Mental Health and Esports
Mental health in sports has finally been shoved into the spotlight thanks to NBA stars Kevin Love and DeMar DeRozan. One of my favorite quotes from a recent K. Love article said it best, “Mental health is an invisible thing, but it touches all of us at some point or another. It’s part of life.” In sports, we commonly tell athletes they need to “be tough” or show minimal emotion while competing. However, we are all human, and the mental portions of sports/Esports affect everyone no matter what the skill level. For example, I get tilted (upset or off your game in gaming lingo) when I play League of Legends and need to take mental breaks. If it happens to a mediocre Gold 2 jungler, you can bet it happens to all skill levels, of all ages. As most of you who read my blog consistently know, I’m not a mental health expert whatsoever. My primary focus is on desk/gaming ergonomics and proper body mechanics as you work throughout the day. Luckily, we are graced with some incredible insight from Dr. Adrienne Meier Ph.D. a mental health expert who has worked with Esports and traditional athletes alike. I’ll let her interview speak for itself.
Please introduce yourself.
My name is Adrienne Meier, Ph.D and I am a licensed psychologist practicing in Los Angeles and New York City, though my home base is in Los Angeles with Dr. Ermshar & Associates. I specialize in forensic psychology and neuropsychology, and I provide psychological assessment and therapy (including teletherapy). I aim to help individuals identify and address any areas that may be hindering them from reaching their full potential. 
Tell us a little bit about your background in the mental health field.
I have a Ph.D. in Clinical Psychology. I completed my clinical residency at New York University’s (NYU) Bellevue Hospital Center and then returned to California for a neuropsychology fellowship at City of Hope Medical Center. I’ve worked in various clinical settings including outpatient community mental health clinics, Veteran Affairs (VA) medical centers, inpatient psychiatric hospitals, and jails. Through my experience working with a wide range of clients, I have become really passionate about helping people improve their overall wellness and providing them with the tools to help them thrive personally and professionally.
What is your expert opinion with video games helping people escape or cope?
Video games have really gotten a bad rap, but they can provide an excellent outlet for coping with stress and escaping from the pressures of life, if used in moderation of course. Research suggests that using gaming as the sole method of coping or escaping can become a problem. In fact, if escaping or coping is the motivation behind why someone is gaming it can lead to addictive behaviors and decrease overall quality of life (Kardefelt-Winther, 2014). However, video games can provide an excellent, temporary distraction from life stressors. In addition, the World Health Organization (WHO) recently added “gaming disorder” as a diagnosis. However, there are mixed opinions among mental health providers about creating such a diagnosis, because video games can be beneficial and can provide an excellent, temporary distraction from life stressors.
Have you seen clients improve in their mental health using video games as an outlet?
Video games can be great tool to enhance overall wellness. Even the American Psychological Association agrees that gaming has mental health benefits. Gaming can also boost self-confidence and self-esteem, as they can provide a sense of mastery and achievement, which improves one’s perception of themselves and their abilities. In addition, gaming provides social interactions with others who have similar interests and can serve as a source of emotional support. Even though these social interactions originate in a gaming context, it can transfer into social interactions outside of gaming and result in friendships. I’ve seen clients improve their overall well-being and mental health through the use of gaming, as it provided them with a means of coping as well as a community of support.
What has been your experience with Esports, content creators and streamers, and influencers?
I provide therapy for individuals from all different walks of life, which has included individuals who participate in Esports and content streamers as well as content creators and influencers. As such, I have learned about these specific cultures as well as struggles that are unique to each. More and more people are relying on internet-based activities for their sole means of income and entertainment, so it is essential therapists become well versed in these diverse activities.
Have you noticed similarities with Esports athletes and established professional sports athletes?
Individuals who play Esports and professional sports do have some similarities, as both are engaging in highly competitive activities. Even though Esports athletes do not need to be in peak physical condition, gaming requires athleticism, unique skill, and perseverance. They also maintain a grueling practice schedule. In fact, given that Esports is not a physical activity, these athletes can train even longer and sometimes even practice up to 14 hours a day.
What would you tell an Esports athlete after a significant loss in a tournament?
There’s no doubt about it…losing sucks! However, you can choose whether or not to let a loss negatively impact your confidence and hinder your performance in future competitions. It is normal to replay the game in our minds or to rehash mistakes we might have made, but this is not productive. Given the stakes, it is unlikely an Esports athlete did not train well enough or try their best during a competition, so these are not helpful things to say to oneself. Instead, if it is possible, identify the concrete reason for a loss that is related to the game, then those issues can be addressed in future practice. However, it is important to then take proactive steps to put the loss behind you so you can move forward. Some people benefit from imagining they are turning a page in a book or newspaper, to symbolize putting the loss behind you so you can focus on your next competition. As John Wooden, a renowned college basketball coach once said, “Losing is only temporary and not encompassing. You must simply study it, learn from it, and try hard not to lose the same way again. Then you must have the self-control to forget about it.”
What trends have you seen with patients that spend prolonged periods at their desk?
My clients who make a living gaming or creating online content often struggle with taking a break, which can contribute to low mood, anxiety, and increase risk of health problems! My clients are often are engaging in the same repetitive hand movements all day (which can cause carpal tunnel) and lack any substantial activity due to the sedentary nature of their jobs. The research has consistently shown that a sedentary lifestyle negatively impacts mental health and physical health, so at the very least, it is essential to take five minute breaks to walk and move around every hour. In addition, developing an exercise routine (even if it only involves a daily walk or stretching) is imperative to ensure overall physical well-being. Even though there has been a lot of media on how sitting is the new smoking and can kill you, more recent studies have found that if you are physically fit, prolonged sitting isn’t as bad for you!
With such a toxic online environment, how do you help patients cope with that aspect?
Online communities can be toxic at times, and we have all encountered internet trolls. It is always important to take a moment to consider the source of the information. These are often individuals who don’t really know us, so whatever critiques or insults they might have are usually baseless. In fact, if you are being targeted by trolls, it likely means you are successful and these trolls are envious of your skills and accomplishments. Internet trolls desire attention, so they feed on instilling feelings of frustration and anger in whoever they are targeting. As such, one of the best ways to deal with them is to ignore them. Since they are not getting the reaction or attention they crave, this often results in them leaving you alone. At the end of the day, we only have so much emotional energy to go around, so why spend it on individuals we don’t know and don’t care about? We can be selective in how we choose to spend our time and who is worth responding to online. However, even if you can successfully ignore an online troll, you’ll still have feelings about what they are saying about you. It is important to accept these feelings and not bottle up these feelings. It can be helpful to unplug from electronics for at least a few minutes to get a break from the toxic environment, so you can address your emotions before returning to work or gaming. You can accept your feelings by channeling and expressing them through productive outlets such as journaling, meditation, and/or exercise (to name a few). It is also important to rely on your social support by spending time talking about your feelings with trusted friends, family members, or your therapist. Taking a few moments to address your feelings will improve your overall well-being and allow you to return to gaming or work with a better perspective. The goal of this blog is to provide information on all the facets of health and not just ergonomic tips. I hope this article can help you or anyone you may know that is struggling with mental health issues in gaming or any other profession. I want to thank Dr. Meier once again for taking the time for the interview and providing such great insight. You can follow Dr. Meier on Twitter @DrAdrienneMeier Thank you for reading, Dr. Drew FTW!