Friday 19 January 2018

Is Pokemon go! a quick fix for depression and anxiety?

Pokemon Go (Silverburn/PA Wire)
Pokemon Go (Silverburn/PA Wire)

The near universal use of social media and gaming has been the subject of much criticism. The critics point to the dangers of sitting alone, interacting with people in virtual reality and conversing with others, largely unknown to them but described as "friends". They point to the danger and horrors of life-like graphic images.

On the other hand, the enthusiasts see those who question the social media/gaming culture as killjoys who are out of touch with modern modes of communication and interaction.

'Pokemon Go!', a new computer game, released just seven weeks ago, has managed to defy the potential naysayers through the testimonials of those using it. This mobile game is built on the 'Pokemon' Game Boy games beloved by children since 1995.

My boys were enthralled by them, as were all of their school pals. The characters had cute names and loveable faces - such as the turtle named Squirtle, and Pikachu the electric mouse.

This new game is an app for the iPhone or Android phone. Once the game is loaded it requires the player to use the device's camera to search for Pokemon in the local area. A game map also directs players to nearby landmarks that help them catch these little creatures, for which they can acquire in-game rewards.

This is a game that requires the player to move around and walk varying distances in the real world - hence the suffix "Go". It seems simple and even childishly innocent as hoards of people wander the streets using their smartphone as they are guided to certain locations. There they may meet others also playing the game.

In the first month this mobile game had over 45 million daily users (although this is beginning to decline). Why the popularity? Is it just stupidity, marketing or crowd following?

The testimonials of many, including people I know, is impressive. They boast of the game's power to help them overcome crippling agoraphobia, depression or social anxiety disorder. People with severe melancholic depression who cannot get out of bed, let alone leave the house, report that the game motivates them to become more active. Many report that for the first time in months or even longer they have left home and spoken to others also playing the game.

Likewise those who are agoraphobic or cannot interact because of social anxiety disorder claim to have been enabled by the Pokemon quest to leave the comfort zone of their home and simply begin talking to people again.

There are thousands of similar positive messages on Facebook, Twitter, Reddit and others.

Of course, none of these claims has been verified scientifically, as the game is too new. There is little doubt that these will be tested in the coming months and years, using intervention studies. But randomised controlled trials will be difficult to carry out because it will be impossible for the subjects and the researchers to be unaware of which intervention they are receiving.

In its absence, there is a danger of bias because of the publicity the game has received, and also because of the enthusiasm of those in the game arm of the study compared to the comparator arm. It is unlikely that it is the characters in the game itself which are responsible for the reported positive effect on mental health, and it is more likely to be due to the effect of exercise. There is a body of scientific literature pointing to the benefits of exercise on mood due to the release of endorphins that this stimulates and that are known to improve mood.

This game was not designed as an intervention for depression or anxiety but as an activity game and should not replace recognised treatments like antidepressants or psychological interventions. 'Pokemon Go!' is ancillary to these.

The concern continues that this game fundamentally is still about people chasing virtual, non-human characters in the real world. This marks a step from searching for them in virtual reality, as in the earlier versions. Breaking the barrier between the virtual and real world in which we inhabit is a dramatic step, the impact of which is yet to be ascertained.

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