How video games can help anxiety and depression

Kate Cann

Stereotypes and misconceptions of gamers are pretty widespread, but the fact that video games can benefit your mental health isn’t often discussed. There’s a stigma associated and, instead of emphasizing how video games can help anxiety and depression, games are often associated with addiction, a lack of motivation and even obesity, and it paints a terrible picture of the people who play when, in truth, most people who play games are getting a benefit to their mental fitness, confidence, and social skills. A lot of research into gaming has tried to dig into potential adverse impacts leading to violence, depression, and addiction. While that kind of investigation has its place, the issue is a lot larger and requires a more balanced look as more recent science shows there’s a lot of value to playing games. Because of how drastically gaming has changed in the past few years by becoming much more diverse, realistic and socially engaging, it’s especially important to pay attention to the newer, more positive research, such as this paper on The Benefits of Playing Video Games. What does that research show, though?

Can Gaming Help Depression?

The link between depression and video gaming is strong, but Jane McGonigal recently wrote to clear up some of the misconception: "No wonder several major video game studies have showed a correlation between playing more than 20 or 30 hours a week (depending on the study) and depression! Some researchers originally interpreted this as evidence that video games can cause depression. But today, a more common interpretation among the researchers that I compare notes with is that many depressed players are actually attempting to self-medicate with games. They experience a dramatic sense of relief from their symptoms while playing, and therefore, the more depressed they feel, the more they play."
She suggests avoiding having an escapist mentality towards games (using them to escape the real world) and instead adopting a ‘gameful’ mindset where you meet challenges willingly and seek to make incremental gains consistently. If you simply use games to escape, you’re going to play more when your life is more stressful and use less of your mental resources/effort to tackle the issues affecting you. When someone playing a lot is told they need to get up and do something with their life instead of ‘doing nothing’ like they do when they’re playing games, that reinforces that games are something with no real value, to be used only as an escape from/alternate life. It’s a vicious cycle that only reinforces harmful stereotypes.
“The game of Chess is not merely an idle amusement. Several very valuable qualities of the mind, useful in the course of human life, are to be acquired or strengthened by it, so as to become habits, ready on all occasions... we learn by Chess the habit of not being discouraged by present bad appearances in the state of our affairs, the habit of hoping for a favourable change, and that of persevering in the search of resources.”
— Benjamin Franklin, 'The Morals of Chess.'

Think Gamefully

Instead, thinking gamefully, you can challenge your troubles and recognize games as a positive enhancement to regular life, as opposed to something that takes over and serves an unhealthy mentality. You can still play games in order to change your mood, but it’s suggested that you do so with a goal in mind, like enhancing your problem-solving abilities (like in Portal 2), building bonds with friends/loved ones (cooperative multiplayer games like the Lego series or Halo) or practicing resilience in the face of a problem that just keeps bouncing back (like the troubles you encounter wandering the wasteland of Fallout 4). That kind of goal-oriented, purposeful gaming builds both real-world problem-solving skills and self-confidence, as well as having the exact opposite effect of escapism because playing to improve helps you connect to and use different parts of your brain, become less depressed and better able to cope with a range of emotions and real-life problems. One major way gaming engages your brain is by continually providing new puzzles and levels of difficulty. As humans, if there’s no avenue left to improve, we generally stop an activity, but games offer a constantly evolving challenge and motivate incremental improvements that keep us playing until the end in many cases. If you fail at a task in a video game, you simply try again. This drive to always improve or ‘level up’ can be adapted to the rigors of everyday life and help you become more resilient as well as causing you to instinctively respond better to challenges. If you mentally associate a reward with overcoming a challenge, as is the case in games, you’re naturally more motivated to persevere and work through to the other side of problems in your life.

Video games can get you off the couch!

You don't have to sit in front of your TV or a computer screen for hours to get a little bit of that gaming experience, either. The games on your smartphone or tablet will help foster all of these same rewards, just on a smaller scale as they can't be quite as complex or realistic as console/computer games. You still get some of the cognitive benefits scientists talk about, but mobile games are designed for shorter periods of play, so you’ll usually find the challenge/rewards much quicker and thus don’t need to dedicate as much time as you would digging your teeth into a bigger game. Mobile games are usually linked to social media platforms and can help engage you with friends who also want to play (as long as you avoid being that Facebook friend who spam invitations to the game of your choice), and reward players for coming back to them for short periods every day.

