Gaming disorder: when gaming becomes a problem
Gaming disorder is a recognised condition in the WHO's ICD-11 in which a person loses control over gaming, lets it take priority over almost everything else, and carries on despite clear harm — to studies, work, sleep or relationships — usually for at least a year. Hours alone do not define it: many people play a lot without harm. It affects a small minority of gamers, more often boys and young men. Structured talking therapy, family involvement and treating any underlying anxiety, depression or ADHD help most.
Health writers · Aslam Clinic
Gaming disorder is a pattern of gaming that has taken control of a person's life. The World Health Organization recognises it in the classification (code 6C51) when three things are true together: the person cannot control their gaming, gaming has become more important than almost everything else, and they carry on despite clear harm. The harm must be significant — to studies, work, sleep, health or family — and would normally have been present for at least a year. Playing a lot is not, on its own, a disorder.
Games are part of ordinary life for millions of young Pakistanis, and most of that play is harmless or even good: it is social, relaxing and skilled. This page is about telling the difference, and about what to do when the line has been crossed.
What doctors mean by gaming disorder
The ICD-11 description has three core features. Impaired control: not being able to limit when, how long or how often one plays. Increasing priority: gaming pushing out other interests and daily activities — meals, prayer, homework, friends. Continuing despite harm: playing on even after failing exams, losing a job or damaging relationships. The American lists a similar 'internet gaming disorder' as a condition needing further research rather than a formal diagnosis, which reflects real debate about where the edges are.
| Heavy but healthy gaming | Gaming that is becoming a disorder |
|---|---|
| Plays a lot on holidays, less in exam season | Cannot cut down even when exams or work depend on it |
| Stops, grumbling, when asked | Explodes in anger, breaks things or threatens when the phone is taken |
| Still sees friends, eats with family, plays sport | Has dropped friends, meals, sport and prayers for the game |
| Sleeps reasonably most nights | Plays through the night, sleeps through classes |
| Spends pocket money occasionally on the game | Takes or borrows money, or lies about spending, to buy in-game items |
| Gaming is one enjoyable part of life | Gaming has become the only thing that matters, for months |
How common is it?
WHO says gaming disorder affects only a small proportion of people who play. A 2021 review pooling 53 studies from 17 countries estimated that about 3% of people met criteria worldwide, falling to about 2% in the most carefully sampled studies, with males affected about two and a half times as often as females. The same review found that the questionnaire used explained most of the difference between studies — some screens flag far more people than truly have the disorder.
In Pakistan, a 2025 study of 286 higher-secondary students in Karachi found that 17.5% scored positive on a gaming-disorder questionnaire. That is a screen rather than a diagnosis, but the risk factors are worth noting: playing three to four hours on school days, and starting to game before the age of seven, were both linked with higher scores. Violent game content was not.
PUBG, Free Fire and gaming in Pakistan
Cheap smartphones and mobile data have made battle-royale games such as PUBG Mobile and Free Fire enormously popular, especially among boys and young men. These games are designed to keep people playing: short rounds that invite 'one more', rewards that arrive at unpredictable intervals, rankings, and team-mates who depend on you being online. In-game currency and loot-box style purchases add money to the mix.
Concern has reached the state. In July 2020 the Pakistan Telecommunication Authority temporarily blocked PUBG, citing among other things reports about its effect on players' mental and physical health; the move was challenged in the Islamabad High Court. Blocking an app does not treat the person, and a young person who is struggling usually moves to another game. What helps is dealing with why the game has taken over.
Local pressures can feed it. A boy facing Matric or FSc exams he feels he will fail, a young man without work, or a teenager with few safe places to go out in the summer heat may find in the game the success and company that real life is not giving him. Parents who see only the phone, and not the pressure behind it, often end up in a battle neither side wins.
Betting apps and online gambling
Gambling is a separate, recognised condition (gambling disorder, ICD-11 code 6C50), and it can overlap with gaming through loot boxes, skins and betting on cricket or other matches through apps. Warning signs are borrowing or taking money, selling possessions, hidden debts, and chasing losses. Because money is involved, harm can escalate fast. If this is happening, block gambling apps and sites, hand control of money to a trusted person for a while, and seek help — the same therapies used for gaming and other are used here.
Signs to watch for
- Gaming late into the night, and struggling to wake for school, college or work
- Falling marks, missed classes or skipped exams
- Losing interest in friends, sport, family events and prayer
- Lying about how long they play, or playing in secret
- Intense anger, crying or violence when asked to stop or when the device is taken
- Spending money on the game that they cannot afford, or taking money
- Skipping meals or showers, headaches, eye strain, and wrist or neck pain
- Seeming low, anxious or irritable whenever they are not playing
Gaming problems often go hand in hand with , , social anxiety or loneliness. For some young people, the game is where they feel competent and accepted when school or home feels hard. Asking about this is as important as counting hours.
What helps
The best evidence is for structured talking therapy, particularly . A 2026 review of treatments for problematic digital technology use found that psychological therapy improved gaming disorder, although results between studies were mixed. Therapy usually aims for control rather than a lifetime ban: understanding the , setting limits, rebuilding sleep and routine, and filling the space gaming leaves with things that matter.
- Family involvement — especially for teenagers, sessions with parents to agree rules and reduce conflict.
- Treating what sits underneath — ADHD, depression, anxiety or bullying, which can drive escape into games.
- Rebuilding sleep — a regular bedtime without the phone in the room. Night-time gaming and feed each other, and poor sleep worsens mood and concentration.
- Real-world rewards — sport, a gym, a part-time job or a club, where skill and belonging can grow outside the screen.
There is no medicine for gaming disorder itself. Medicines are used only when there is a separate condition that needs them, such as ADHD or moderate to severe depression, and then only after a proper assessment. Be wary of anyone selling a quick fix — a 'detox camp', an injection or a tonic.
Progress is usually gradual. A realistic early goal is not zero gaming but getting sleep, school or work and family meals back on track, with gaming fitted around them. Setbacks around holidays, results day or a new game release are common and are a reason to revisit the plan, not to abandon it.
Family rules that work
- Agree the rules together, in a calm moment, rather than announcing them in the middle of a fight.
- Keep phones and consoles out of bedrooms at night — charge them in a shared room.
- Link gaming to the day's essentials: school, homework, meals and prayer first, then play.
- Use clear, predictable limits and give a warning before time is up — a match cannot always be abandoned mid-round.
- Make sure every adult in the house enforces the same rules. In joint families, a grandparent or uncle handing over a phone undoes the rest.
- Model it yourselves. Children notice when parents are on their phones through meals.
- Avoid sudden confiscation as a punishment for everything; it often leads to explosions and secret play. Planned, agreed reductions work better.
When to get help
See a doctor, psychiatrist or clinical psychologist if gaming has caused falling marks or missed school or work for more than a few weeks, if family rules have been tried and repeatedly fail, if there is aggression when gaming is limited, if money is being taken, or if the person seems depressed or anxious. Many psychologists offer online sessions, which suits young people who resist a clinic visit.
Common questions
Still not sure what to do?
Reading about a symptom only goes so far. A doctor who can ask you questions and examine you will get further in ten minutes than any article can.
