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Press start…to make friends, to be in charge. Press start…to escape. Press start, because really, do you even have a choice?

It begins of course with an introduction to a new world, where success is not about age or experience; you are in complete control. There is constant stimuli – and immediate pay-offs.

That lure is a tidy trap that nips at the shoelaces of the curious, the careful and the daredevil alike. And if you are not cautious, it hurtles you down the road of anger, desperation and a devotion so powerful it can only be called addiction.

Last month, the World Health Organisation made official the term ‘gaming disorder’. The organisation defines the disorder in the 11th Revision of the International Classification of Diseases (ICD-11) “as a pattern of gaming behaviour (“digital-gaming” or “video-gaming”) characterised by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”

Do you know someone who is hooked to gaming? “If the person shows signs of restlessness if they don’t play or cannot stop, social isolation so they can spend more time playing, show physical symptoms such as obesity, poor hygiene, headaches, or muscle tension due to over sitting or over use e.g. Carpal Tunnel Syndrome [those are signs of addiction],” explains Fadwa L. Lkorchy, Psychologist at German Neurological Centre.

WHO gives these symptoms about 12-months to resolve themselves – if they do not, the organisation says, it can be diagnosed as a disorder.

Who is agoraphobic?

Afraid of meeting new people, making eye contact, or venturing out of the comfort of your home? The abnormal fear of being helpless in a situation that may result in panic, anticipatory anxiety and finally avoidance of open or public places is called Agoraphobia. Did you know?

Dr Mrabet Jihene, clinical psychologist at Life Psychological Counselling Centre, says before we begin to classify and treat a behaviour as an ‘addiction’, it’s important to figure out its cause and effect. "The question is, is gaming causing trouble in the child or teenager’s [life] or is it children who are experiencing depression or ADHD, or agoraphobia, or family conflict [and] are escaping those problems through gaming?”

Nielsen, a global measurement and data analytics company, recently released its US Games 360 Report, which explores Americans’ relationship with gaming. It found that there has been a rush of people clambering on to gaming platforms “with two-thirds of the US population 13+ now considered gamers”.

Natural draw

Do you remember playing peek-a-boo with an adult when you were a child? Or being fed? Do you remember the song you sang while learning the alphabet or the way you made word associations when you were cramming for a test? If you consider Pavlov’s conditioning technique– a repeated response to a particular stimuli – we are all already trained to like to play, to learn. Why then should a medium that wraps you in tentacles of knowledge and power (at least online) be any different?

But that niggling feeling that life is incomplete without that game; chasing the rush of a score; that has consequences.

It’s all in the head

Playing games involves repeated actions that spark connections related to memory and learning. Dr Jihene explains that it also stimulates the premotor and parietal cortex area in the brain - sensory movements in games that require real-time action - and the prefrontal lobe, which controls decision-making. Also stimulated is the dorsal anterior cingulate cortex that controls cognition and running.

It’s basically hijacking these areas of thought.

Dr Jihene explains: “Even if a player fails in a game, the reward centre, which is the dopamine centre, is still stimulated – it’s correlated with deliberation time in beating risk taking. So they [gamers who are addicted] will continue to take risks. It will be very easy taking the decision to take a risk, because the centre of the stimulation will be stimulated all the time.” This risk-taking behaviour breeches real-reel life boundaries. ”There is continuous seeking of dopamine reward for the brain.”

What is Dopamine and why do we want it so much?

This neurotransmitter helps control the brain's reward and pleasure centres, and aids in motivation – that drive towards a goal. A deficiency dopamine has been known to result in Parkinson's Disease.

It triggers cravings and compulsions and changes the structure of the reward system until it mirrors the mechanism as seen in the brains of those with other addictive disorders.

“Sometimes it will help reinforce isolation,” says Dr Jihene. That’s besides the eye strain and weight gain; “it can provoke obesity because the child/teenager will spend hours and hours doing nothing but playing”. Besides, “it will also provoke problem to adapt to the reality when the child will come back from game to reality.”

