The design of online games has reached a new level of sophistication, appealing to millions of people.

There are more than 2.3 billion active gamers in the world this year, of which almost half spend money on games. A recent report by the international games market research company Newzoo estimates that the global games market will reach $137.9bn in 2018, with digital revenues accounting for 91 percent.

As the gaming phenomenon grows, the World Health Organization (WHO) has identified a new disease - gaming disorder. The WHO defines the disorder as "a pattern of gaming behaviour with increasing priority given to gaming over other activities ... and continuation or escalation of gaming despite the occurrence of negative consequences."

So what does gaming disorder really mean and how can it be treated?

"What happens when we are immersed in a video game, is that the brain starts to activate the sort of exciting reward system, neurological pathways that are associated with excitement and pleasurable activities, and of course it makes us want to do it more and more," children and adolescent psychiatrist Dr Richard Graham told Al Jazeera.

"So game designers and perhaps social media platforms have learned how to activate those systems to keep us in the game and on screen for as long as possible."

With many of his patients in the 14 to 15-year range, Graham said that many youths are facing increasing stress due to the pressure of school. One of the ways they try to escape the ordinary pressures of life is through technology - which then can become an unhealthy escape.

"Where we start to move into the territory of addiction is when what was once almost a healthy way of coping with stress starts to have a grip of its own. That person is no longer able to have control over their use and they feel compelled to keep increasing the amount of whatever is is - a substance or gaming," Graham explained.

"The loss of control is absolutely key to an addiction. But also when they do try to stop, they do get that withdrawal reaction..."

All game designers, all producers of technology are themselves in a highly competitive arms race with each other, trying to produce those products that are going to be the 'Fortnight' of the next season.

Dr Richard Graham, child and adolescent psychiatrist, Nightingale Hospital

In the gaming and digital detox programmes that Graham runs, the withdrawal reactions can sometimes be extreme. According to him, there's "such agitation and aggression the police could be called. Violence could erupt … the young person might also become acutely distressed and panicked and sometimes place themselves at risk of harm to themselves. And that was scary, and so a service was set up to provide a safe place to support people."

Real-time immersion into virtual realms is enhanced by the sheer volume of real-time players, the lure of competition and rewards such as high scores, or ranking within the game. This combination, according to Graham, intensifies the addiction: 

"One then gets into large group or crowd experiences that I think amplify those trends even more. And the buzz of being part of something that's massive and online … [where players] are swept along in some astonishing crowd-like process to be online, and in game, for as much of the time as they could."

Graham said the "digital economy", from social media to mass multi-player gaming is also driven by unbridled competition among companies and developers who are in "a sort of arms race to get people more and more on screen to the point where it will affect everyone's health and well-being."

He recommends that developers consider functionality and the installation of features that allow players to pause, or to save their position without losing their rank, or rewards accrued during the game.

"For young people, it's incredibly distressing to get to a certain point in a game and then their parents say it's time to eat and they just don't want to stop, because they don't want to lose all of that, and a simple piece of functionality would actually make a huge difference if they could pause."

Families can run interventions, take their children for camping trips or walks in nature. Though not always immediately successful, this approach, said Graham, can provide enough time out of game for those suffering from the disorder to actually see what they've been missing.

"The interesting thing is that once you take that step, you sort of wake up to the fact that something else is going on around you, and there actually might be some impact on your life. Perhaps you are missing friends that no longer come and knock to see if you want to join them on a trip to the cinema … or that you realise that you're going to have to repeat your year at school because you have missed so much."

Source: Al Jazeera