Chasing that high score could be hurting your mental health.

The potential risks of playing too many video games have been debated since arcades, home consoles and computers began going mainstream in the 1970s and 80s. But the World Health Organization announced on Monday that it is labeling “gaming disorder” as a mental health condition for the first time, and has included the term in its updated International Classification of Disease being published this year.

WHO doesn’t give a specific window for whether four hours, 12 or 24 counts as too much time gaming. It warns that the digital distraction becomes a disorder when “increasing priority [is] given to gaming to the extent that gaming takes precedence over other life interests and daily activities,” and if the person continues to play or escalates how much they play despite negative consequences, such as interfering with their work or education, dissolving their relationships and hurting their personal health.

But those players are likely a small portion of the gaming population. Dr. Joan Harvey, a spokeswoman for the British Psychological Society, told Time that parents shouldn’t necessarily panic if their kid loses track of time while playing a game. ”People need to understand this doesn’t mean every child who spends hours in their room playing games is an addict, otherwise medics are going to be flooded with requests for help,” she said.

Yet ever since WHO first warned that it was including “gaming disorder” in its first draft of its updated ICD last fall, gamers like Tracy Michelle, 27, from Queens, N.Y. have started taking stock of their screen time.

“That made me scared. I’ve been playing 10 to 14 hours a day for the past five days. A lot of people in the gaming community are asking, ‘Do I have a gaming disorder?’ and trying to confirm what the qualifications are,” she told Moneyish.

The World Health Organization has recognized “gaming disorder.” (iStock/MATJAZ SLANIC)

Michelle has been gaming for the past two decades, and recently started monetizing her past-time by streaming her own Twitch channel. She’s earned $250 a month by gaming and chatting in real-time on the social video service that’s an online hub for gamers, which is further incentive for her to stay plugged in.

“It’s very easy to lose track of time while you’re playing,” she admitted, noting she once sat down to play survival game “Ark,” where you build houses and train dinosaurs, at 2 p.m. “I said, ‘I’ll play for a couple of hours and then get work done’ … and the next time I looked at the clock, it was 11 p.m.!” she said. “My entire day had been spent on this game.”

Katy Murray, a gamer who makes around $1,000 a month streaming on Twitch under KatyRose9, told Moneyish that while she streams for four hours a day, she has recorded impromptu 12-hour streams where subscribers tune in to watch her playing new games, to get her tips for reaching achievements, or to even just chat about what’s going on in their lives.

“There’s a particular game called ‘Skyrim,’ and I played so many hours on that because you want to level up, you want to get better gear … and I really enjoyed it because I was in a different reality,” said Murray, 26, from Chicago. “It was a fantasy world, which is way more exciting than boring everyday life of: Work, pay the bills, feed the cat.”

In fact, that’s the plot device behind “Ready Player One,” the recent film adaptation of Ernest Cline’s best-selling 2011 novel of the same name. It depicts a dystopian future where the real world is such a mess, everyone stays logged into a massively multiplayer online role-playing game (MMORPG) that doubles as a virtual society.

We’re not too far from that IRL. More than 150 million Americans play video games, and the industry sold more than 24.5 billion games and raked in more than $30.4 billion in 2016. About half of those gamers are women. The Entertainment Software Association reports 41% of women play regularly, and Google research found 65% of women ages 10 to 65 in the U.S. game on mobile devices, and 43% of them play more than five times a week.  And Twitch (which is owned by Amazon) recorded 100 million viewers per month in 2014, and is expected to hit 345 million by 2019.

So health professionals are growing more concerned – especially after tragic cases like these:

  • In April 2017, a teen was killed in a fight over a Queens internet cafe console. Three young men began punching a homeless man who refused to give up his seat to let them play “League of Legends,” and the man fatally stabbed one during the melee.
  • In February 2017, a Twitch streamer died of unknown causes after streaming for 22 hours. The 35-year-old father of three was doing a marathon gaming session to raise money for charity, took a pause to take a smoke – and never returned to his screen.
  • A “League of Legends” player dropped dead of a heart attack while playing the game for 23 hours straight in a Taiwan internet cafe in 2012 – and his body sat there for nine hours before anyone realized he had passed.

“Use of the internet, computers, smartphones and other electronic devices has dramatically increased over recent decades. While the increase is associated with clear benefits to users, for example in real-time information exchange, health problems as a result of excessive use have also been documented. In a number of countries, the problem has become a significant public health concern,” a WHO spokesperson told Moneyish.  “There is increasing and well-documented evidence of clinical relevance of these conditions and increasing demand for treatment in different parts of the world.”

An Oxford study of more than 19,000 male and female gamers published in 2016 found 2% to 3% of surveyed gamers showed symptoms of being addicted. A poll from online security service ESET in 2016 found that 10% of surveyed gamers admitted to playing for 12 to 24 hours straight. And about 8.5% percent of U.S. children who play video games are addicted to them, with comparable numbers of young gaming addicts across the globe.

“These games are designed to keep you hooked,” Hilarie Cash, cofounder and chief clinical officer of reSTART Life, a treatment program for internet, video game and virtuality reality addiction, told Moneyish. “People who are building games understand the principles of behavioral psychology very well. So they build in unpredictable rewards, which is the same principle that works in gambling. We tend to get hooked if an action brings a reward frequently enough, but not too frequently.

The World Health Organization has recognized “gaming disorder.” (iStock/Voyagerix)

“And ultimately with this recognition [by WHO], we’ve finally got some leverage for our government to take it seriously, and to make efforts toward public education, research and treatment, so it’s a big deal,” she added.

But it’s not game over just yet, players say. There are also studies to show that playing video games has benefits such as increased cognitive efforts and enhanced motivation to hit long-term goals — like reaching multiple levels and ultimately winning the game — which is similar to the benefit children get from participating in sports and clubs. Gaming has also been linked with better memory and improved hand-eye coordination.

“I already have a mental disorder. I suffer from anxiety, as do many gamers in the Twitch community, and we using gaming as an outlet,” Murray said. “So while I understand why they would consider gaming a mental disorder, I think they are missing the big picture. It’s less about video games themselves, and more about what players are trying to escape from — why do they want to win this game so badly, reach this achievement or feel this adrenaline rush?”

This story was originally published in December 2017, and has been updated with the WHO officially recognizing “gaming disorder” as a mental health condition.