The real toll of virtual worlds

19 Nov 2025

From social isolation to depression, gaming addiction creates a destructive cycle that threatens mental health.

BY Mr Patrick Teo, Senior Clinical Counsellor, Care & Psychosocial Disciplines; and Dr Lim Chau Sian, Senior Consultant, Department of Psychological Medicine, CGH

Video gaming addiction was first identified as a concern among American students in 1983. Decades on — after a huge surge in popularity in the early 2000s — what began as a niche worry has evolved into a significant health issue requiring focused research and specialised treatment programmes. By 2012, the gaming community had swelled to one billion players worldwide, a number that has grown further in the wake of the COVID-19 pandemic.

According to Statista, a German data gathering platform, Singapore's games market revenue is projected to reach US$826.33m in 2025, with user numbers expected to grow to 3.9m by 2030. The concern is particularly acute for Singapore's young population. In 2021, The Straits Times revealed that two-thirds of children aged seven to nine were already using smartphones daily, with usage extending up to six hours per day.

The dark side of play

Gaming Addiction or Gaming Disorder is defined as a pattern of gaming behaviour that takes control of an individual's life. The condition is characterised by impaired control over gaming habits, with players prioritising games over essential daily activities, despite mounting negative consequences.

There are multiple factors that keep players glued to their screens.

1 Games are designed with compelling mechanics and structures. These include intermittent rewards, thrilling moments, impressive visual effects, level progression and hidden secrets. These elements create constant anticipation and stimulate pleasure responses, encouraging continued gameplay.

2 Various game genres such as action, adventure, combat, role-playing and team-based games offer players numerous opportunities. Players can achieve goals collaboratively, socialise with international players, gain in-game status and power, create customised characters different from their real-world selves, compete with others and earn recognition within the gaming community for their achievements.

3 Players often develop a virtual persona they perceive as superior to their real-world identity. For some individuals, virtual friendships feel less intimidating than real-world interactions. Additionally, the fantasy gaming world serves as an escape from real-life situations, stresses or problems that people may struggle to address.

Achievement, socialising and escapism from the real world are strong predictors of addictive gameplay.

Minds under siege

Gaming addiction can have severe consequences on an individual's mental wellbeing and overall quality of life. Excessive gaming often leads to social isolation, resulting in profound feelings of loneliness and deteriorating self-esteem. As players become increasingly immersed in virtual worlds, they may experience strained family relationships and difficulties in maintaining meaningful connections with others. The addiction can trigger or exacerbate depression, particularly when gaming becomes the primary coping mechanism for real-life challenges.

Moreover, the sedentary lifestyle associated with prolonged gaming sessions can lead to various medical health issues, including poor sleep patterns and irregular eating habits. The cumulative effect of these factors often creates a destructive cycle where relationship problems intensify, further driving the individual to seek solace in gaming, thereby deepening their addiction and mental health struggles.

Breaking free from the controller

Treatment for gaming addiction requires a holistic approach. A CGH multidisciplinary care team of psychiatrists, addiction counsellors, psychologists and social workers establishes an understanding on the extent of the individual's gaming habits and its related problems, and develops an appropriate and personalised treatment plan for the individual.

Some individuals may respond well to straightforward behavioural modification techniques, which are geared towards changing their daily habits so as to engage in healthier activities instead. Others might require deeper psychological intervention to address emotional trauma or underlying mental health concerns. This tailored approach ensures that treatment addresses not just the gaming behaviour itself, but also the unique circumstances and psychological factors that contribute to each individual's addiction.

Therapeutic models used to address gaming addictions focus on educating both the affected individual and their support system, while providing guidance throughout the recovery process.

For young gamers, parental involvement is crucial to the treatment’s success. Parents — who are equally impacted by their child's gaming habits and negative behaviours — receive guidance on supporting their child's recovery effectively while maintaining their own wellbeing.

If you have concerns about gaming addiction, whether for yourself or a loved one, seek professional help by consulting your healthcare provider or a mental health professional.

Watch for these critical warning signs:

Preoccupation with gaming thoughts and fantasies instead of concentrating on other activities.
Progressive increase in gaming duration and frequency, often neglecting basic needs.
Escalating expenditure on gaming products, such as character customisations or 'skins'.
Noticeable loss of interest in previously enjoyed hobbies and activities.
Lying about actual device usage.
Social withdrawal and isolation.
Using gaming as the primary method to regulate negative emotions.
Emotional volatility when prevented from gaming, ranging from restlessness to intense anger, frustration, depression, anxiety or even violent behaviour.
Defensive responses when confronted about excessive gaming habits or asked to stop playing.
Declining academic or work performance due to gaming interference.
Persistent gaming behaviour despite negative consequences.