Key points

Studies report problematic gaming prevalence at 3–6% of teens worldwide, with higher rates in Asia.

Impulsivity, depression, a hyperactive reward system and emotional dysregulation may underlie gaming disorder.

Many gaming adolescents over-consume highly caffeinated drinks.

Excessive gaming for hours without breaks is a symptom of a behavioral problem and a coping strategy. Lonely, depressed adolescents often turn to gaming—offering connection, stimulation, and escape. Yet gaming may temporarily soothe distress, but also may worsen it, creating a cycle of plummeting mood and withdrawal from healthier social interaction. Large cross-sectional studies have consistently demonstrated that adolescents with high problematic gaming levels also report more depressive symptoms, lone

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