By Dr. Allison Kawa
I am the reigning Mario Kart champion in my home. Video games are becoming increasingly ubiquitous in the lives of modern adults, adolescents, and children; this has been accelerated in the wake of the COVID-19 pandemic and quarantine. The technology and research behind video games is so incredibly nuanced and complex that it is impossible to categorize them in binary terms like “good or bad” and “healthy or unhealthy.” This means that the idea that a person can be “for” or “against” video games is a lie! The complexities of how video games impact the brain are superimposed onto the individual differences inherent in the players, which further complicates decision-making. Ultimately, parents have to make choices that are right for their specific families based on a multitude of factors, including what happens to the brain during video game play. Let’s explore this in more depth.
In order to understand what video games do to the brain, it is helpful to know a few basics about how the brain works. There is a saying that “neurons that fire together wire together.” This means that when we associate or encounter things repeatedly, networks form in the brain that allow for faster, more efficient, and more automatic processing. Physical, emotional, and cognitive experiences we have while playing video games will therefore contribute to and even change our brain networks. The first time you hit a button to block an incoming punch, your reaction time is slow and you have to think more deliberately about the action. Over time, this becomes instinctive, which makes you a faster blocker and a better defender. What’s even more intriguing is that eventually you will be a great blocker in many different games, not just the first one you learned the skill while playing.
The human brain is quite adaptable, and new networks can and do develop through the lifespan. However, there is a developmental period when the brain is especially receptive to rewiring that lasts until we are about 25-years-old. For this reason, video games can and will rewire the brains of kids, teenagers, and young adults more readily than the brains of those older than 25. It is important to remember that rewiring is not inherently a bad thing. In fact, as we will learn a bit later, video games can actually produce positive and adaptive changes in the brain.
The rewiring in our brains happens, in part, because of the release of chemicals called neurotransmitters. There are a lot of them, but we are going to focus on dopamine. Things that signal the possibility of a reward trigger dopamine release; this includes things like sex, money, and a tasty chocolate. Oh dopamine, our feel-good neurotransmitter. When dopamine is present in the brain, we get: motivation, pleasure, reward, a sense of well-being, sustained interest, and better attention. Dopamine is also important for our cost/benefit analysis of pleasure, learning and memory, executive functioning, motor control, pain processing, sleep, and stress response. Video games are designed to make your brain release dopamine—that’s why they are fun and motivating to play! This flood of dopamine makes your visual-motor pathways come online, it stimulates your reward pathways, it elevates your mood, and your focus increases.
Your brain also releases a hormone called cortisol during video game play. Cortisol is your body’s primary stress hormone that helps to control mood, motivation, and fear. It is involved in the “fight-or-flight” response to danger, and cortisol controls sleep/wake cycles, boosts energy so you can handle stressful situations, and helps to bring you back to baseline once the stress is done. When your cortisol levels rise as you play video games, you feel excited and stimulated. You experience physiological changes like increased heart rate, muscle tension, and increased levels of blood-sugar. Cortisol can also play into more intense emotions and less inhibition. In the right amounts, this makes video game playing thrilling, entertaining, and enjoyable.
Video Games 101
Before we launch into the pluses and minuses of video games, it is important to break down the concept of video games a bit further because there are some important terminology differences.
- Sandbox games: games without a clear endpoint or objective
- Minecraft, Grand Theft Auto, The Sims
- Action/Shooter a.k.a. First Person Shooter (FPS) and Third Person Shooter (TPS): games requiring the shooting of weapons. In FPS, the camera view mimics what a person would see if they are holding the weapon. In TPS, the view allows the player to see the avatar.
- Apex Legends, Fortnite, Call of Duty
- Action-Adventure: games with a storyline and goal
- The Legend of Zelda, Resident Evil, Assassin’s Creed
- Role-playing Games (RPG): the player assumes a character role in a fictional setting, often to complete quests
- Fallout 4, The Witcher 3, Among Us
- Real-Time Strategy (RTS): several players simultaneously play the game “in real time” to secure areas on the fictional map or to destroy opponent assets
- Warcraft, Age of Empires, Civilization 6
- Multiplayer Online Battle Arena (MOBA): two teams of players compete against each other on a predefined battlefield. Each player controls a single player whose unique abilities both improve over time and aid the team’s overall strategy.
