I write this post with a heavy heart.  Apparently, decades of research consistently shows that video games are, in fact, linked to mental illness.  No one could be more distraught than me.  I enjoy video games.  I play them regularly, and I seem to have grown into a (mostly) high functioning, productive member of society.  So, I was skeptical at first, but I’ve grown more convinced after researching this post.

Those of us over the age of 30 remember a time when hysteria over video game content was rampant.  The media would push stories warning our parents that the video games we were playing would turn us into murderous sociopaths.  For a representative example, see this 1998 New York Times article Children and Violent Video Games: A Warning.

It’s almost Christmas. Do you know what your children are playing? Might they perhaps be ripping out the spines of their enemies, perpetrating massacres of marching bands and splatting their screens with sprays and spurts of pixelated blood?

Video Games Industry Comes Under Fire

After defeating opponent, Mortal Kombat often displayed a Fatality reward
Mortal Kombat was one of the most controversial video games of its time.

Perhaps the most iconic video game of them all was Mortal Kombat [the uncensored Sega version, not the watered down Nintendo port].  Not only did parents target this and other video games, but so too did the United States Senate, back when they were focusing on the real problems of the day.  In fact, the Senate formed a media watch group to warn parents each year of the most violent video games.


Some of the most controversial video games of the time included: Doom (1993), Grand Theft Auto (1997), Silent Hill (1999) and, of course, Mortal Kombat (1992).  For an excellent recap of the most controversial video games of the past three decades, read this piece from CNN.

Man holds Sega Genesis Mortal Kombat cartridge
Mortal Kombat and video games like led industry to self-impose a ratings system.

The best retrospective I could find on the controversy that the video game Mortal Kombat caused is this BBC article: Mortal Kombat: Violet game that changed video games industry.  The Brits mused:

It allowed combatants to rip the heart out of a vanquished foe, or tear the head off a fallen opponent, and hold the appendage up as a trophy.

The game encouraged players to do this with the infamous message “Finish him!” that would repeatedly flash on the screen when a bout was over.

How could a game like this, regardless of how popular it was, be sold on shelves next to Super Mario World?

The video games industry decides to self regulate

In fact, video games hysteria reached Capitol Hill in 1993 with a series of congressional hearings on whether to impose a rating or regulatory framework upon the video games industry.  Under threat of regulation from the federal government, video games manufacturers worked together to create the now-familiar ratings system that essentially copies movie ratings.  Most video games today are rated E for Everyone, T for Teen, or M for Mature.  For a great discussion of the history of congressional hearings that led the video games industry to self-regulate, read this article from Wired.

Scientific research on video games: no verdict yet, but coming soon

Modern research on video games seems to point to a link to mental health.  In fact, the American Psychiatric Association identified “Internet Gaming Disorder” as a candidate for further study in the Diagnostics and Statistics Manual 5th Edition, noting that it may trigger the same neurological pathways as drug use.  The proposed list of symptoms is as follows:

  • Preoccupation with Internet gaming
  • Withdrawal symptoms when Internet gaming is taken away (sadness, anxiety, irritability)
  • Tolerance, the need to spend more time gaming
  • Inability to reduce playing, unsuccessful attempts to quit playing
  • Giving up other activities, loss of interest in previously enjoyed activities
  • Continuing to play despite problems
  • Deceiving family members or others about the amount of time spent on Internet gaming
  • The use of Internet gaming to relieve negative moods, such as guilt or hopelessness
  • Risk, having jeopardized or lost a job or relationship due to Internet gaming

Tellingly, the APA’s opinion is that:

‘gamers’ play compulsively, to the exclusion of other interests, and their persistent and recurrent online activity results in clinically significant impairment or distress. People with this condition endanger their academic or job functioning because of the amount of time they spend playing. They experience symptoms of withdrawal when kept from gaming.

Although most of the research comes from Asian countries, the APA and other researchers seem convinced that the findings apply in the good old USA (#AmericaFirst).  The APA specifically labels it “Myth No. 1” that the research is equivocal, concluding instead that the link is very real.

Other researchers agree with the APA, while some disagree

Additionally, researchers published a study in The Journal of Pediatrics that concluded:

The prevalence of pathological gaming was similar to that in other countries (9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming.

If you prefer not to read the actual study, an excellent recap is provided in this New York Times Article.  A separate study in JAMA Pediatrics also found that “young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence.”  The study notes that most of this internet use was to play online video games.

However, not all researchers agree.  As the New York Times reported:

Dr. Gentile, an associate professor of psychology at Iowa State University, says his latest results don’t prove that playing video games causes depression. Rather, he says, in young people a range of mental health problems and what he calls “pathological gaming” may develop in tandem, much as illnesses like the flu and pneumonia can set off one another and lead to new problems.

Two types of video games addiction?

World of Warcraft logo
This MMO video game has been found to be especially addictive due to its “never ending” status

Every player of video games knows that there are both offline single-player games, as well as online multiplayer adventures (MMOs).  At least one organization that has reviewed the literature suggests two separate types of addiction, each based on the single-player or MMO nature of video games.  Additionally, they suggest both emotional and physical consequences:

Some of the physical signs or symptoms of video game addiction include:

  • Fatigue
  • Migraines due to intense concentration or eye strain
  • Carpal tunnel syndrome caused by the overuse of a controller or computer mouse
  • Poor personal hygiene

Some of the emotional signs or symptoms of video game addiction include:

  • Feelings of restlessness and/or irritability when unable to play
  • Preoccupation with thoughts of previous online activity or anticipation of the next online session
  • Lying to friends or family members regarding the amount of time spent playing
  • Isolation from others in order to spend more time gaming

Of particular concern is the addiction potential of online MMO-style video games:

The other type of video game addiction is associated with online multiplayer games. These games are played online with other people and are especially addictive because they generally have no ending. Gamers with this type of addiction enjoy creating and temporarily becoming an online character. They often build relationships with other online players as an escape from reality. For some, this community may be the place where they feel they’re the most accepted.

So what’s a player of video games to do?

Mario holding Princess Peach in video games
Mario and Peach have starred in countless games with the same goal: Save the Cheerleader Princess.

It seems clear that not all video games carry the same addictive potential or mental health consequences.  In this writer’s opinion, no reasonable person could conclude that any game starring the eponymous hero Mario as he rescues Princess Peach carries the same mental health implications as Mortal Kombat, Doom, or any of their modern day iterations.

Furthermore, if you’re old enough to have played the classic Super Mario Brothers on the original Nintendo Entertainment Systemthen you have probably already baked in any “damage” caused by your love of video games.  Remember, the average age today of people who play video games is 35.

Best of both worlds

However, as players parents, the research suggests that we should limit our children’s exposure and offer less violent video games, and perhaps impose time limits.

Which, honestly, is the best of both worlds if you have ever found yourself fighting with your child over who can play PS4 or Xbox or 3DS.  Not only can you say “because I’m the parent and you’re the child;” you can rely on the published research linking excessive use of video games in adolescence to worse mental health outcomes.  If your child is especially nerdy intelligent, you could even show them this blog post and have them click the links to read the studies for him or herself.

My take: the average reader of this blog is well into their 30s and beyond.  Enjoy your video games.  If you have children, exercise some judgment and control over their gaming.  Just because you enjoy slaying prostitutes in GTA V does not mean you have to allow your child to do so!

And seriously, stop slaying prostitutes.  We all have to earn a buck somehow. [Editor’s note: I am not a prostitute.]

Video Games May Be Linked to Mental Illness
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