When Mr. Hsieh died in a crowded room, nobody took any notice. For hours, he sat there slumped over and face-down on a table. Even when his dead body was carried out of the room, few paid much attention. Why? Because he died in an internet café in Taiwan. The other gamers were simply too involved in their gaming to pay attention to what was going on around them. Death was caused by cardiac arrest probably brought on by sleep deprivation.
But was the ultimate cause of Hsieh’s death video game addiction? It certainly must be considered a major contributing factor. If an alcoholic passes out on a cold night and freezes to death, the cause of death may be listed as hypothermia. However, few would deny that the underlying cause may be the alcoholism that caused him to pass out in the first place.
Hseih was known to disappear for days to play games at his local internet café. He had all the symptoms associated with video game addiction. The World Health Organization (WHO) has recently classified gaming addiction as a mental health disorder. The condition becomes a mental disorder when a persistent pattern of gaming behavior develops that “takes precedence over other life interests.” The organization points out that “for gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.” In short, gaming addicts put gaming above all other aspects of life, even when they know that relationships and health are being harmed as a consequence.
Gaming addiction often leads to a lack of sleep which, in turn, leads to heart failure. Dr. Daniel Kuetting and his colleagues at the Department of Diagnostic and Interventional Radiology at the University of Bonn studied the effects of sleep deprivation on people who worked 24 hour shifts. They found that, “short-term sleep deprivation in the context of 24-hour shifts can lead to a significant increase in cardiac contractility, blood pressure and heart rate.” It is safe to assume that the condition worsens if one stretches the time of being awake even further. Many of the gamers who have died of their addiction had, like Mr. Hseih, been playing for up to three days straight. Most died of heart failure. Though most such gamers would survive a three-day gaming marathon, those in poor physical condition or with pre-existing heart problems would be at a much greater risk.
Just as not all those who drink alcohol become alcoholics, not all game players become gaming addicts. Studies vary in the number of gamers who become addicts but it’s generally agreed that around 8-10% are either addicted or have problems related to gaming. According to the most recent statistics, 6.2% of adults have Alcohol Use Disorder (what we used to call, alcoholism), and we can assume that the percent of adults with some kind of drinking problem is much higher. A big difference between the two addictions is that around 88,000 people a year die alcohol-related deaths. These include driving accidents, fires, suicides, homicides, health problems, and falls. Even including deaths like that of Daniel Petric’s shooting of his parents for taking away his Halo 3 game, video gaming deaths are nowhere near as many as those related to alcohol addiction or even gambling, but it doesn’t mean that gaming addiction doesn’t ruin lives. For example, 15% of women filing for divorce listed excessive gaming as a contributing factor. To put this in perspective, here is a reminiscence of self-described gaming addict, Mike Fahey.
“The woman I had once told was the love of my life was sitting undressed in my bed not a foot away from my computer desk, begging me to join her, and I kept putting it off. I was so close to level 40 I could taste it. I was in the Dreadlands, kiting large enemies back and forth, killing them slowly with my Bard songs. I still remember the urgency I felt, along with the annoyance that this woman was trying to keep me from reaching my goal. Couldn’t she understand how important this was to me?”
So what games are most addicting and, potentially, most life-threatening or life-destroying? There are a number of lists that claim certain games are more addictive than others. Of course, games are made for different platforms but the following names come up a lot. They are in no particular order. It should be noted that men are 7.5 times more likely to become addicts than women so games that appeal to men are, in all probability, the ones that will cause the most problems.
World of Warcraft
Call of Duty
Candy Crush Saga
League of Legends
If you expanded this to the most addictive games ever, you’d have to include games like Tetris, Super Mario, Pac Man, and Age of Empires. Remember that everyone has their own poison. I’ve known Tetris addicts, Asteroids addicts, Wolfenstein, and Duke Nukem addicts.
But, according to experts, the most dangerously addicting games are multiplayer online games aka. massively multiplayer online role-playing games (MMORPGs). These are the ones parents should pay most attention to if they feel their child is losing contact with the real world or is having social, behavioral, or academic problems.
Among these potentially problematic games are the following. (the asterisks indicate free online games).
Grand Theft Auto
Call of Duty
League of Legends/Dota 2*
Star Wars Battlefront
Fornite* (also the fastest growing online game)
According to psychologists who treat gaming addiction, the games that are mentioned most are,
World of Warcraft
Call of Duty
although my gamer son claims this list is out of date.
But what precisely is it that makes these games the most addicting among the thousands on the market? Experts on gaming addiction give the following reasons why some games are more addictive than others.
Addictive games will be,
1. Online Multiplayer Games: MMORGs.
2. Games that allow players to create their own characters, teams, and worlds. This social element creates an alternative world and an escape from reality.
3. Games that have no predefined end or goal, which means they can continue to be played forever.
4. Games that have levels or rewards for playing more or for acquiring more skills. Games that are difficult to advance in tend to create a ‘give up factor’ which would kill potential addiction. Rewards stimulate addiction.
5. Games that have frequent upgrades to keep the game fresh and interesting.
6. Games that generate emotions. These are not always positive emotions, such as a feeling of accomplishment. Negative emotions, such as anger or a need for revenge, can also lead to more gaming.
Taking all of the above into consideration, I would suggest that the crystal meth of online games would have all of these elements and, in addition, be free and available on multiple platforms. With all of the above factors in mind, I sorted through a list of the best multiplayer games and came up with the following which should be considered among the current games with the most potential to cause addiction.
Warhammer 40,000, Fortnite, Heroes of the Storm, Dota 2, Smite, League of Legends, and Paladins.
Others that need to be watched are Terraria, Trackmania Turbo, PlanetSide 2, and Pixel Worlds.
Video game addiction is a physical addiction. Robert Lustig, a professor of pediatrics and endocrinology, recently reported his research on how gaming “can overrelease dopamine, overexcite and kill neurons, leading to addiction.” He further states that “when the brain gets used to a higher level of dopamine, it wants us to keep seeking out the addictive substance or habit.” Teens and young adults are particularly susceptible to dopamine addiction. Add to this the fact that video game developers actually try to make gaming as addicting as possible and you have the dopamine trap known as gaming addiction.
The free online game model works because addicted gamers will pay real money for in-game content. Thus, the more gaming addicts companies can create, the more money they can extract from gamers. And the sad truth is that gamers seek games that are addicting. In the end, it’s a perfect example of a codependent relationship. Mental health experts say that “people with codependency often form or maintain relationships that are one-sided, emotionally destructive and/or abusive.” That about sums it up.