Gaming to Exercise

There are even games designed to get you off of the couch completely! Thanks to motion tracking technology that comes with the Xbox One, Playstation 4 and Wii U consoles, there’s a whole new style of game that gets you moving physically. They make workouts fun by incorporating gameful thinking (you unlock rewards, level up, compare your results) and tracking you to make sure you’re doing the exercises correctly. Alternatively, they’re perfect for jumping in front of the TV with a friend and playing a game of digital tennis in the living room, complete with invisible rackets! There’s a lot of information and different games out there — way more than can be covered in a single blog post — but everything starts somewhere, and talking about how gaming can change the way you approach depression is as good a jumping off point as any. Next up, it's time to tackle how gaming can provide diverse environments and help you manage anxiety! We've discussed approaching games with a ‘gameful’ mindset where you welcome challenges and meet goals intently, and highlighted the link between depression and gaming in a positive way that provides the basis for a more productive overall mindset when it comes to playing games.

Practicing Mindfulness

Along the same lines, you can approach an anxiety problem by gaming mindfully. Being mindful is to be in a state of active attention in the present. When you're mindful, you look at your thoughts or feelings from far away, without judgment on whether they’re good or bad. It’s the opposite of avoidance, one of the more negative tendencies of anxiety, and means you’re living in the moment. Anxiety is apprehension about a future or past event, so practicing mindfulness is a natural counter to it. When you live with constant anxiety, there’s an almost unending sense of dread to everything. Your body’s fight or flight system is always engaged, and there always tends to be a feeling something harmful is about to occur. Every change a significant with intense nervousness, and even small challenges seem massive with the added weight of your thoughts. It’s exhausting, and few environments ever feel truly safe. Games offer a space to experience a wide array of emotions without the sense of real danger or threat to your well-being. You go into the game with the understanding that it IS ‘just a game’ and can’t harm you, and you reinforce that with consistent rewards from the challenges it presents.

Video games can ease (or test) your anxiety!

That's not to say it's easy for an anxious person to find a game that helps. Not all games are comfortable for all people, and a lot of folks with anxiety find themselves shying away from shooters or games requiring quick reflexes, finding the immersion and stress to be too much. I'm personally intolerant of any horror in games - I just don't consider becoming that tense fun or rewarding, so I don't play them. Racing games, too - even Mario Kart can bring me to the brink of panic. And yes, I regret missing a few games I've heard are great, but I've made some personal progress by playing slightly scarier games like Fallout 4 without much trouble, even if I usually stick to it when my husband's nearby. Games are meant to be stimulating, so somebody prone to overstimulation can get there pretty quickly -- totally understandable! There's no shame in sticking to more detached experiences like Mario or the array of adventure/puzzle games out there. There are even games specifically designed for tackling depression and anxiety!
“Thinking gamefully, you can challenge your troubles and recognize games as a positive enhancement to regular life, as opposed to something that takes over and serves an unhealthy mentality.”
A little bit of anxiety can be motivational, though. We eagerly anticipate the feedback from our input in both the short term, whether it’s seeing a shot land or your character jump across a gap, and the long term, like when you collect all the blue properties in Monopoly. Positive feelings, as with rewards in games, elevate levels of the neurotransmitter dopamine, whereas a lack of dopamine spurs negative feelings and depression. Dopamine is directly responsible for the little rush of the reward system, and it's usually riding high when you're gaming with goals in mind. Games also introduce competition in the form of high scores and multiplayer, adding another layer of potentially active and productive anxious feelings. If these feelings become overwhelming, negative or excessive, you can choose to knuckle under and use it as a type of exposure therapy (like I do with the more nerve-wracking moments in Fallout, because that next reward is always around the corner) or simply move on to a different style of game that suits your mood better (like me bowing out of playing Resident Evil altogether). At the end of the day, a game does you no good if it spawns real-world negative feelings that aren't constructive, like creating anxiety without following up with a little dopamine bump reward.
“When we play a game — and this is in the scientific literature — we tackle tough challenges with more creativity, more determination, more optimism, and we’re more likely to reach out to others for help.”
— Jane McGonigal

Are there really social benefits to gaming?

