Do Video Games Make Depression Worse?

Until recently, I had never considered the idea that my gaming habit, which could charitably be described as heavy, could be harmful to my mental health. It wasn't just that I dismissed that idea; the idea had never popped into my head.

But as psychological professionals debate whether or not "gaming addiction" should be listed as a condition in the next update to the Diagnostic and Statistical Manual of Mental Disorders (the psychological Bible)—and as I finally take my mental health seriously—I am reevaluating that idea. I'm reevaluating it, even though my psychiatrist and my therapist have never discussed gaming as an issue.

Unfortunately, there is not a whole lot of scientific data, in the form of psychological studies, to help me out in my journey of self-discovery. There are, however, a few researchers who are intent on studying the possible link between gaming and mental disorders like depression. I spoke with two of them to get a more personal perspective than I would have gotten from simply reading their work.

***

The first researcher is Dr. Douglas Gentile of Iowa State University. He, and a handful of other researchers, performed a study a few years back that was published in the journal Pediatrics. It was called Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study. (A longitudinal study looks at one group of subjects over time.) In this study, they looked at the gaming habits of schoolchildren in Singapore over the course of two years to try to determine if what they refer to as "pathological gaming" has an impact on the subjects' lives and mental health.

They found a definite correlation between heavy gaming and symptoms of depression.

"I was expecting to find that the depression led to gaming," Gentile told me. "But we found the opposite in that study. The depression seemed to follow the gaming. As kids became addicted—if you want to use that word—then their depression seemed to get worse. And, as they stopped being addicted, the depression seemed to lift."

Gentile: "I was expecting to find that the depression led to gaming. But we found the opposite in that study."

Despite the evidence, Gentile didn't quite buy that.

"I don't really think [the depression] is following. I think it's truly comorbid. When a person gets one disorder, they often get more. If you've been diagnosed with bipolar disorder, a year or two later you might end up with anxiety problems or social phobias. They all start interacting with each other and make each other worse. [The test subjects' gaming 'addiction' and mental health problems] are close enough in time that they're probably affecting each other. As you get more depressed you retreat more into games, which doesn't help, because it doesn't actually solve the problem. It doesn't help your depression, so your depression gets worse, so you play more games, so your depression gets worse, etc. It becomes a negative spiral."

The other researcher I talked do is one Daniel Loton, a PhD candidate at Victoria University in Australia. His study is also longitudinal, but over five months instead of two years. The other main difference is that the participants in this study are older, with an average age of 25.

Loton's study, which also looks into a link between gaming and mental health, has not yet been published, and, indeed, he has not even completed analysis of all the data in his surveys. So far, he has only fully analyzed how a gaming habit relates to a person's coping style. For the purposes of this discussion, that is perfect, because Gentile's study did not examine gaming as a coping mechanism.

Just so we're clear, Loton defines coping styles as "constantly-changing cognitive and behavioral effort to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person." More or less, that simply means how a person deals with profound stress in general.

There are three terms you need to know here: approach, distraction and withdrawal. Approach coping would be a person utilizing his or her support circle (family, friends, etc.) when dealing with problems, and, if he or she is suffering from a mental illness, seeing mental health professionals for treatment. Distraction coping is when a person attempts to, ahem, distract himself or herself from their problems for short periods of time. Withdrawal coping is essentially not coping at all; when you withdraw, you aren't even trying to help your situation because you've given up hope.

In Loton's study, he found that the link between a person's gaming habits and his or her mental health is bridged by that person's coping style. Loton asserts that whether or not a person's gaming habit can be considered unhealthy—whether or not he or she is pathological, as Gentile would say—correlates strongly with coping style. If a person tends to utilize approach coping, then his gaming habits probably won't negatively impact his life, even if he does what others might consider to be an excessive amount of gaming. If a person usually withdraws, on the other hand, then he is more likely to become a pathological gamer while also having what Loton calls poorer mental health outcomes.

***

When I lost my job in January, I struggled immensely. For the next few weeks, I would spend an hour or so a day looking for more work, while devoting the rest of my day to playing Star Wars: The Old Republic. It was absurd and definitely out of the ordinary for me, but I was depressed. That's how I dealt with it.

