Brain and Gaming

Video Gaming Effects on Mental Health

Approximately 2.7 billion video gamers were reported worldwide in 2020 and this number is likely to increase in the next years and decades with the development of new video gaming technologies such as digital technologies, including web-based and smartphone-based games delivery.

Although video gaming is entertaining, its implications on mental health are beginning to emerge through studies that evaluated its benefits and disadvantages on anxiety, depression, and cognition.

Benefits of Video Gaming on Anxiety, Depression, and Cognition

1- Benefits of Video Gaming on Anxiety

Based on 2017 estimates, 284 million people lived with anxiety disorder globally, and this number is likely to be higher now [1].  Interventions with digital technologies have been shown to improve the quality and accessibility of mental health care in high- and low-income countries [2].

Several studies demonstrated the positive effects of video gaming on reducing anxiety. Web-based video games were shown to lower anxiety levels and increase the feeling of belonging to a group in adolescent boys [3]. 

Another study included 59 participants diagnosed with depression and divided them into video game participants (30 participants) and non-video game participants (29 participants).

Using the STAI (State-Trait Anxiety Inventory) test which is designed to assess anxiety of an individual from everyday situations, the researchers showed that the video gamer group had a significantly reduced severity of state and trait anxiety compared to the non-video game participants [4].

Other studies have shown that games such as MindLight (strategy game), Max and the Magic Marker (commercial video games (CVGs)), Rayman (CVG), Nintendo Wii Exergames, and RPGs, significantly prevented or reduced anxiety after or following continual play, while exergames, video games that require physical activity or movement of the body, have been shown to combat anxiety associated with COVID-19 lockdowns [5][6].

2- Benefits of Video Gaming on Depression

Based on 2017 estimates, 264 million people lived with depression globally, and this number is also likely to be higher now [1]. Several studies reported improvement in clinical cases of depression through playing games such as Candy Crush (CVG), Angry Birds (CVG), Limbo (CVG), and casual games.

These games have been shown to decrease depression by promoting enjoyment, motivation, and flow states in veterans who were treated for mental and/or behavioral health problems, and other individuals who were diagnosed with depression [7][8].

Another study assessed the effect of commercial video games (CVGs) on participants with depression. The participants were prescribed to play CVGs for one month, three times per week (with 24 hours between each session), and for 30 minutes.

The effects were measured using the PHQ-9 questionnaire which monitors the severity of depression and response to treatment. The results showed that participants who played CVGs had significantly reduced symptoms of clinical depression [9]. These observations confirm that CVGs can also alleviate clinical depression in patients.

3- Benefits of Video Gaming on Cognition

Anxiety and depression can have effects on multiple levels of cognition ranging from effects on perception to attention to learning and executive function [10][11]. Several studies have demonstrated the benefits of video gaming on cognition, and mental health [12]. The effect of video gaming on cognition is assessed using the Stroop test and the Trail-Making Test.

The Stroop test, which was first developed by Stroop in 1935 [13], assesses the response of subjects to stimuli based on characteristics other than those typical of most relevant and more readily apparent ones. For example, naming the colors of displayed words instead of naming the words.

The Trail-Making Test (TMT) relies on drawing lines between circles that contain consecutive numbers (e.g., 1, 2, 3…etc.) to evaluate both the memory and executive function of the subjects.

The results of one of the studies investigated the effects of video gaming on cognition and showed that video gamers respond faster to the Stroop test, but make significantly more errors compared to non-video gamers.

In the Trail-Making test, video gamers had faster response times, but errors did not differ from those in non-video gamers. The study’s authors concluded that video gamers possess enhanced processing speed and task-switching ability; however, they favored speed over accuracy on the task that evaluated cognitive inhibition ability compared to non-video gamers [14]. 

Disadvantages of Video Gaming on Mental and Physical Health

Although many studies demonstrated the benefits of video gaming on anxiety, depression, and cognition, other studies also highlighted the negative effects. These effects were shown to be associated with increased violence, headaches, stress, obesity, and harm to the vision (eyes).

In a study that tested the idea that violent video game exposure (VVE) influences the player but also the player’s social network, it was found that aggressive video games can increase aggressive behaviors and desensitization to violence which could spread among connected individuals that did not play violent video games [15].

A study included 87 participants who played a violent or nonviolent game for 20 minutes and were asked to read a stress-provoking story aloud while their voices were recorded. The researchers found that voice stress was higher among violent video game players than among nonviolent video game players [16]. 

