while the study is exciting, “there is a lot of work still to do.”

Using video games in therapy

Over the years, gaming studios and creators have launched video games like Depression Quest, Sea of Solitude, Elude and Actual Sunlight that were designed specifically to help gamers deal with or understand mental health issues like depression and anxiety better through their unique storylines. Other video games may help too — a 2021 article on Wired detailed how therapists have begun to use online gaming as a part of their overall treatment plans, especially with their younger patients. It also cites several studies like a 2017 study that appeared in Prevention Science which, the article says, ‘found that MindLight was as effective as a cognitive behavioural therapy programme in reducing children’s anxiety’, and a 2018 study titled Zombies vs. Anxiety: An Augmentation Study of Prescribed Video Game Play Compared to Medication in Reducing Anxiety Symptoms, which concluded that ‘clinicians should consider these non-stigmatising and low-cost CVGs (casual video games) as a feasible intervention for patients who wish not to take additional medication’.

Dr Shyam Bhat, psychiatrist and physician at Nirvikalpa: The Mind-Body Centre in Bengaluru treats patients from all over the world including the Middle East. He recommends games like Sparx as a part of the overall treatment plan to some of his adolescent and younger patients.

“In one study, Sparx was found to be equivalent to cognitive therapy for the treatment of mild depression and anxiety in adolescents. And these games are already available for free online,” he says. “Such games can teach cognitive and behavioural skills, which are useful for the prevention as well as treatment of milder forms of anxiety and depression.”

Dr K Arun Kumar, specialist psychiatrist at Aster Clinic Jubilee Medical Complex, says that video games as an aid in treatment came in the limelight only in the last few years, especially during the pandemic. “Children could relate more to video games, instead of attending long counselling sessions,” he says.

He explains that gaming helps mostly through ‘an increase in adherence to the treatment plan’ and that it helps them to feel accomplished, builds emotional resilience by helping them to accept failures better and motivates them to keep trying, teaches strategic planning and improves online communications with other players — while also pointing out that most of the research on the topic is still ongoing. “Research was done mostly on specific video games that were designed as a treatment plan — like CBT or physical activity-based,” he adds.

Safe online spaces for gamers

Fifteen-year-old Dubai-based Emarati Ahmed* (name changed to protect minor’s identity) was once pushed down the stairs at school by bullies. The reason? His ‘outdated’ laptop. He didn’t confide in his parents about this, or anything else — even the fact that he could be suffering from depression and social anxiety. “My dad will just tell me to man up,” he says. “He is quite strict and had smashed my first PC (personal computer) because I got poor grades.”

The only person he spoke to about the bullying incident was a gamer friend based in the Netherlands. “He taught me how to upgrade my old Asus G75VW. I swapped the hard drive for a new one and got an external GPU bracket and could finally game on it.” Ahmed, who spends an average of nine hours a day gaming, has 198 gamer friends online, who he describes as ‘close’. “I met them through games like Call of Duty and Counter-Strike and gaming communities on Discord and Reddit. I feel safer with them than my ‘offline’ friends.”

Such camaraderie is not unusual among gamers. There are groups like Gamers of Compassion and D2 Sanctuary on platforms like Reddit and Discord (the latter is banned in the UAE) that provide a safe space for gamers battling mental illness. “The most common thing people deal with in the group is anxiety, followed by depression. We also have a few people with autism that I know of. But that’s only what I know — most people that join the group don’t say anything and they just hang around and read,” says Blake, the US-based founder of Gamers of Compassion.

Dr Kumar explains that young gamers find solace in the anonymity of the internet, where they feel heard. “However,’ he continues, “there are chances of getting misled as these forums merely share personal experiences. It could be like the blind leading the blind, and precious time will be lost before professional help is sought.”

Pros & cons

While discussing the topic, therapists also strike a cautionary tone by pointing out that using video games for therapeutic purposes comes with limitations.

“Technology including gaming, while useful, will not be able to replicate certain essential elements of therapy like the empathic presence of a therapist, real-time communication and the sensitive responses to the unfolding of the clients’ emotions as they share their thoughts and feelings,” says Dr Bhat.

Dr Kumar adds that mental health issues need to be dealt with under expert guidance and with parents’ participation. “Video games could only be complementary and may not be the sole line of management,” he says. “All casual games may not be therapeutic. It might help as a distraction strategy but can, in fact, be counter-productive as the individual keeps avoiding the actual stress instead of dealing with it. It leads to poor coping skills and might worsen depression and anxiety. Moreover, these games provide instant gratification in a short span of time due to the dopamine surge, and uncontrolled use can lead to other issues like addiction, attention and memory problems, poor social skills, sleep and appetite disturbances.”

Gamers of Compassion’s Blake, too, believes that gaming is not a substitute for therapy. “However, I think they are a way for people to escape from the struggles that they face and to find community and friendship — and that’s not a bad thing when you’re constantly reminded of what you’re going through.”

How much is too much?

The World Health Organization (WHO) recognises ‘gaming disorder’ as a mental health condition. But what sets a fan apart from a gaming addict? Here are a few signs to look out for:

• The inability to control gaming, such as not being able to stop

• Prioritising gaming over other interests and activities

• Continuing to game despite negative consequences, such as losing a job

• Symptoms of withdrawal when unable to play video games, such as irritability or anxiety

• Tolerance over time — needing to play more or more powerful games

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