When the itch isn’t scratched

Like all addictions, it’s about the thrill. “That’s why there is withdrawal – people are having anger and sometimes depression” when they don’t get what they want. This is also why the need to take greater risks, to up the levels of gaming to create greater dopamine released in the body – which by this time is getting habituated to the rising levels of the hormone - and the failure to calm this obsession may result in rage, anger, or even depression.

Is playtime over?

Did you know?

The UAE Community Development Authority created an application called ‘My Right’, addressed to children, which helps to explain to them how to identify a person in need and how to help her/him?

No, not really. Unless it’s taking over your life. There are many proven benefits to gaming.

In 2013, a study published in the journal Cell explored the impact of playing action games on dyslexic kids aged seven to 13 years old. The project found that the children could read faster, with no loss in accuracy. In fact, in some cases they eclipsed traditional reading treatments. Here’s a look at other benefits:

■  Socialisation: Dr Jihene says, even if the games are [played] at home…most of the games now are online and they are played on groups, so it will help in socialisation
■  Technology aid: She adds that it will help children be introduced to the technology; improve reaction time; improve creativity and imagination.
■  Dreams and wishes: The kids can realise all their fantasies which will give them some satisfaction and self-esteem, especially with kids who are shy.
■  It will improve the eye-hand coordination. It will help to enhance focusing process – we can focus on many factors at the same time without confusing them.
■  Cognitive benefits: Meanwhile, Dr Lkorchy says, “Some research showed some cognitive benefits to gaming such as improvement in memory, perception, attention, and decision making.”

Gamer’s speak

Fifteen-year-old Ansh Mundra is a fan of PS4.  His current obsession is “Fortnite – I play that game mostly. Before that I used to play Fifa, I used to play Call of Duty. Whenever my friends and I have time we just hop on a play a few games, have fun,” he says. He is quick to shed his initial label of addicted-to-the-game, but does admit to get into trouble sometimes for playing too much. “If you say your parents are ok with you gaming, you are lying,” he laughs.

For his peer, 16-year-old Nihal Simha, the games he plays over a five-six hour period during the weekends with friends is almost a guilty pleasure. He loves to play Fortnite, Minecraft and Call of Duty. ”If I’m free I definitely play more,” he says.

Twenty-six-year-old Shahbaaz Ali Khan’s relationship with gaming began when he got a Nintendo system free with some pizzas. Then, “Once we got a hand-me-down PS2, we got some great exposure to the classics of the system - Rachet and Clank, Prince of Persia. It’s the console that set us on the right path,” he says in an interview with Gulf News.  For now though he’s playing a lot of Player Unknown Battleground, an online multiplayer battle.

The long-time gamer likes to play on his PS4, and calls the process “therapeutic”. When asked about the bait-and-trap nature of the exercise, he says: “I think a lot of games today are built to be addictive. The freemium ones especially get you hooked on the free aspect but then you have to keep playing to progress or pay to get the best items. I’m not a fan of these games and tend to stay away from them.” 

“A single game can cost around  Dh300, which means buying more than one game every couple of months starts pinching your budget  a little,” says 25-year-old Uday Chandran, who uses the medium to destress after a long day. He says playing isn’t an addiction, it’s more a habit. “I've been gaming for years, when I don't have, I don't crave it…it's a way to unwind, and really good way at that because it helps you zone out quite effectively,” he explains. God of War, Fifa 18 and Fortnite are his current habbits.

For the serious gamer, who insists on using his moniker Hansel 'Superfuzz' Anthony, playing – which he does a few times a week – does not mean socialising either. “Interaction is kept to a minimal, even when I'm playing online. Most interactions are limited to game/server requests and team strategies, if any,” he explains. His field of choice? Fifa, first-person shooters, racing, action/adventure games.

He plays about three times a week – to “release some steam” or “chill” – but says he’s not addicted. After all, “IF you still can find the time to game between work, household chores, social life, etc..  Wow,” he says.