- League of Legends, Smite, Dota 2
- Simulation and Sports: games that simulate experiences or sports
- Madden NFL, NBA2K, Mario Kart 8
- Educational: games that target academic skills in a game-life format
- Math Vs. Zombies 2, Teacher Monster, Reader Rabbit
Video Games as Vitamins
There are a number of positives associated with video game play. Any adventure game with a storyline, quest, or strategy requires the player to: master different situations, strategize, survive, accumulate weapons or other materials, and defend turf. This translates to improved abilities to switch between tasks, think of overall strategy, perform several tasks simultaneously, adapt to new information, and modify strategy on-the-fly as new input is registered. Action-oriented videogames are associated with enhanced visual perception, tracking of multiple objects, mentally rotating objects, visual-spatial memory, and spatial attention. In fact, laparoscopic surgeons who play video games are faster and more accurate than their non-gaming counterparts! Video game enthusiasts also develop cognitive strengths in terms of mental flexibility, working memory, and abstract reasoning. Educational games can enrich a student’s knowledge base, academic skills, and academic fluency as well as their motivation and interest in learning. There are numerous games that have a collaborative or social component, and these have been shown to increase positive social behaviors as well as provide platforms to help make and sustain meaningful friendships. Finally, the world of gaming can provide a sense of mastery, confidence, and control that is missing from real life, especially during the challenging time of the COVID-19 pandemic.
Video Games as Villains
A well-rounded examination of video games must include the negatives as well as the positives, and everything is not “bonus lives” and “powerups” in the land of gamers. Remember when we talked about video games re-wiring the brain? One study found that young adults addicted to gaming had lower volumes of gray and white matter in their brains; this translates to difficulties with decision-making, impulse control, and emotional regulation. To make this point more explicit, the actual number of brain cells in addicted gamer’s brains was changed. Now we cannot say for sure that the video game play caused this structural change because we don’t have brain scans from before the study participants started playing. It could be that some difference in brain functioning led to the videogame addiction. However, the association is notable and striking since the gamer’s brains were measurably different from their non-gaming peers. Excessive video game play has also been shown to interfere with sleep, mood, and social learning.
Negative effects seem to be strongest with violent video games, even when play time is relatively short. For example, after 10 to 20 minutes of playing a violent video game, brain activity increases in areas that are associated with anxiety and emotional reactivity while activity decreases in areas that control emotional regulation and executive functioning. Additionally, playing a violent video game for 10 to 20 minutes increases the number of aggressive thoughts. This means that after playing a violent video game for less than 30 minutes, your emotions (especially anxiety and anger) are more intense, your thinking is more violent, and you have less ability to control yourself.
There is an interesting chicken-and-egg conundrum when it comes to problems with focus, attention, and anger. Children and adolescents who have difficulties in these areas tend to be attracted to action-entertainment games. Yet, these same types of games get the brain revved up into a state of fight-or-flight, leading to (you guessed it) difficulties paying attention, managing emotions, controlling impulses, following directions, and tolerating frustration. This is because the body responds to danger cues in video games, such as being attacked by a monster, as if it was actually occurring in real life. The brain knows that it is a game, so the cognition attached to the attack is, “This is exciting and fun! I’m finally going to kill this guy!” The body, however, releases tons of cortisol and this can depress immune functioning, cause irritability or depression, and destabilizes blood sugar. Wild fluctuations in blood sugar cause cravings for sweets and unhealthy snacking, which is one major reason why video games are associated with increased risk of obesity. Repeatedly triggering this fight-or-flight response makes it harder for the body and brain to regulate over time, so the return to a sense of calm and stability takes longer and longer. Fight-or-flight is designed for action: you are going to beat the tar out of something or run away from it as fast as you can. When there is no physical discharge following a fight-or-flight activation, the nervous system becomes dysregulated. Sometimes, an emotional outburst (i.e., temper tantrum) becomes the means by which that pent up energy is released.
What To Do?
Knowledge meant to empower us, not to intimidate us. We need to take what we know about the games and interpret all this information in light of the individual gamer. Those who already have problems with attention, impulse control, following directions, and regulating their feelings are at a higher risk of having their brains rewired in ways that exacerbate those deficits. That is not to say that video games need to be completely eliminated for these folks, simply that they may need shorter game play time or access to different kinds of games. For example, playing Minecraft or Roblox in sandbox modes may foster interpersonal connections and creativity while playing Call of Duty reliably produces a fit when it’s time to turn off the game in the same person.
Make a mindful choice and set limits accordingly rather than making blanket judgments or decisions. Remember to be flexible and adjust your rules or policies as needed. For example, we know that the problematic side effects of gaming are compounded by sleep problems and they are cumulative. If sleep becomes an issue, maybe scale back on gaming to reset things. Similarly, if you have an especially enthusiastic gamer in the house, rotate game genres or even better, do a tech detox for a week if things feel like there are more negatives than positives to having videogames in the house. Parents are encouraged to play videogames with their children so that it becomes a shared experience and so that parents can observe firsthand what effect the particular game has on their child. Some questions to ask are:
- What games does my child like to play? Why are they attracted to that game?
- Are there specific types of games that seem to cause troublesome behaviors after my child plays them?
- Are there specific types of games that have a positive impact on my child’s behavior and mood?
With new games coming out all the time, it can be hard to stay on top of the latest and greatest games in order to make thoughtful choices for your family. Keep gaming devices in a central location or, if your child uses a gaming computer, have them use it in a common area so that you can see what they are playing. Common Sense Media is a wonderful resource for finding information about the themes and ratings of various videogames before you buy them as well. Game on, player!