You don’t just generate dopamine while reacting and being rewarded in-game. If you game with friends, new and old, you reap a lot of real-life social benefits.

Probably the best part about modern gaming is the social aspect. Thanks largely to the internet, you no longer have to schedule time side by side to interact in a gaming environment. While gaming in the same room is ultimately the healthiest outlet, online interaction is still incredibly valuable and can teach you a lot about working with others. A study at East Carolina University showed that just 30 minutes of online gaming a day was enough to foster a significant boost in long-term happiness and mood, thanks in no small part to the social aspect. Some games are specifically tailored toward interaction with other players, such as Massively Multiplayer Online (MMO) Games, and provide a space where you have to form parties and work together to progress. They encourage active listening and contribution from every player, greatly rewarding cooperative play and fostering a level playing field socially. In MMOs, everybody plays a role in the group's success, and each person has to openly communicate with the others in some aspect, whether it's in-game typed chat or voice chat, to complete objectives. That team play leads to a good sense of personal responsibility and a healthy level of pressure to learn to work through.

Don't discount 'online friends'

Since people began connecting on the internet, there's been a pervasive thought that friendships built online are somehow lesser than those kickstarted by physical interaction. Anybody who allows themselves to have significant interaction with people online knows this not to be true, as many of us have made very real, very lasting bonds with people that were first met in an online venue. Some of the guests at my wedding were folks I've met through online gaming, and I couldn't ask for better friends. I've spent countless hours with these people, working through in-game challenges while discussing any number of things, from our personal lives to world news, and we've gotten to know one another incredibly well in these hours-long conversations. Even though we don't all game as much as we used to, we remain in touch and make time to play every once in a while. These relationships require just as much attention and care as those created offline and operate on many of the same social cues. There aren't any special feeding instructions for online friends, and there shouldn't be a need for competition between online and offline relations - they're on an even playing field. But there is such a thing as healthy competition! Competitive games give the same dopamine rush, combined with often open (for better or worse) voice chats that encourage players to speak up during play. Though cooperating creates a greater array of social obstacles to overcome, the competitive gameplay still (hopefully) tickles our drive to be gracious winners or losers and deal with an emotional rollercoaster in real-time. On top of that, competitive shooters like Call of Duty can actually increase your visual attention and engage a number of other cognitive enhancements.

Don't Forget Tabletop!

Every time I say 'games', you're probably unconsciously putting 'video' in front of the word, and you're missing out! One more traditional, face-to-face form of gaming comes by way of the tabletop. Tabletop games include card games, roleplaying games, board games and more, which you can find on Wikipedia. What tabletop games lack in hand-eye coordination, they make up for in their aid to social anxiety by forcing you out of your shell and into real-world interaction with other people. You're given the added bonuses of eye contact and taking physical cues from other players, giving a whole new layer of additional contact to overcome. Most people with social anxiety have a naturally difficult time engaging in these kinds of activities, but it's been found incredibly worthwhile in curbing the avoidance and shyness associated with social anxiety disorders. You're working as a group, overcoming a multitude of small challenges, reaping rewards - and getting those sweet dopamine hits - as a result. Everybody gets a turn being the center of attention and having the pressure that goes with it, and the element of chance in most games keeps things fair for everybody, regardless of the pre-existing skills they might have to give them an advantage in-game. Many areas have tabletop gaming groups that get together to play a certain game or type of game every week, and they're generally comprised of people looking to cooperate and meet new friends. It can foster a great, positive environment for social growth and general fun! So go forward with games in mind and make sure to consider the benefits so many have gotten from them. Gaming doesn't have to be sitting alone on your couch, not speaking to anybody - you can regularly connect with friends, new and old, and take on challenges together, whether working as a team or competing in the positive gaming space. As more studies are done, we'll come to get a better picture of the encouraging ways gaming affects mental health, and hopefully start to remove the stigma of the lazy, antisocial gamer from the front of people's minds.


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