Your partner seems to be spending more and more time playing their favorite online video game. They’re up late at night playing, long after you fall asleep. They no longer have much interest in sex. You ask them to cut down, but you don’t get much response. What do you do?

Can you really be addicted to video games?

Most people these days live in two worlds—the real world, and the online world. As we’ve discussed before, in episode 3 of Relationship Doctor, this has serious implications for intimate relationships in the 21st Century.

75 percent of American households include at least one video gamer.

One of the most popular ways people live in the Internet is through online video games. According to the Entertainment Software Association, 75% of American households include at least one video gamer. The video game industry makes more money than the film and music industries combined.

Gaming can be a fun, engaging diversion in the right context. For some people, though, video game use can become a problem. Many mental health professionals think that, for a very small percentage of regular users, video games can be addictive. That’s still controversial, as we’ll discuss today. But what’s clear is that video gaming can occasionally have serious negative consequences.

As my editor, a former video game journalist, notes, “I’ve seen marriages dissolve, people who lost friends and even jobs because of gaming, and young adults flunking out of college as the result of problem gaming habits. These stories aren’t the norm, but they’re out there.”

Can you be addicted to video games if it’s not a drug?

New neuroscience suggests that video games can activate changes in your brain similar to addictive substances like drugs or alcohol. Problem gaming can be a form of self-medication.

In 2013, the American Psychiatric Association (APA) reviewed the arguments for and against including something called Internet Gaming Disorder in its most recent Diagnostic and Statistical Manual (DSM-5).

The APA felt there wasn’t enough research evidence to make a decision. But they did include it in a special section at the back of the manual as a potential disorder requiring further research study.

The APA felt there wasn’t enough research evidence to make a decision on whether Internet Gaming Disorder should be included in the DSM-5

More recently, the World Health Organization (WHO) made the decision to add “gaming disorder” to its International Classification of Diseases.

According to the APA, there are nine criteria for Internet Gaming Disorder. (Remember, at this time the “disorder” is merely a proposed condition in need of further study.) Five of these criteria have to be present within a year to make the diagnosis:

1. Preoccupation with gaming
2. Withdrawal symptoms such as sadness, anxiety, or irritability when gaming is not possible
3. Tolerance, or the need to spend more and more time gaming to satisfy the urge
4. Unsuccessful attempts to reduce or quit gaming
5. Giving up other activities, or losing interest in activities you previously enjoyed, due to gaming
6. Continuing to play despite its causing problems in your life
7. Deceiving family members or others about the amount of time you spend on gaming
8. Use of gaming to relieve negative moods, such as guilt or hopelessness
9. Having jeopardized or lost a job or a relationship due to gaming

As you can see, being addicted to gaming is not just about what you do; it’s about what you give up in order to keep doing it.

As with just about all mental disorders, the condition has to have caused “significant impairment or distress” in several aspects of a person’s life to be considered problematic.

How can I talk to my partner about video game addiction?

Let’s get back to the situation we discussed at the beginning: Your partner seems to be spending more and more of their time playing online video games. And they’re doing it to a point where they no longer seem very invested in your relationship.

You’re not an addiction expert, but you are an expert in what you need in a relationship. At some point, you’ll need to sit your partner down and talk about the problem. Pick a time when you’re both well-rested and not in a hurry.

You’re not an addiction expert, but you are an expert in what you need in a relationship.

“Listen,” you might say, “I think you and I are at a crossroads here. I want to be with you, but you’re spending so much of your time and energy on gaming that it doesn’t feel like we’re in a real relationship anymore. I’m hoping we can get our relationship back.”

Maybe they’ve been worried about their video game habit, too. If so, that’s a good sign. Ask if they have any ideas about what to do, to get themselves back in the real world with you.

You might want to look together at the APA criteria for the newly proposed Internet Gaming Disorder condition.

What if your partner refuses to talk about being addicted to video games?

But now let’s imagine a different scenario. Let’s say your partner doesn’t want to discuss the issue. Or they get angry, or they say you worry too much.

To your partner, gaming may feel more like a solution than a problem.

Why wouldn’t they be interested in getting help if their gaming habit is a problem? That’s paradoxical, right? To your partner, gaming may feel more like a solution than a problem. When they’re gaming, they feel happier, more involved, more alive.

What’s the best treatment for video game addiction?

There aren’t any authoritative guidelines yet, since video game addiction is a relatively new issue. But there are excellent reviews online that summarize what’s known, and not known, about what to do when video gaming becomes a problem.

The APA has a web tool where you can type in your zip code, and the search term “behavioral addiction,” and get a list of well-credentialed care providers in your area.

In addition, there are 12-step programs specifically for online gamers; websites where (for a modest price) you or your partner can get access to a suite of practical resources; and at the extreme, residential treatment programs that offer a serious “detox” from life online and a special community of other people trying to rebuild their lives.

One important disclaimer: These programs all have their enthusiasts and skeptics. I can’t specifically recommend any of them, but if you want to increase your understanding of what help is available, they’re a good place to start.

The secret truth about addictions and addiction-like behavior

I’ve spoken to lots of people with addictions—both chemical and behavioral—who’ve told me the main thing they had to learn was that they’re different from other people. Most people can play video games without going down the rabbit hole to addiction. But for whatever reason, some people just can’t. They’re like a race car with no brakes. That self-knowledge has helped addicted people stop.

It takes serious motivation to change any kind of addictive behavior.

Words can be of limited value when you’re dealing with an addiction. But maybe you’ll get a look of recognition if you tell your partner you think they’ve become like a race car with no brakes. Maybe they’ve noticed that about themselves.

Remember, you’re asking them to consider giving up the thing that, to them, feels like the solution to their problems. But you’ve just offered them something valuable, here in the real world—you’ve been paying attention. You’ve noticed something important going on. And you care enough to want to talk with them about it.

It takes serious motivation to change any kind of addictive behavior. And one of the most powerful sources of motivation can be a real relationship with someone in the real world who cares.

What to do when someone you love has a problem with video games

Here are the main things to keep in mind if you’re worried about your partner’s gaming behavior.

1. Don’t get into an argument with your partner about whether their gaming habit is an addiction or not. Instead, stick to the facts as you’ve experienced them—your feeling of abandonment; your discouragement about the relationship; your lack of a sex life together.
2. You have no control over your partner’s behavior. The only thing you can control is how you react. Keep your reactions low-key and matter-of-fact.
3. Speak your truth. All of us today live simultaneously in two worlds: the real world and the online world. Tell your partner you can’t manage your relationship in this world all by yourself. Tell them you can’t—and won’t—do it alone.