Given that anecdote falls well within the realm of the studies mentioned above, I shared it with both researchers, and I got very different responses. We'll start with Gentile.

Gentile: "Even kids know that [gaming is] not a very good coping mechanism... And so the problem stays there, ready for you once you're done."

"What you did is absolutely no different, even at this time when you were depressed, than you do when you're not depressed," Gentile told me. "It just was more extreme, because you were dealing with more extreme issues at that time. And even kids as young as 10 will say they do this. They'll play games or watch movies as a coping mechanism. But even kids know that it's not a very good coping mechanism. It's a distraction. It doesn't actually solve the problem. And so the problem stays there, ready for you once you're done.

Loton put a more positive spin on the situation, connecting my game-playing to my efforts to find work.

"Do you feel as though during that time, that those hours of video game playing is what actually allowed you to apply for the jobs? So if you didn't have something else that you enjoyed like that at the time, you would have been applying for less jobs?"

As I heard these responses, I didn't feel like either of them was wrong, even though they disagreed.

***

Any good psychological professional will tell you that long-term, clinical depression is far too complex to blame on any one thing. There are usually all sorts of environmental factors in addition to whatever imbalance a person might have in his or her head. Sure, you can sometimes look at a particular depressive episode and point at a cause, but it doesn't do it justice to ignore everything else that plays a part.

In order to discover just what part The Old Republic played in the episode I described above, we need to take a closer look at what was really going on inside my head. That is no easy task for most people, including myself, but I will do my best to share a holistic view of that situation with you.

When I lost my job, I was a dead man walking. I was not at a point in my mental health treatment that I could deal with something like that in any sort of positive way, and my friends, bless them, weren't properly equipped to carry me through something like that. It was only a matter of time until I tried to hurt myself.

SWTOR was my morphine. It did not fix me, but it delayed the inevitable and made me comfortable. It held my bad feelings down while I searched in vain for anything tangibly good in the world. The fact that something good did not come in the 16 days between the end of my employment and a night I tried to kill myself is not the game's fault.

SWTOR was my morphine. It did not fix me, but it delayed the inevitable and made me comfortable.

For 16 days, I lived in a state of numbness, shocked at what had happened but not dead. Some part of me was sad, but my daily dose of SWTOR allowed me to forget that sadness most of the time. It didn't end up making me happy, and it didn't find me a job, and it didn't stop me from eventually going off the edge.

It also didn't send me over that edge. Without SWTOR, I would have found other, similarly ineffective ways of managing my situation, and I would have spent more time drinking, and the outcome would have been the same. It's likely, indeed, that without SWTOR my moment of truth would have come sooner. That game gave me more of a shot at life than anything else did. (And, as I've written before, in a roundabout way, it helped me.)

Games are not my problem. My problem is that I have a severe mood disorder and a boatload of emotional baggage. When we examine the cause of my myriad emotional issues, it would be unfair to say it was caused by that one thing that makes my life seem more bearable than it otherwise would be.

Were I another person, I would probably view those events differently. Indeed, everyone has different factors that contribute to their depression. We all react to those factors in our own ways. A broad psychological study looks for what people have in common and cannot account for each unique circumstance. The researchers I talked to may find ways to deliver some truths about what happens to us when we're depressed and playing games.

***

So what's the answer here? Well, I can't really give you one for anybody but myself. All I know is that in the case of this one person—me—gaming was a lifeline. Loton said as much. Eventually that lifeline broke, and that's because, as Gentile offered, playing games a lot was not the solution to my very large problems.

That means that gaming is not bad for me and my mental health.

Ultimately, that means that gaming is not bad for me and my mental health, but maybe I could use a more productive coping mechanism. It's really that simple.

That analysis may not apply to you. You are different from me. You can learn, broadly, from my take on my situation. You and/or your therapist have the ability to know you better than I or any psychological study can. That, ultimately, is the lesson and the key to understanding whether, when life darkens and we suffer from depression, playing games is a help or a hindrance, a negative force or a relief.

Phil Owen is a freelance entertainment journalist whose work you might have seen at IGN, GameFront, Appolicious and many, many other places. You can follow him on Twitter at @philrowen.