Introduction:
Ever since the early 1970s, video games have slowly become a staple in modern day culture, especially among the younger people. Video games have only become more popular since, growing to millions, if not billions of daily consumers. Due to the popularity however, the connection of mental health and video games became a highly researched topic, where there is a spectrum from video games being beneficial to improving one’s mental health to video games leading to a potential internet addiction and dissociation. The articles Gaming Well: Links between Videogames and Flourishing Mental Health, Gaming Your Mental Health: A Narrative Review on Mitigating Symptoms of Depression and Anxiety Using Commercial Video Games, and The association between online gaming, social phobia, and depression: an internet survey all analyze the positives and negatives of video games on mental health. Thus, through this literature review, the question “In what ways and to what effects does playing video games contribute to one’s mental health?” will be answered.
Internet and Video Games:
Video games are defined as, for the purposes of all of these articles, “to electronic/digital games played on personal computers, home consoles (eg. Microsoft XBox, Sony Playstation, Nintendo Wii), tablets (eg. iPads), mobile devices (eg. smartphones, hand held [devices] like Nintendo 3Ds), and the web (eg. via Facebook and other websites)” (Jones, Christian, et al. p. 1). Video games can be accessed and utilized through the internet, with multi-player games or with accessing an internet “cloud”, which is an internet-based storage, for games. This is evident since “As of 2020, 63.2% of the world’s population was reported to have access to the internet… with 2.7 billion gamers reported worldwide in 2020” (Kowal M et al., p. 2). Furthermore, “over 95% of homes with children under the age of 18 have a device for playing video games, and 94% of children aged between 6 and 15, and 90% of people aged 16 and 25 play video games” (Jones, Christian, et al., p.3). This is important to understand because this means that the internet is widely accessible to more than half of the world’s population to different people. Moreover, this is also important because it shows that video games are also widely accessible among many different types of mediums. Internet access with video games would lead to multiplayer games, which can either be competitive or cooperative. Additionally, with this, it can be analyzed that, with these different types of mediums, different types of games, and different levels of engagement, gamers fluctuate with the amount of time that they could potentially spend on each video game(s).
Positives of Video Games on Mental Health:
Video Games used as Therapy
Video games can potentially have a positive effect on mental health as a mode of therapy. It is stated that “nearly 264 million people… and 284 million people (are) adversely affected by depression and anxiety disorders, respectively” (Kowal M et al., p.1) and “Depression and anxiety are often experienced simultaneously, with up to 81% of individuals having an anxiety disorder having a depressive disorder too” (Kowal M et al., p.1). However, despite detailing that there are so many people suffering from depression and anxiety, therapy is generally inaccessible due to its high costs. Monthly treatments range from “US $370 in the US… between US $108 and US $340 on an average across Europe” (Kowal M et al., p.2). Even with this staggering monthly cost, the wait time in places like the European Union are “between 7 to 30 days” (Kowal M et al., p.2). These are important to understand because it exemplifies how inaccessible and unavailable therapy really is to the general public. Thus, many mental illnesses will go unchecked.
Video games can be used as an alternative therapeutic option in the absence of easily available and accessible therapy. Unlike the therapy sessions monthly, video games are “affordable and readily available, ranging from free-to-play games to games worth US $71” (Kowal M et al., p.3), which, with any purchase from the price range of video games, is only a one-time payment. Depressive symptoms such as loneliness and social isolation can be helped by internet-based multiplayer games like Minecraft and Animal Crossing: New Horizons, as stated in the article, in order to “connect isolated individuals” (Kowal M et al., p.5). Other depressive symptoms like low self-esteem, lack of self-identification, and anhedonia can be mitigated with RPGs (Role playing games) like World of Warcraft, Pokemon, and Final Fantasy can help by promoting “goal achievement and reappraisal and facilitate flexibility and efficient emotional regulation” (Kowal M et al., p.5). For anxiety, “30-to-45 minute sessions of Plants vs. Zombies … 4 times per week with traditional pharmacological selective serotonin reuptake inhibitors … revealed a greater reduction in state anxiety severity” (Kowal M et al., p.5). These are all important to understand because it shows that video games do have a positive effect on people who suffer from mental illnesses like depression and/or anxiety. While, it is evident that video games do not entirely work alone (since there are added pharmacological supplements) and that regulation is important, it is undoubtedly a positive considering that video games are easily accessible at the user’s availability, compared to the costly and time consuming therapy. Moreover, it is evident that different types of games are important for certain aspects of mental health, thus gamers can potentially choose specific genres of games in order to help with depressive or anxiety symptoms.
