The American Psychiatric Association (APA) is considering adding the Internet Gaming Disorder (IGD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a tentative disorder, which needs further research and data. The DSM is the world’s most widely used diagnostic criterion on mental disorders. The IGD has been identified as a disorder to be included in the DSM as it has all the symptoms and traits of an addiction. The data collected from many countries reveals similar symptoms, which qualify an individual to be diagnosed as an addict. In light of collated data, the IGD is coming up as a resistant and recurrent urge to play video games. The urge is debilitating to the extent of causing significant impairments in day to day educational, social and occupational functioning.

The proposed symptomatology of IGD includes nine symptoms. The similarity between these and symptoms of addiction to a substance is simply undeniable. The symptoms include preoccupation with videogames; unpleasant symptoms when a videogame is taken away; urge to spend ever-increasing time on videogames; failure to control participation in videogames; losing interest in previous hobbies and leisure activities due to it; continued engagement with videogames despite knowing the negative impact on health and psychosocial functioning; relentless lying about the time being spent on these games; use of videogames as solace from distress and jeopardising or losing a significant relationship, job, education or career opportunity because of these.

The similarity to drug addiction is not only what is observable through these symptoms. There is a huge overlap between the two that has been seen in the brain scans of drug addicts and habitual video game players. In both cases, the same brain areas are activated and produce similar outcomes on significant aspects of functions like learning, memory and emotion regulation. One does not need to be an expert to note irritability, shortening of attention span, self-neglect and seclusiveness in a child who spends more time on video games than usual. The outcome of spending significant time on screen is more less the same even if you are not gaming on the internet. You may also find many avid book readers complaining about losing their attention to any serious reading material since they replaced printed stuff with the screen.

As clinicians, we have started seeing more children with a fixation with video games and screens in general (including watching content online and chatting). However, this fixation is not coming up as a stand-alone problem, rather it is being reported as a concurrent issue coupled with other well-known disorders, like anxiety, depression and drug addiction more than others. Children and adolescents, who are on autistic spectrum disorders are more prone to fixation with video games and screens due to their lack of interest in socialisation. As far as the impact of such fixation is concerned, there are two types that cause more worries than others; one is the fixation with violent video games, the other is watching porn. Both have a huge negative impact and debilitating outcomes. In both cases, the individuals involved adopt unhealthy and maladaptive behaviours and start losing touch with reality and productive life functions. The list of these difficulties can be very long and vary from culture to culture.

The pressing question is not to identify the impact, though. What needs to be strived for is the aetiology of it. What is pushing the civilisation towards this individualised and solitary activity? Here is the difference between IGD and drug addiction, the addiction to screens is more unsociable than addiction to substances. Individuals addicted to screens form only virtual relationships rather than real ones. In most cases, they don’t even know the exact identity of one another, but these virtual relationships generate the same and sometimes even more emotional effects than the real ones. The cases of cyberbullying and suicides as a result of these are the evidence. Similarly, the engagement in the violent activities by individuals playing video games reveals the emotional impact of their fixation. The million-dollar question to raise here is whether the children committing suicide or violent crimes as a result of their fixation with screens were emotionally healthy before getting fixated to screens.

There are two civilisational trends that no one can contradict. One is snowballing loneliness and emotional deprivation. The second is intensifying intolerance and lack of empathy. Generally, people are curtailing their relationships. They are quick to terminate relationships if there are conflicts instead of trying to resolve those. This generates a lot of resentment, anger and the urge to harm others. A brief review of the cases of mass shooters in Western schools would reveal poor relationships or even a total disconnect with their parents and loneliness before doing what they did to others. Their indiscriminate shooting tells us about their lack of insight about who they were angry with. An adequate understanding of this civilisational trend can help us reach a point where we might be able to identify the reasons behind this fixation with screens - particularly in our children and adolescents - and eventually be able to manage those.

Growing children, primarily, need a healthy attachment to their parents and siblings and then their peers. A childhood trauma, particularly abuse of any kind makes the child very vulnerable to going into isolation, loneliness, agitation and violence. An unappreciative and critical parent may pave the way to such difficulties, where the return may need therapeutic support. The important fact about IGD and fixation to screens is that it is a civilisational feature – no one can escape it. A toughened fixation is more likely if the human relationships are in jeopardy, which produces its definite result and that is more and more intolerance. A healthy parent-child relationship, in fact, is the first and foremost overarching therapy to avoid and address a fixation to screens.

The writer is a clinical psychologist and head of a Psychology Department in Ireland. He can be contacted at akhtaralisyed@gmail.com