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Escaping Reality—VR, Depression, Anxiety, and Addiction

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Disclaimer: I’m not a mental health expert, nor professional anything. This post is not medical or psychological advice. Its purpose is solely to observe my own experience, and explore the ways in which I feel VR has affected me, and possibly start a conversation on the topic. I’m just an introspective gamer dealing with some tough emotions, and exploring my own thoughts through this blog.

What led me to think about VR addiction and mental health?

I love playing games and exploring new experiences in virtual reality, but recent events in my life have shown me that I’ve been abusing it.

Escapism

I’ve been dealing with copious amounts of depression and anxiety lately and, trying to figure out where everything went wrong. That’s not to suggest that VR gaming is the sole cause of these feelings, they are something I’ve dealt with for a large part of my life. But, during the plague year (COVID 2020) gaming in VR became a new crutch for me. I used virtual reality to escape my own reality. I was avoiding responsibilities and not dealing with a lot of personal issues. This also led to neglecting my romantic partner to the point where our 10-year relationship fell apart and eventually ended.

Over the past year I was attempting to forge a new career path for myself. I worked with the same company for 15 years, and each year corporate decisions, and decline in management, made the job progressively worse. As a result, at the end of February 2020 I finally quit my dead-end, low-wage delivery job. It was making me more miserable with every day of every year that passed. Stress from the job was causing or adding to depression and low self-esteem. After quitting, I used some savings, and some income from part time work with entrepreneurial members of my family, as a means of paying the bills while I pursued a new path. I wanted to get out from under the corporate thumb and do something for myself.

I tried to figure out how, if at all, I could turn my love of gaming and VR into a source of income—Follow your passion, right? I’d started this blog. It’s a fun project to work on (when I’m motivated enough to put together new posts), but it’s not a lucrative hobby for me by any means. I barely make enough from AdSense revenue to cover the yearly web hosting and domain name registration.

At some point I decided I should start streaming on Twitch and/or start a YouTube channel—both of which are fine ideas for people with the passion and dedication to actively work on growth and engagement. I applaud those who succeed in these endeavors. I am not one of those people. I wasn’t getting viewers. A few people were interested in watching a few minutes of gameplay for new releases, but they quickly moved on—Nobody wanted to see this 40-year-old, depressed, chubby, and anti-social man with his head in a box, flailing his arms about in his living room for several hours a day. My streams never achieved affiliate status.

I wound up spending most of my time just playing VR games while my significant other got up and went to work everyday. I was using the time in virtual worlds as a way of avoiding dealing with my anxiety and depression, and as a replacement for having a real social life. Gaming had become my latest form of escapism. As a child I used books for the same purpose. I always had my nose in some fantasy, horror, or sci-fi novel, while I tuned out the seemingly everlasting arguments of my parents that only stopped when they divorced. In young adulthood it was illicit substances that helped me avoid uncomfortable emotions, but I outgrew or overcame that phase of my life.

Upgrade your Oculus Quest 2

During all the COVID closures I became a bit of an agoraphobe, only leaving the house when necessary—to go do a job or grab groceries. Playing games and exploring virtual worlds gave me a sense of getting out and doing things.

So all this has got me thinking about the effects of using VR and gaming as a coping mechanism for depression, anxiety, and as a replacement for face-to-face social interactions in the real world, and what kind of effect that can have on mental health.

Gaming Addiction

Gaming used to be a fun hobby for me. It was a great way to unwind and blow off steam after work, or to waste a few hours of a day off. But without a steady job to go to I quickly found myself losing more and more time to an activity that quickly became an addiction. My ex is also something of a game addict. She’d spend entire evenings playing casual mobile games on her phone or tablet. Between the two of us and our vices, we seemed to not have much time where we were both present and in the moment with each other.

Gaming is addictive by design.

