If you're the type who sits down for a game of "EverQuest" for an hour and later realizes that 10 hours have gone by, you could have a problem on a par with drugs or gambling.
But help is on the way — albeit pricey help. A rehab clinic at the Wild Horses Center in Amsterdam has opened its 16th-century townhouse doors for the sole purpose of treating video game addicts for the whopping fee of 500 euros ($640) a day (not covered by health insurance, natch). The clinic is operated by addiction consulting firm Smith & Jones; its first residential gaming treatment program began July 15 and will continue for four to six weeks.
The clinic was started because, with the exception of a few gamer-rehab clinics in the U.S. and Canada, there are not many places for video game addicts to go, and more and more gamers are seeking help.
"We got one kid in who was gaming 18 hours a day — I wanted to send him somewhere, and we looked around and there was nothing," said Smith & Jones' Keith Bakker, who started the Amsterdam rehab clinic. "We began to see a need for attention in this area in 2005, when a small number of clients being admitted for drug and alcohol addictions were also telling us about their compulsive gaming behavior. This was new to our staff — we had never heard of people spending up to 16 solid hours on a game trying to 'level up.' "
Like gambling, gaming can be a habit-forming, antisocial escape. While physical side effects may not be as apparent as with, say, chronic cocaine use, in rare cases it can lead to heart failure, suicide, seizures or even drug addiction.
A 28-year-old South Korean died of heart failure last year after playing a game of "StarCraft" for 50 hours at an Internet cafe. The parents of a 13-year-old Chinese teen who killed himself after playing a computer game for 36 hours are suing the game's distributor. And the Chinese government has opened the country's first clinic for "Internet addiction," with more than two dozen nurses and doctors treating mostly teens (see "China Opens Government-Run Clinic For Internet Addiction").
According to Smith & Jones, which employs the 12-step program used by Alcoholics Anonymous, 20 percent of all gamers can develop a dependency on gaming and not shut off the console freely and willingly.
"Many of these individuals have neglected family, romance, school and jobs, not to mention their basic needs, such as food and personal hygiene," the Smith & Jones Web site reads. "The symptoms of gaming addiction are very much like gambling. These people think, 'Next time, I'm going to win.' This mentality is part of what hooks people into the compulsive cycle."
A leading expert in the field is Dr. Maressa Hecht Orzack, director of the Computer Addiction Study Center at McLean Hospital in Belmont, Massachusetts. Orzack has been helping video game addicts for more than 11 years and was asked to help with the Amsterdam clinic, though she prefers cognitive therapy to a 12-step program.
"It's a program where I tell them to learn to be aware of what they are doing," she said. "It essentially means that their emotions are determined by their thoughts. We look at a situation, we talk about it and then I say, 'What are you thinking about?' Most of them have some other big issue that they're escaping. Mood disorders and depression and anxiety disorders, these coupled with the fact that the games are designed to be addicting, that is pretty compelling."
The most addictive games, she said, are "World of Warcraft," "EverQuest," "Final Fantasy" and pretty much anything "where there is role-playing involved."
Orzack treats John, a bright 20-year-old unemployed man who spends more than 10 hours a day playing "War of Warcraft," where he owns four characters. His addiction has led him to flunk out of more than one college and have an abusive relationship with his younger brother.
"His mother called and said he really needs to see you and he wants to see you," Orzack said. "Something is going on in his life that he is escaping. In the game, he finds a sense of belonging. Some say escape and some say fun, but most want to be part of an organization.
"It's role-playing," she continued. "They are part of an organization, and many of them are missing this in their outside lives. They believe they are the characters. They may be depressed, anxious or overwhelmed, or they may have attention-deficit disorder. Some of them take drugs when they're playing also, and that enhances the effect."
The worst way to deal with video game addicts, Orzack said, is to take away the games, which forces players into withdrawal and can lead to violence (if they are not at a raid in time, their character will be killed).
"We took it away [from John] and he became violent, curled up, couldn't stand it and was totally devastated," she said. Instead, Orzack recommends playing for time and not to win — for instance, challenging addicts to play for only two hours and setting an alarm clock.
Right now, she recommends that addicts go to Amsterdam or call a local hospital to seek therapy.
"I spend half my time trying to find referrals," she said. "I get five or six messages a day from video game addicts asking for help."
While some gamers use drugs just so they can stay awake and play longer, Dr. Orzack said video game addiction can be worse than drugs or alcohol.
"They have to use the computer for schoolwork, so the temptation is always there," she said.
But Smith & Jones promises help. "We will help participants evaluate the damage that gaming has had on their lives as well as the destructive effect it's had on their loved ones. Our goal it to teach them new skills that will help them to enjoy life apart from their addiction. We will show them that real adventure is better than fantasy adventure."