Then there are those who believe that spending only "about three hours" a day on gaming is something "non-serious players" do. One such player, who loves Massively Multiplayer Online-Role Player Games (MMORPG), says to play is to invest time, effort and money in the medium. "It's like a second job that you pay to do," says the gamer, whose name has been withheld upon request. Asked about their addictive quality, he explains that the kind of scheduling one has to do - in terms of time and strategy; your team may have players in varying timezones - leaves little energy for anything else. He recalls a fellow gamer who once went for about three days without bathing because of  her commitment to the game. Now these MMORPGs are addictive, he says.

The VR/AR question

Augmented Reality activities - that juxtapose real and game reality, such as Pokemon GO - and virtual reality games are new methods of playing and have over the past few years garnered a tonne of publicity, but are they addictive? You decide. The Death by Pokemon Go study, by Mara Faccio and John J. McConnell, credits $500,000 in vehicle damage, 31 additional injuries, and at least two deaths in the US to the Pokemon GO craze.

Meanwhile, VR gaming is taking a popular turn. "VR gaming is essentially still in its infancy. It’s kind of like the 1980s again in some regards, with the technology not being ready for mass adoption in homes, we’re seeing VR arcades spring up to allow access to this evolution of gaming," says Steve Bambury, Head of Digital Learning and Innovation at Jess. In Dubai, you can put on a VR headset and play Ghostbusters Dimension at Hub Zero, Citywalk.

"VR games and apps produce a more visceral reaction in users which in turn can lead to a more emotive response," he adds. However, he does issue a note of caution. "The immersive nature of VR could potentially increase the risk of people struggling to maintain a healthy balance between time spent in the virtual world and time spent in the real world."

Death in the family

While rare, it isn’t unheard of – someone dying on the player’s chair. Last year, 35-year-old American gaming participant and father of three Brian Vigneault was taking part in a marathon playing session. He may have been playing for a good cause but excessive consumption of energy drinks and a 22-hour play ending in a fatal heart attack.

What if you are addicted?

Both Dr Lkorchy and Dr Jihane call for counseling if you find yourself spending a little too much time on online games. In addition, Dr Jihane prescribes:

  • Cognitive behaviour therapy:  talking to a professional and trying to reduce addiction step by step.
  • Group therapy: linking gamers so they can discuss the addiction and its pitfalls.
  • For children, she adds, a parent/guardian’s firm hand in laying down the rules and following through on the reward/penalty system decided will help provide structure and discourage addiction.

Types of games

Massively Multiplayer Online: Step one, enter virtual game room. Step two, engage with players from around the world on the platform of your choice - personal computer, video game console, smartphones, etc. World of Warcraft is one such game.

Simulations: Want to learn how to fly a plane or how it feels to be an astronaut in space? This is the one for you! You experience simulations of real-world vehicles and learn how to control them.

Adventure: Ok, so you get a backstory and a mission. And it’s up to you to save lives – or just complete your tasks. If teams are not your thing, choose one of these.

Real-Time Strategy: Welcome to the battlefield where strategy can mean winning a war or dying a painful death. Usually, you’d gather items and armies, form alliances and allegiances.

Puzzle: Riddle me this – who likes to solve mysteries? Whether you like simple or complex zigsaws, these are games to get that grey matter working.

Action: Quick reflexes, check. Self-starter, check. This is the one you want. Use your wits and skills to get your avatar into the winners’ circle.

Stealth shooter: Eye spy with my little eye – kaboom. That’s right, as the name suggests you are in a war zone or spying and stealth is one of your weapons.

Combat: Get over here. One-on-one fights – choose your character and use their powers to defeat your enemies – think Mortal Kombat.

First Person Shooters: You see the field through your character’s eyes.

Sports: World Cup fans, here’s something to keep you hooked: there’s a Fifa game. But you can choose other sport too including baseball, basketball and more. Just don’t feel tricked into thinking you are getting exercise.

Role-Playing: Would you like elfish ears to go with that magic sword? In a role-playing game, you pick your part in a narrative and play along.

Educational:  Or educative, this games combine subjects like math and logic with quizzes to entertain as they teach.