Dave Taylor always knew his lust for playing "Fallout" and "Total Annihilation" bordered on the pathological. The video games would hold the West Hollywood software programmer in such a vise-like grip that he'd often play for 24-hour stretches, forestalling sleep, skipping meals and twisting himself in knots to delay bathroom breaks.
"It's super unhealthy," he said. "But man, I'm just so swept away in another world and so focused on my goals that I don't care. It hurts to be away from the game."
Now some doctors are lobbying to give his condition a formal medical diagnosis -- video game addiction.
The American Medical Assn. is scheduled to debate such a proposal in Chicago on Sunday, then vote on it early next week. Backed by the Maryland State Medical Society, the proposal advocates that the Diagnostic and Statistical Manual of Mental Disorders, considered by many psychiatrists to be the final word for assessing mental illness, include video game addiction.
The proposal also would have doctors exhort parents to curb their children's use of the Internet, television and video games to two hours a day. In addition, it would have the AMA, the influential physician organization with 250,000 members, lobby the Federal Trade Commission to improve the current system for rating video game content.
Getting the AMA to deem video game addiction a psychiatric disorder is the first step in a long process required to create a new mental health diagnosis. The ultimate arbiter is the American Psychiatric Assn., which publishes the authoritative DSM guide on mental disorders, currently in its fourth version. Getting APA approval could take years.
Executives in the $30-billion game industry are already on the defensive. They say the measures are not supported by scientific evidence.
"The American Medical Assn. is making premature conclusions without the benefit of complete and thorough data," said Michael Gallagher, president of the Entertainment Software Assn., a trade group that represents video game publishers.
But doctors in favor of the proposal say the condition exists and needs to be recognized by the medical establishment so it can be properly treated.
It's already happening in South Korea. In 2005, government officials there sent psychologists into Internet gaming cafes to warn players of addiction dangers after a man died of heart failure brought on by exhaustion and dehydration after a 50-hour binge playing "World of Warcraft." A spokesman for Blizzard Entertainment, the game's Irvine-based creator, declined to comment on the case.
Physicians in the U.S. are concerned about the exposure children have to media violence, particularly in a medium as engaging as games. They're also alarmed by the growing popularity of risque fare such as "Grand Theft Auto: Vice City" and "Manhunt 2." The latter, which features a mentally ill patient on a killing spree, was recently banned for sale in Britain and Ireland, with officials citing "unremitting bleakness and callousness of tone." In the U.S., the game received an "Adults Only" rating from the Entertainment Software Rating Board, a designation that would make the title unavailable at major retailers including Wal-Mart Stores Inc., which refuses to carry adult titles.
Take-Two Interactive Software Inc., the game's New York-based publisher, said Thursday that it was temporarily suspending the game's release, which had been planned for July 10.
But addiction also can be triggered by casual games that don't involve anything more frightening than a "game over" message, said Maressa Hecht Orzack, director of the Addiction Studies Center at McLean Hospital in Belmont, Mass., and an assistant clinical professor at Harvard Medical School.
Orzack diagnosed herself as being addicted to solitaire in 1995. Her late husband would find Orzack draped over her keyboard, fast asleep in the middle of a game. Lacking sleep, she sometimes turned up late for her appointments or missed them altogether.
Now Orzack, a clinical psychologist, treats half a dozen patients for video game addiction and fields a dozen requests each day from other people seeking treatment.
"They're desperate for help," Orzack said. "They drop out of school. They lose their jobs. They don't get to meals. Often, they lose sleep because they're up late playing games. They also jeopardize their relationships with their family and friends. It can get so out of control."
Liz Woolley started to see some of these symptoms in her son, Shawn, when he started playing an online multiplayer game called "EverQuest," which players jokingly call "EverCrack." As her son became increasingly involved with the game, he started withdrawing from his friends and family.
Shocked by the transformation, Woolley, of Harrisburg, Pa., tried to get help for her son. She was disappointed when the psychiatrists he saw treated him for depression, not addiction.