Video Games and Mental Health through the lens of the PERMA Model
Another way that video games can positively affect mental health is not just through a therapy alternative, but just through general everyday use. Video games can be a factor in positive well-being and flourishing mental health, defined as “high levels of emotional well-being, are happy and satisfied, tend to see their lives as having a purpose, feel some degree of mastery and accept all parts of themselves” (Jones, Christian, et al., p.2). Using the positive psychology model of P.E.R.M.A. (Positive Emotion, Engagement, Relationships, Meaning, Accomplishment), which is the five elements developed by Martin Seligman that account for what makes up the “good life”, it can be seen that general video game use has a positive effect on all of these factors in a person’s life.
For Positive emotion, the “depressed mood was significantly lower in the ‘low’ (1-6 hours of video game time per week) use group compared to the ‘never’ and ‘high’ (10+ hours of video game time per week) use groups” (Jones, Christian, et al., p.3). Comparing the groups, the “self-esteem was also higher in the ‘low’ use group with self-concept regarded higher by players than non-players” (Jones, Christian, et al., p.3). An important thing to take note of is that it is clear that the most effective use of video games is with moderation of the screen time. The addition of a form of leisure can help those who have a depressed mood, as stated in the article, to improve their emotions in comparison to those who do not have video games as a form of leisure. Furthermore, playing video games for a prolonged period of time is actually detrimental. Thus, it can be understood that video games can be beneficial at a controlled pace.
For Engagement, “video games through physical input, adjustment of difficulty, and real-time visual feedback, can provide near immediate and on- demand flow experiences for their players” and furthermore “Findings affirm that dissociation is positive and normal that ‘altered’ states of consciousness that many gamers reached (such as the ‘dissociative’ identification some gamers have with their characters), provide sme gamers with relaxation as well as some of the most satisfying, meaningful experiences of their lives” (Jones, Christian, et al., p.4). An important thing to note is that the immersion that video games can provide through storytelling, compelling characters, and a believable open world, can be a form of escapism for people. This escapism can increase their engagement in the video game, which can translate to having more engagement in other things when the right type of immersion arises. The dissociation gamers feel is an intense form of immersion, as they connect themselves with their virtual avatar. Thus, it can be understood that video games are important in increasing engagement.
For Relationships, it states that “MMO gamers under the age of 18 have reported that the friendships they form online are comparable or better than their real-life friendships”. Moreover, “Massively multiplayer onlines’ are online ‘places’ in which social interaction can occur… (where) two-fifths of study participants said they would discuss sensitive issues with their online gaming friends that they would not discuss with their real life friends” (Jones, Christian, et al., p.5). An important thing to note here is that, in addition to the immersion felt from just the storytelling, compelling characters, and a believable open world, the virtual community that specifically massively multiplayer online games create can foster long-lasting relationships, much like ones people would make outside of video games. When gamers “discuss sensitive issues”, it is because they feel as if the other gamers have a deep connection with them as they have similar interests and use this platform to escape and foster relationships as well. Thus, it is evident that video games can foster the same, or even more meaningful, relationships as ones in everyday life.
For Meaning, gamers having an “Involvement in meaningful activities brings a sense of purpose and fulfillment to daily life… Connecting with millions of video game players across the world, against a common in-game attack, is bigger than any one player and this has been associated with deriving meaning and subsequently well-being” (Jones, Christian, et al., p.5). An important thing to understand is that, building off of the positives of relationships, the online community coming together for big events can give gamers a feeling of purpose; being a part of something larger than themselves. With this, gamers can feel accomplished, bringing meaning into their own lives.
Lastly for Accomplishment, “Working towards goals and objectives to accomplish can contribute to a sense of achievement and satisfaction in life… The ‘achievement’ factor measured the desire to become powerful in the context of the virtual environment through the achievement of goals and accumulation of items associated with power (Jones, Christian, et al., p.6). An important thing to note is that, for accomplishments, it relates a lot to how engagement allows gamers to dissociate and immerse themselves.
Negatives of Video Games on Mental Health:
Within a different context and circumstance, video games can potentially have a negative effect on mental health, especially when video gaming is not done in moderation. Considering that “online games (are) becoming one of the major daily entertainments from millions of people” (Wei, HT., p.2), when gamers do not game with moderation, it is stated that “80% of online gamers sacrificed at least one element of their lives, such as sleep, work, education, and socializing with friends, family, and partners to play online games” (Wei, HT., p.2).
