Gaming & internet addiction

What is gaming addiction?

Gaming addiction, known medically as gaming disorder, is when gaming becomes hard to control and starts to crowd out the rest of life, even though it is causing harm. The World Health Organization (WHO) includes it in ICD-11, the international classification of diseases, as a disorder due to addictive behaviour. It is defined by three features:

• Impaired control: difficulty controlling when gaming starts, how long it goes on, or when it stops
• Increasing priority: gaming takes precedence over other interests and daily activities, such as sleep, meals, studies, work and family
• Continuing despite harm: gaming carries on, or increases, even as problems pile up

For a diagnosis, the pattern must cause significant problems in personal, family, social, educational or work life. It is normally present for at least 12 months, although it can be diagnosed sooner when the problems are severe.

Most people who game, including many who play a lot, do not have gaming disorder. Studies worldwide suggest that about 2 to 3 in every 100 people are affected, with higher rates among teenagers and in boys and men. Indian studies of school and college students have reported widely varying rates, partly because they used different questionnaires.

It is not a sign of laziness, bad character or poor parenting. Many games and apps are designed to keep people playing, and some young people are more vulnerable to getting stuck.

What about social media, phones and the internet?

Problematic social media, internet or smartphone use is not a separate diagnosis in ICD-11. That does not mean the problem isn’t real. Endless scrolling, short videos, chatting, streaming or online shopping can take over sleep, studies and relationships just as gaming can.

A psychiatrist assesses these problems in the same way. Is there loss of control? Is it taking priority over everything else? Is it continuing despite harm? And is something else, such as anxiety, depression or ADHD, driving it? Treatment follows the same principles too.

Betting apps, fantasy sports played for money and online card games with cash stakes are forms of gambling rather than gaming. They carry extra risks around money and debt, and are covered on our gambling page.

Signs to look out for

You or someone close to you may have a problem if you notice several of these:

• Playing or scrolling far longer than planned, and losing track of time
• Repeated failed attempts to cut down, or broken promises to stop after one more game
• Staying up late or through the night, then struggling to wake for school, college or work
• Falling marks, missed classes or assignments, or problems at work
• Irritability, anger or aggression when asked to stop or when a device is taken away
• Losing interest in friends, sport, hobbies and family time
• Skipping meals, bathing or other self-care to keep playing
• Lying about time online, or gaming secretly late at night
• Spending on in-game purchases, sometimes using a parent’s card or UPI without permission
• Using games or the phone as the main way to escape stress, sadness or loneliness

Doctors look at the overall pattern, how long it has been going on and how much it affects daily life, rather than any single sign.

How much screen time is too much?

There is no magic number of hours. A college student who games for several hours at the weekend but sleeps well, studies and sees friends may be fine. Another who plays less but lies about it, misses exams and explodes when asked to stop may need help.

WHO advises people who game to watch how much time they spend, especially when it pushes out other daily activities, and to notice changes in their physical health, mood and social life. Some useful questions:

• Is sleep suffering?
• Are studies, work or responsibilities slipping?
• Can they stop when they have agreed to, most of the time?
• Do they still spend time with people offline and enjoy other activities?
• Is money being spent without control?

Why does it happen?

There is rarely a single cause. Several factors usually combine:

• Game and app design. Unpredictable rewards, levels, daily streaks, loot boxes and in-game purchases are built to keep people coming back.
• ADHD. Fast, rewarding games are especially absorbing for young people with attention difficulties. In studies of teenagers with problematic gaming, roughly 4 to 7 in 10 had ADHD.
• Anxiety, depression and low self-esteem. Games offer escape, achievement and a sense of control that may feel missing elsewhere.
• Stress and loneliness. Exam pressure, bullying, a move to a new city, conflict at home or feeling left out can push a young person online.
• Age and sex. Teenagers and young men are at higher risk, though girls and women are affected too.
• Home environment. Easy access, devices in the bedroom, very strict or very loose rules, and constant arguments about screens can all make things harder.

How it affects the body and mind

Long hours of gaming or screen use, with poor control, can affect many parts of life:

• Sleep: late nights, a disturbed body clock and daytime tiredness
• Studies and work: poor concentration, falling marks, missed deadlines and dropping out of courses
• Mood: irritability, anger outbursts, anxiety and low mood
• Physical health: eye strain, headaches, neck, back and wrist pain, too little exercise, irregular meals and weight gain
• Relationships: conflict at home, withdrawal from family and fewer real-world friendships
• Money and safety: unplanned spending, and contact with strangers online who may bully, deceive or exploit

The encouraging news is that sleep, mood and concentration often improve once gaming comes back under control.

What happens when you try to cut down

Unlike alcohol or opioids, gaming does not cause dangerous physical withdrawal. But cutting down is still hard, and it helps to know what to expect. In the first days and weeks, many people feel:

• Restless, bored or empty
• Irritable, angry or tearful
• Strong urges to check the phone or log back in
• Low or anxious, especially if gaming was covering up these feelings
• Unsettled sleep as the body clock adjusts

These feelings usually ease as new routines take hold.

How change happens matters. A phone snatched in the middle of a fight, or the Wi-Fi switched off at midnight without warning, often leads to explosive anger, secret use on a friend’s phone, or a young person refusing to talk at all. Gradual, agreed and structured change works much better. If there has ever been violence, self-harm or threats of self-harm around device limits, plan the next steps with a professional rather than alone.

