In the digital era, video games have become an integral part of audiovisual culture.  With sophisticated graphics, interactive narratives, and compelling stories, games offer entertainment and an opportunity to escape from the stress of reality.  Gaming does have the potential to positively impact mental health by assisting individuals to learn higher-level and abstract thinking skills, communicate with others, and relieve stress.  However, spending hours playing video games can have a negative impact on health.  Video game addiction is now a commonly diagnosed disorder recognizing both the mental and physical effects of gaming.  Not everyone who plays video games is addicted, but it is important for parents to take proactive steps to encourage responsible gaming habits and avoid negative physical symptoms.

An addiction is defined as a person’s inability to control the use of a substance or behavior, despite negative consequences.  Those who become addicted to video games are so engrossed in the screen time that they ignore other normal activities.  Addiction occurs when the reward center in the brain releases dopamine in response to a pleasurable experience or hyperarousal.  If a person experiences hyperarousal while playing video games, the brain associates the activity with dopamine, a powerful neurotransmitter in the brain.  The person develops a strong drive to seek out that same pleasure again and becomes more driven to return to the behavior.

Spending hours every day sitting in front of a computer playing video games may have severe implications for physical and mental health.  Chronic hyperarousal can decrease the body’s immune function, cause irritability, and unstable blood sugar levels.  In children, some can develop cravings for sweets while playing video games.  Overeating while gaming may lead to the child becoming obese.  Obesity can lead to heart problems and heart-related disorders.

Combined with the sedentary nature of gaming, children’s diet and weight can be negatively affected as well.  When gaming, some users may forget to eat regular meals or drink water leading to dehydration and other issues associated with a poor diet.  Not moving or exercising for long periods of time can lead to physical health atrophy, a wasting away of cells, organs, and muscle tissue.  Sometimes children will even avoid stopping the game to go to the restroom, which can lead to hygiene issues.  Other common physical ailments include eye strain, fatigue, wrist and hand pain, back problems, neck pain, and reduced spine mobility.  

Many children may play video games late into the night, leading to sleep deprivation, which is closely linked to mood disorders, increased stress levels, and decreased academic performance.  The blue light emitted from screens suppresses melatonin production, making it harder for children to fall asleep and regulate their emotions effectively.  Poor sleep due to excessive gaming can exacerbate mental health issues such as anxiety and depression, making children more vulnerable to emotional instability.
 
To mitigate the hidden risks of video games on children’s physical and behavioral health, parents and caregivers must take proactive steps to encourage responsible gaming habits.  Some children can self-regulate and engage in physical activities on their own.  It is important to encourage these behaviors.  Be on guard if the child becomes noticeably more anxious and quicker to lose their temper when spending a lot of time on screens.  Be sure to play with the child, teach kindness, be involved, and get to know the child’s friends and their activities.  

Encourage active screen time over passive screen time.  Active screen time involves the child interacting with other people or being cognitively or physically engaged.  For example, allow the child to play educational games, or games that require players to build something together.  Other options are fitness-type games that require movement while playing.  Passive screen time includes watching screens with minimal cognitive engagement, such as scrolling through social media, watching online videos, or playing simple games.

Set reasonable limits for the child’s screen time and video game types, especially if the child’s use of screens hinders involvement in other activities.  The American Academy of Pediatrics recommends limiting screen time to no more than one to two hours per day for children.  Encourage gaming breaks and ensure that video games do not replace physical activity, homework, or family interactions.  Establish clear gaming schedules that prioritize responsibilities before entertainment.
 
Choose age-appropriate games with positive themes and avoid violent or excessively stimulating games.  Utilize parental controls and game ratings to determine suitability.  Engage in co-play with children to better understand the content they consume.  Parents should set an example by demonstrating responsible screen usage and engaging in non-digital activities together as a family.  If concerns about a child or loved one’s use of screen time arise, consult a behavioral or addictions specialist or discuss physical symptoms with a pediatrician.