In an online survey based in Taiwan, the survey collected data from “722 online gamers with a mean age of 21.8 ± 4.9 years… 601 participants were males and 121 were females… (and their) mean weekly online gaming time was 28.2 ± 19.7 hours” (Wei, HT., p.3) along with their scores for the Depression and Somatic Symptoms Scale (DSSS), Social Phobia Inventory (SPIN), and Chen’s Internet Addiction Scale (CIAS), which are all self-administered tests to scale Depression, Social Phobia, and Internet Addiction; the higher the score meant the more severe the mental health issue was. The results of the survey showed that “longer weekly online gaming hours and (being female) as significant predictors of high DSSS scores” (Wei, HT., p.4), as well as a “higher SPIN score, longer weekly online gaming hours, and longer history of online gaming as significant predictors of high CIAS scores” (Wei, HT., p.4). Furthermore, the study “(showed) a positive correlation between total online gaming hours and total CIAS score, indicating that excessive use of online games result in higher risk of internet addiction leading to more functional impairment… a positive correlation between online gaming hours and depressive symptom, somatic symptom, and pain symptom” (Wei, HT., p.5) and how gamers who spent longer hours in the week playing video games “had higher scores for loneliness or isolation, higher scores for depression, lower scores for social belonging in real life, lower scores and self esteem, and reduced ability to cope with emotional problems compared with those without dependency” (Wei, HT., p.5).
These are all important to note because, while displayed in the Positives of Video Games on Mental Health section that moderation of video game play time can result in a flourishing mental health, sustained and increased online video game playing time can result in some detrimental mental health deficiencies like increased depressive symptoms, loneliness, social anxiety, and decreased self-esteem and ability to emotionally cope. Moreover, along with an increase in depressive symptoms and social phobia symptoms, it illustrates how, with higher online video game playing times, it can develop behavioral addictions like an Internet Addiction. This internet addiction can lead to, as stated, “significantly higher rates (3 times more) of irritability, daytime sleepiness… depression, suicide ideations, anxiety, and obsessions/compulsions” (Wei, HT., p.5), especially since internet addiction can cause gamers to sacrifice aspects of their life such as sleep as stated before. Thus, it can be understood that playing video games for extended amounts of hours weekly can result in gamer’s mental health deteriorating, instead of improving with the stimulus of gaming, further demonstrating the importance of moderation when it comes to video gaming.
Conclusion:
Altogether, video games are currently one of the biggest forms of entertainment, where nearly 40% of the population are gamers (60% of the population having access to the internet), and continues to grow since its creation in the 1970s. However, playing video games becomes a double-edged sword when it comes to how it affects your mental health. On one hand, illustrated through the articles Gaming Well: Links between Videogames and Flourishing Mental Health and Gaming Your Mental Health: A Narrative Review on Mitigating Symptoms of Depression and Anxiety Using Commercial Video Games, video can both become a form of easily accessible and affordable therapy in the absence of traditional forms of therapy, with genuinely positive effects on depression and anxiety, while also being a general everyday form of entertainment that can positively affect your positive emotions, level of engagement, relationships, meaningfulness in your life, and lead to feelings of accomplishment with moderation. However, as emphasized in the article The association between online gaming, social phobia, and depression: an internet survey, without moderation, excessive amounts of video gaming throughout the week can lead to a behavioral addiction like internet addiction which can lead to increased feelings of depression, anxiety, suicidal thoughts, loneliness, and decreased feelings of self-esteem and ability to emotionally cope. The internet addiction can also lead to a sacrifice in daily activities like sleep, work, school, etc., which can increase irritability, daytime sleepiness, and sleep deprivation. Therefore, in order for video games to have a positive effect on one’s mental health, it has to be done in moderation.
Works Cited
Jones, Christian, et al. “Gaming Well: Links between Videogames and Flourishing Mental Health.” Frontiers, Frontiers, 1 Jan. 1AD, https://www.frontiersin.org/articles/10.3389/fpsyg.2014.00260/full.
Kowal M, Conroy E, Ramsbottom N, Smithies T, Toth A, Campbell M Gaming Your Mental Health: A Narrative Review on Mitigating Symptoms of Depression and Anxiety Using Commercial Video Games JMIR Serious Games 2021;9(2):e26575 URL: https://games.jmir.org/2021/2/e26575 DOI: 10.2196/26575
Wei, HT., Chen, MH., Huang, PC. et al. The association between online gaming, social phobia, and depression: an internet survey. BMC Psychiatry 12, 92 (2012). https://doi.org/10.1186/1471-244X-12-92