When to see a psychiatrist

Consider speaking to a psychiatrist if:

• Gaming or phone use is affecting sleep, studies, work or relationships
• Repeated attempts to set limits at home have not worked
• There are anger outbursts, aggression or damage to property when limits are set
• The person has stopped going to school, college or work, or rarely leaves their room
• There are signs of low mood, anxiety, attention difficulties or hopelessness
• Money has been spent without permission

You don’t need to wait until things become severe. Early help is simpler and more effective.

How gaming addiction is diagnosed

A first consultation is a conversation, not a judgement. The psychiatrist will ask about gaming and online habits, the kinds of games and apps used, spending, sleep, studies or work, mood, friendships, family routines and what has already been tried. Young people are usually seen both with their parents and on their own for part of the time, so everyone gets a chance to speak freely. Young people under 18 are seen with a parent or guardian.

An important part of the assessment is looking for ADHD, anxiety, depression and other conditions, and understanding whether gaming is the main problem or a way of coping with something else. Questionnaires may help measure severity. The diagnosis follows international criteria (ICD-11), and the plan is built around the young person’s and family’s goals.

Treatment

The aim is usually healthy control, not a life without technology, since screens are part of studies and work. For some people, stepping away from one particular game or app is part of the plan. Treatment usually combines the following.

1. Building motivation and agreeing goals

Many young people don’t see a problem at first. Motivational conversations help them connect gaming to what they care about, such as exams, a career, fitness or friendships, so that change is something they choose rather than something forced on them. Goals are specific, realistic and reviewed regularly.

2. Cognitive behavioural therapy (CBT)

CBT helps people understand and change the thoughts and habits that keep gaming going. It commonly includes:

• Recognising triggers, such as boredom, stress, late nights or an argument
• Questioning thoughts that justify just one more round
• Planning a daily routine with set times for sleep, study, meals, exercise and gaming
• Building offline activities, skills and friendships
• Handling urges, frustration and low mood without logging in

Research reviews show that psychological treatments reduce gaming disorder symptoms, and can also ease depression and anxiety.

3. Family therapy and parent guidance

Screens are a family matter, so families are closely involved. Sessions help to:

• Reduce daily arguments and power struggles
• Agree clear, fair rules and consequences in advance
• Keep parents consistent and on the same page
• Rebuild trust and time together

4. Treating other conditions together

When ADHD, anxiety or depression is present, treating it is often key to lasting change. This may include counselling and, where needed, medicines such as stimulant or non-stimulant medicines for ADHD, or antidepressants. Medicines should only be started, changed or stopped by a doctor.

Outpatient, online or inpatient care?

• Outpatient care suits almost everyone, with regular sessions while living at home and studying or working.
• Online consultations work well for parent guidance, follow-up and families outside Delhi NCR.
• Inpatient care is rarely needed, and is considered only for serious safety concerns or a severe mental health condition alongside the gaming problem.

Dr. Tarwani sees patients at Sukoon Health in Gurugram and South Delhi, and online.

Recovery and relapse

Recovery is gradual. New game releases, holidays, exam results, a breakup or a stressful week can all bring old habits back.

A slip does not mean treatment has failed. The right response is to notice it early, talk about what happened and adjust the plan, not to give up or bring in harsh punishments. With time and support, many young people build a healthier relationship with gaming and technology, and get back to their studies, friendships and interests.

For parents and families

Watching your child disappear into a screen is worrying and often frustrating. Most parents have already tried shouting, pleading and taking the phone away. These steps tend to help more.

Stay calm and connected

• Talk at a quiet moment, not in the middle of a game or an argument
• Show interest in their world: ask what they enjoy, and sometimes watch or play alongside them
• Describe specific concerns (“You’ve been late to school four times this week”) rather than using labels like lazy or useless

Set limits together, not in anger

• Agree rules in advance, write them down and review them together regularly
• Avoid snatching phones or cutting the internet in anger; it usually escalates conflict and pushes use into secrecy
• Give a warning before time is up, and let a game reach a natural stopping point
• Use calm, predictable consequences rather than threats you won’t carry out
• Notice and praise effort and progress, not just perfect days

Make a family media plan

• Screen-free meals, and all devices charged outside bedrooms at night
• Set times for gaming and social media that fit around sleep, study and outdoor activity
• Age-appropriate parental controls, especially for younger children
• Rules that apply to adults too, because children copy what parents do
• Plenty of offline alternatives: sport, hobbies, and time with cousins and friends

Protect money and safety

• Don’t save cards on game stores or apps, and don’t allow in-game purchases without your permission
• Use payment methods that need an OTP, with spending limits
• Watch for secretive behaviour, new online contacts or a child quickly switching screens when you walk in
• If your child is being threatened or exploited online, report it to the police or the national cybercrime reporting portal

Look after yourself too, and try to keep both parents and grandparents consistent. You are welcome to consult Dr. Tarwani first, on your own, to plan the next steps.

Common myths

• “It’s just a phase; they’ll grow out of it.” Many young people do settle, but when sleep, studies and relationships are suffering, waiting can let problems deepen.
• “Taking the phone away will fix it.” Sudden confiscation without a plan often leads to anger and secret use. Lasting change comes from agreed limits and treating any underlying problems.
• “Anyone who games for hours has an addiction.” Time alone doesn’t define it. Loss of control and harm do.
• “It’s caused by bad parenting.” Gaming disorder happens in caring, involved families too. Parents are part of the solution, not the cause.
• “Phone overuse isn’t a real problem because it isn’t a diagnosis.” It can still cause real harm, and it is assessed and treated in a similar way.