As a result of in-app purchases, subscription based sales models, and a need to keep high userbase for multiplayer, modern games are actively designed to become addicting. They need you to come back everyday so they can keep making money. Casinos actually paved the path for gaming addiction. They spent a lot of time, money, and research on engineering gaming addiction with goal of finding ways to increase what they refer to as “time on device” and “continuous gaming productivity.” Slot machines use all their flashing lights, exciting sounds, and enticing rewards to keep you pulling their levers. A lot of internet games use all those same gimmicks. Casinos don’t tend to have clocks or windows. They want you to lose track of time and focus on gaming. When you put on a VR headset, it’s a lot like walking into one of those casinos. You block out the real world and sunshine and can easily lose hours of your day.

One specific example of a game that I was hooked on is the extremely popular battle royale from the studio BigBox VR, Population: One. Aside from all the fun things that make you want to play in the first place, the game uses FOMO (Fear Of Missing Out) to keep players returning daily. They drive engagement with ploys like limited time availability for character and weapons skins. These are rewards that are only temporarily purchasable or earned through participation in limited time public events. There’s also an emphasis on weekly leaderboards which rank by total number of kills. The top leaderboard positions often aren’t indicative of skill level, but go those who devote the most amount of hours to playing. They also added Social Silver, and in-game currency that players can send each other. Social Silver has daily limits on sending and receiving, and requires you to be friends with those other users… cha-ching, bring in all your buddies.

Population: One was acquired by Facebook earlier this year—A company already known to manipulate its users in order to increase engagement. Check out this TED Talk with Tristan Harris about tech companies manipulating people to hold their attention. (Harris even makes small mention of AR and VR being susceptible to the same types of manipulation.)

Gaming addiction is a very real thing. The disorder is recognized by the WHO and was added to the International Classification of Diseases ICD-11th revision in 2018. Although internet gaming addiction (other than gambling) was not an officially recognized disorder by the American Psychiatry Association’s at the time of publication of the DSM-5, they did list it in a section of conditions for further research and included signs and symptoms to watch out for. You can read more about it in this WebMD article or here on Psychiatry.org.

Depression, Anxiety and Gaming

After the shock of a breakup, which caused a total change of lifestyle for me, I’ve all but quit playing video games. I’m taking time to focus on putting my life back together, and attempting to achieve some new semblance of normalcy. I’ve played maybe a total of 3 hours over the past 50 days, and come away feeling uncomfortable afterwards. It seems I may have developed an aversion to it. I began to wonder about the psychological effects of VR and gaming, especially when it is abused.

How did my VR gaming affect my mood?

The ups: While playing I’ve experienced a gaming high. When I was having fun, playing competitively and winning, I felt successful. My body chemistry rewarded me for it. My body was producing feel good chemicals like the neurotransmitters dopamine and serotonin. These can both be linked with gaming addiction. I’ve also experienced a pleasant adrenaline rush from exciting experiences.

The downs: I recognized periods of high stress and agitation as well as those times where I felt elated or manic. Feel bad (stress related) hormones adrenaline and cortisol can also be linked to gaming. VR’s hyperrealism can exacerbate this. Horror games with jump scares are a prime example of experiences that can cause this dump of stress chemicals. Prolonged playing heightened my feelings of depression and anxiety. I also experienced guilt and shame at wasting so much time in these activities, and that probably added to feelings of low self-worth or self-esteem.

…addictive video game use has been found to be related to personality traits such as low self-esteem (Ko et al., 2005) and low self-efficacy (Jeong and Kim, 2011), anxiety, and aggression (Mehroof and Griffiths, 2010), and even to clinical symptoms of depression and anxiety disorders (Wang et al., 2018). Potential consequences of video game use have been identified as well, such as a lack of real-life friends (Kowert et al., 2014a), stress and maladaptive coping (Milani et al., 2018), lower psychosocial well-being and loneliness (Lemmens et al., 2011), psychosomatic problems (Müller et al., 2015Milani et al., 2018), and decreased academic achievement (Chiu et al., 2004Gentile, 2009).

