Kantachai, 21, does not believe gaming for 10 hours nonstop is an issue as long as he is able to space the time between his playing to accommodate other activities.
"Gaming is my hobby. I don't see a problem with playing for long hours because it does not cause others any trouble," said the 4th year student.
As a child, Kantachai was bullied for being fat at school. His parents got divorced, and he was raised by a single mum. This led him into gaming in the hope of finding companionship. Gaming, he said, helps him feel less isolated and he meets many new friends online.
"Game addiction is better than drug addiction," he said. And even when his grades began to fall and he admits to having "heard the sound of a game" in his head while in class, the university student believes that he's still a "normal person" in every way.
Another student, who requested anonymity, said that he can play video games for eight hours a day during his summer break.
"But during academic term, I play a maximum of five hours a day," he said.
"It does not impact my health in any way," he added. "I have made many friends through gaming. We are pretty close as all of us play the same games and it is also more fun when you play with other people. It has not made a negative impact on my life. Not yet."
In June, "Gaming Disorder" was included in a new draft of the World Health Organization's (WHO) International Classification of Diseases, the highly regarded compendium of medical conditions. And though the medical community is still working out the finer details on what constitutes addiction, extreme gaming is officially a disorder. The announcement by the WHO sent a ripple through mental health and technology circles, prompting scrutiny and revision of so many areas, from addiction treatment to health insurance and the continuing expansion of the gaming industry.
Thailand has shown great concern over this new psychological condition. In February, the Department of Mental Health revealed that the number of children diagnosed as addicted to gaming had increased by six times from 2015. At the moment, the Institute of Youth Mental Health has 429 cases of gaming addiction, or one-third of all youngsters diagnosed with psychiatric conditions. An unofficial estimate by the institute states that 1.6 million Thai children risk developing an addiction to gaming.
"The advent of mobile technology has made it easier for people from all age groups to get drawn towards gaming, and if not controlled, become addicted to it," said Dr Apichat Jariyavilas, a psychiatrist and spokesperson for the Department of Mental Health, Ministry of Public Health
"Two decades ago, playing computer games took on a very different meaning. It meant having to either walk to the gaming parlour to play or set up a computer in the house. This in a manner controlled the hours people played. Today everyone can play on their mobile phones and tablets at any hour of the day. Mobiles go with us everywhere; school, office and social events, making it all the more difficult to restrain yourself from putting a time limit on playing."
According to the WHO, a person develops gaming disorder if he or she has "impaired control over the onset, frequency, intensity, duration, termination, or context of gaming; increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and the continuation or escalation of gaming despite the occurrence of negative consequences".
But the manual of the American Psychiatric Association calls excessive video gaming a "condition" but not a formal diagnosis or disease. It says more research is needed to determine if it qualifies as an addiction. The only behaviour classified as an addiction in the association's diagnostic manual is compulsive gambling.
The Thai Department of Mental Health said that "game addiction" is manifested by frustration when not playing, mild depression and aggressive behaviour, and it's closely related to symptoms such as anxiety.
Dr Apichat said gaming has its place as a tool to de-stress, when used in moderation. However, its overuse can impact the person's human relationship skills with friends and loved ones, followed by the inability to keep up with career and schooling responsibilities, and lastly leave them with poor emotional and physical health.
Dr Apichat remarked that gaming disorder can manifest in restlessness and/or irritability when unable to play, and a preoccupation with thoughts of online activity, some also resort to lying to friends or family members regarding the amount of time spent playing, while others distance themselves from daily activities in order to spend more time gaming.
He said Thais have a misconception that video games can be played for an indefinite number of hours without repercussions.
The psychiatrist explained: "Research tells us there are elements of addiction attached to gaming. The more stimulating elements the game has the more addictive it becomes. That is why it is pivotal to create an awareness that gaming disorder is no longer restricted to children but rather adults of all ages as well, it is real and can impact lives for the worse if it is not controlled."
Moreover, family and friends can also keep any eye on loved ones that may be getting addicted to video games, the doctor said, as there are always physical telltale signs like fatigue, poor personal hygiene, migraines and more.
In the US, many parents still rely on "Google and word-of-mouth" when finding treatment for their children's gaming behaviour, according to The New York Times.
"No formal organisation exists to set treatment standards and answer questions," the report said, adding that "in Asia, a centre of video game activity and addiction, rehabilitation centres designed to stamp out uncontrollable playing have existed for years. South Korea bars young players from online gaming portals between midnight and 6am and subsidises some gaming addiction treatment clinics".
Besides the state Department of Mental Health, private rehabilitation centres in Thailand -- some of them positioned in the high-end market -- also offer a treatment specifically for online and gaming addiction.
Counselling, medication and behavioural monitoring, said the Department of Mental Health, are some of the treatment methods, and it takes up to six months to see progress. At the moment, the department is working with teachers and parents to design a checklist that will help filter children who display a risk of excessive gaming.
"Choose games for your child, limit the amount of time they can play and encourage other activities," said child psychiatrist Wimolrat Wanpen. "That's a start."
