The Hidden Mental Health Problem in Streaming

Video gaming has evolved from a single player experience to a social occasion where multiple players can game together or watch games streamed online. For most people, it is an enjoyable and harmless activity but for others it can cause serious mental health problems.

Three billion people worldwide play video games and around 3% struggle with gaming disorder. However, there is not enough professional help available to prevent and treat problematic gaming behaviors. Clinicians and counselors need to understand gamer culture and get equipped with specialist skills and practical tools to support streamers, gamers and their loved ones.

This blog is inspired by a recent video1 from Twitch and YouTube broadcaster Devin Nash. He has highlighted the hidden mental health problem in streaming and examines what it is about streaming that is making mental health problems so prevalent.

What is live streaming?

The live streaming of video games is an activity where people broadcast themselves gaming to a live audience online. It became popular in the mid-2010s on the streaming service, Twitch, and is now available on other platforms including YouTube and Facebook Gaming.

Streaming offers gamers the opportunity to create and present their own authentic content. As they record and broadcast in real time, there is no editing process and viewers can follow along and comment live.

It is a highly-accessible activity because all someone needs to be able to stream is an internet-enabled device and a platform to broadcast on. As a result, streaming has exploded in recent years, as demonstrated by the statistics below.

Dive Deeper: What is Twitch?

Live streaming statistics

Statista2 reports that 8.8 billion hours of video game live streams were watched globally in the first quarter of 2021, up from 3.6 billion hours in 2019. This growth in live streaming is partly down to the Covid-19 pandemic. As lockdown rules confined people to their homes, live streams offered them a way to connect and socialize virtually.

According to a recent State of the Stream report3from StreamElements and Rainmaker.gg4, in addition to Twitch and Facebook Gaming increasing over 117% year-on-year, both platforms set new viewership records in January 2021. Twitch crossed the 2 billion hours watched threshold and Facebook Gaming exceeded 439 million hours, which represented a 13% month-on-month rise.

Twitch hosts 91% of all streaming content produced. According to statistics from Twitch5:

  • One trillion minutes were watched in 2020.
  • It gets an average of 30 million daily visitors.
  • There are over 2.5 million views at a given time.
  • More than 7 million unique streamers go live every month.
  • 70% of Twitch viewers are between 16 and 34 years old.


The mental health toll of streaming

Many top streamers have suffered from mental health problems – including anxiety, depression and suicidal thoughts – and opened up about the pressures of broadcasting.

In his hidden mental health epidemic in streaming video6, Devin Nash talks about Asmongold, a popular streamer on Twitch, who recently revealed his mental health struggles and suicidal thoughts. When asked if he ever felt like Reckful (a Twitch streamer and professional esports player who took his own life in 2020), Asmongold replied: “I probably shouldn’t say that I’ve wanted to kill myself many times, yes absolutely.”

Devin Nash also mentions Twitch star Pokimane who took a month-long break from streaming in August 2020 after quarantine and overwork had burned her out. In a statement7 released on Twitter she said: “It’s been hard for me to find the same joys and motivation for making content. The things I look forward to the most, like visiting my family, traveling, going to conventions, and meeting some of you aren’t possible. Led me to feeling burnt out for quite some time. I’ve been planning to take a month off. I recognize that I’m very lucky to be able to do work during the pandemic, however, I still need to do what’s best for my mental health.”

Another streamer referred to in the video is Mitch Jones who has struggled with bouts of anxiety and depression over the last few years. In April 2021, he announced8 that he was taking an indefinite break from streaming to pursue a career in music: “I’ve been a full-time streamer for the past 10 years. I became a person that everyone who watched me wanted to see, and it slowly broke down my mental health over time. I lost some of the best people in my life, to death, or just having them leave me for all of my poor choices.” Mitch released a debut album in July 2021 called “If I Could Go Back” and stated in a press release: “I want to write songs to save people who are struggling, just like I’ve been.”

What is behind the mental health problem?

Devin Nash9 believes that streamers are suffering with mental health problems for the following reasons:

‘Always on’ mentality

Popular streamers (like Amouranth, Twitch’s top female streamer) can spend up to 90 hours a week online. There is pressure to broadcast on Twitch because if they are not streaming, their channel is effectively dead – unlike Instagram and YouTube where there is permanent content that provides value. Those who stream the most attract more followers.

Streaming takes a lot of energy interacting with chat and being entertaining. Spending up to 90 hours a week performing while often being sedentary can also a physical and mental tole.

Learn More: Health Consequences of Gaming

Direct feedback and negative bias

During livestreams, streamers receive direct and live feedback with no way to filter it. There is a constant flow of comments (positive and negative) but the brain has a tendency to internalize comments that are negative. Interaction from viewers is often relentless and extends beyond livestreams and into social media platforms as well.

Clout chasing and numbers

Fluctuating follower numbers and viewership figures can put pressure on streamers and make them feel demotivated and depressed, especially when they compare themselves with other streamers.

Parasocial relationships, harassment and stalkers

Obsessive, and sometimes violent and threatening, fans is a shockingly common part of having an influential online platform.

Dive Deeper: Asmongold on Parasocial Relationships10

Direct competition

Livestreaming platforms are highly competitive and at any time you are competing against hundreds and thousands of other creators. Viewer attention spans are low and entitlement high.

Gaming Disorder Clinical Training

gaming disorder

As the number of streamers continues to rise, there will be a greater call for gaming disorder treatment and streaming-related mental health therapy. Unfortunately, there are not enough counselors at present to meet the growing demand.

At INTENTA, our Gaming Disorder Clinical Training is accessible to clinicians and helping professionals all over the world. The 15-hour virtual course can be studied at your own pace over 45 days.

By the end of the training, you will be an internationally-recognized specialist in gaming disorder and equipped with practical strategies for prevention, treatment and recovery. Get in touch to find out more.



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