NCBI: The Association Between Video Gaming and Psychological Functioning

VR’s Relationship to Health and Social Connections

I’m not at all trying to make a claim that VR and gaming are all bad. I’d just let it take over too much of my life. There are many positive uses for the technology. I’ll list just briefly list some of both the positive and negative aspects or applications in this section. Perhaps I’ll write a more in-depth article expanding on VR’s therapeutic uses at a later date.

Positive applications of VR

Fostering social interaction: There are times and circumstances where face-to-face social interaction just isn’t possible. 2020 was a great example. As a result of COVID many people were forced to stay home. People began telecommuting to work, and services like Zoom and Google Meet quickly rose up to replace office meetings. Some get even more of a sense of telepresence using VR.

Facebook’s creative social app Horizon now has added focus on collaborative business meetings with Workrooms which lets users screen share and use interactive whiteboards, and will have Zoom integration in 2022.

AltspaceVR which was acquired by Microsoft lets users make their own worlds and host virtual events. There’s VR church, open mic nights, mindfulness groups and a variety of other community created social events. They’ve also added collaborative enterprise focused features with Altspace for Business using Microsoft Mesh.

PTSD and Phobia treatments: When used in treatment setting, VR experiences can help to alleviate phobias, trauma, and anxiety with exposure therapy. Here’s a great NY Times article on the topic.

Mindfulness and Meditation: There are a lot of applications being developed that focus on improving mindset and aiding in mindfulness. Here are a few such apps:

  • ReMind VR: Daily Meditation for Valve Index and HTC Vive on Steam
  • Meditation VR available free on Steam for Valve Index, HTC Vive, Oculus, and Windows Mixed Reality.
  • TRIPP Meditation 2.0 is an award winning meditation app for Oculus. It uses a subscription based model which boasts over 40 meditative experiences.
  • Guided Meditation VR available through Steam for Valve Index, HTC Vive, Oculus, and Windows Mixed Reality.

Exercise: One good thing about VR versus other types of gaming is that a lot of them require you to be physically active. There are also applications specifically designed to help you exercise. Here’s a few examples:

  • Supernatural a membership based fitness app claiming to have hundreds of on-demand workouts, a companion app for mobile phones, and option of pairing with a heartrate monitor.
  • FitXR another subscription based service that adds new classes daily, and a multiplayer option to workout with friends. You can choose Boxing, Dancing or HIIT routines.
  • Thrill of the Fight on Steam is a boxing game/simulator with a focus on authenticity. Supposed to be a great workout. It’s also available on Oculus Quest.
  • Dance Central the latest in this popular series of dance games now in VR.

Negative Health Effects of VR

As I mentioned above there are risks of escapism and gaming addiction and the negative effects that go with such an addiction. But there are other ways that virtual reality can effect you as well.

VR Sickness: is a nauseating feeling like seasickness. I’ve previously written a post about VR Sickness with tips for overcoming it.

Can be a trigger for anxiety: Some virtual experiences can trigger claustrophobia, anxiety, and panic attacks. I mentioned in the section above that VR can being used to treat PTSD and phobias. This is done through exposure therapy inducing manageable situations and working through the experience with a counselor—but what if you’re unprepared, aren’t expecting it, and aren’t in a treatment setting? Users may find themselves triggered and left to deal with those feelings alone.

Post VR Sadness: an odd dissociated feeling some people experience after spending time in virtual reality. Users may have a sense that the world isn’t real after a virtual experience. Here’s and interesting article on the phenomena in The Atlantic.

Can be isolating: yes there are a plethora of multiplayer and social apps available on VR, but there is also the plenty of single player games. When you stick your head in a box to play games, you’re putting on blinders to your physical environment. You may find yourself cut off from those near you.

How do you feel?

Have you experienced the positive benefits of VR, or the negative side effects of prolonged play? I’d love to hear about your experience, and your opinions on mine. Please leave a comment and let me know what you have to say on the topic.

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