The effect of video gaming on headaches was evaluated by a study that included 954 adolescents who answered a questionnaire about the use of video games, and the presence of headaches. The results showed an association between excessive use of video games and the presence of headaches, that could develop into a migraine-type [17].

Physically, the effect of video gaming can lead to obesity, especially, when playing for long hours video games that do not require physical activity or movement of the body such as exergames. Obviously, long hours of exposure to video games’ screens can also affect the eyes and harm the vision.


Besides exposure to violent video games that can lead to aggressive behaviors and the length of time playing video games that can damage the eyes, promote obesity, and increase headaches, video gaming appears to be beneficial in decreasing anxiety and depression, and in improving cognition in individuals.

Additionally, because of their wide availability and lower cost compared to medication-based therapies, video games can be used as an alternative therapy to traditional mental health care for some mental health issues such as anxiety and depression.


[1] Ritchie, H. and Roser, M., 2018. Mental health. Our world in data. Retrieved May19, p.2020.

[2] Naslund, J.A., Shidhaye, R. and Patel, V., 2019. Digital technology for building capacity of non-specialist health workers for task-sharing and scaling up mental health care globally. Harvard review of psychiatry27(3), p.181.

[3] Ohannessian, C.M., 2018. Video game play and anxiety during late adolescence: the moderating effects of gender and social context. Journal of affective disorders226, pp.216-219.

[4] Fish, M.T., Russoniello, C.V. and O’Brien, K., 2014. The efficacy of prescribed casual videogame play in reducing symptoms of anxiety: a randomized controlled study. GAMES FOR HEALTH: Research, Development, and Clinical Applications3(5), pp.291-295.

[5] Zayeni, D., Raynaud, J.P. and Revet, A., 2020. Therapeutic and preventive use of video games in child and adolescent psychiatry: a systematic review. Frontiers in psychiatry11, p.36.

[6] Viana, R.B. and de Lira, C.A.B., 2020. Exergames as coping strategies for anxiety disorders during the COVID-19 quarantine period. Games for health journal9(3), pp.147-149.

[7] Carras, M.C., Kalbarczyk, A., Wells, K., Banks, J., Kowert, R., Gillespie, C. and Latkin, C., 2018. Connection, meaning, and distraction: A qualitative study of video game play and mental health recovery in veterans treated for mental and/or behavioral health problems. Social Science & Medicine216, pp.124-132.

[8] Pine, R., Fleming, T., McCallum, S. and Sutcliffe, K., 2020. The effects of casual videogames on anxiety, depression, stress, and low mood: a systematic review. Games for health journal9(4), pp.255-264.

[9] Russoniello, C.V., Fish, M. and O’Brien, K., 2013. The efficacy of casual videogame play in reducing clinical depression: a randomized controlled study. GAMES FOR HEALTH: Research, Development, and Clinical Applications2(6), pp.341-346.

[10] Gotlib, I.H. and Joormann, J., 2010. Cognition and depression: current status and future directions. Annual review of clinical psychology6, pp.285-312.

[11] Robinson, O.J., Vytal, K., Cornwell, B.R. and Grillon, C., 2013. The impact of anxiety upon cognition: perspectives from human threat of shock studies. Frontiers in human neuroscience7, p.203.

[12] Kowal, M., Conroy, E., Ramsbottom, N., Smithies, T., Toth, A. and Campbell, M., 2021. Gaming Your Mental Health: A Narrative Review on Mitigating Symptoms of Depression and Anxiety Using Commercial Video Games. JMIR Serious Games9(2), p.e26575.

[13] Stroop, J.R., 1935. Studies of interference in serial verbal reactions. Journal of experimental psychology18(6), p.643.

[14] Kowal, M., Toth, A.J., Exton, C. and Campbell, M.J., 2018. Different cognitive abilities displayed by action video gamers and non-gamers. Computers in Human Behavior88, pp.255-262.

[15] Greitemeyer, T., 2018. The spreading impact of playing violent video games on aggression. Computers in human behavior80, pp.216-219.

[16] Hasan, Y., 2017. Violent video games increase voice stress: An experimental study. Psychology of Popular Media Culture6(1), p.74.

[17] Xavier, M.K.A., Pitangui, A.C.R., Silva, G.R.R., Oliveira, V.M.A.D., Beltrão, N.B. and Araújo, R.C.D., 2015. Prevalence of headache in adolescents and association with use of computer and videogames. Ciencia & saude coletiva20, pp.3477-3486.

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