The first thing I used to do after returning home from school was to turn on my desktop and get back to my favourite computer game. It never crossed my mind that it had the potential of becoming a serious health issue. For a significant number of young Nepalis, gaming disorder is now an affliction.

The World Health Organisation (WHO) has added ‘Gaming Disorder’ as a new mental health condition in the 11th edition of its International Classification of Diseases (ICD-11), stating: ‘The behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.’

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In a developing country like Nepal, the disorder is common among youth who have grown up with electronics. According to Sharecast Initiative Nepal’s Nepal Media Landscape Survey 2018, 95.5% people have access to mobile phones, 18% own computers, laptops or tablets, and 24% have daily access to internet. Together with gaming disorder, an addiction to social media browsing through the smartphone is also becoming an epidemic.

Arun Raj Kunwar, Head of Kanti Children’s Hospital’s Child Psychiatry Unit in Kathmandu, says: “Patients come to us with symptoms, but since most aren’t familiar with gaming disorder yet, they assume it is something else.”

There are warning signs: children may lie to their parents so that they can play games, or say they are unwell so that they can skip school. The symptoms are persistent headache, poor eye-sight, lack of concentration, all leading to falling grades in school.

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Many children have been found to turn to gaming to avoid punishment by teachers or bullying by friends. Narmada Devkota, Clinical Psychologist at Rhythm Neuro Psychiatry Hospital and Research Center in Patan, saying she is getting an increasing number cases of gaming disorder.

Three boys aged 13-14 actually had to be admitted to hospital for a month. One had threatened to stab family members with a knife when not allowed to play his computer game, while another threatened suicide. All three had a history of being bullied that even parents hadn’t known about.

Some children take gaming as a platform to socialise because it is easier to make friends online than in real life. Kunwar recalls treating a 17-year-old recently who had pimples all over his face, and was into computer games to avoid social interactions.

“Parents want us to counsel their children out of gaming disorder but we can’t help them until the environment at home is favourable,” says Kunwar, who recommends parents be involved, find out about their children’s insecurities, help them deal with problems, and provide healthier alternatives like outdoor games that require human interaction.

One of Kunwar’s patients was a good flautist and liked to play the madal at school, so she asked the parents to bring these to the hospital. The patient was praised for his creativity and this gradually improved his behaviour.

While health officials have started taking gaming disorder seriously, passionate gamers claim that including it in ICD-11 was overkill. Those who work in the gaming industry strenuously reject that it is a mental health issue, just as working too much or reading too much aren’t considered harmful.

Nonetheless, the classification of the disorder has shone an important light on such behaviour and heightened the urgency of countering it in Nepal, where the use of computers, Internet and smartphones is spreading rapidly.

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