Dr. Alok Kanojia is pioneering a new approach to mental health — utilizing streaming platforms like Twitch to empower young men to overcome tech addiction and build more supportive communities.
Alok Kanojia, M.D., M.P.H.
Co-Founder, Healthy Gamer
What inspired you to shift from traditional psychiatry to creating mental health content for the gaming community?
Technology is affecting our brains in a way that we’ve never seen in the history of humanity. We have a new kind of addiction, one that affects basically all of our major brain circuits. Gaming gives us a sense of identity, gives us a sense of accomplishment, gives us community, and gives us a way to manage our emotions. I saw a generation of young men lose their lives to gaming, pornography, and technology, and it seemed like the “answers” we have were insufficient. How much does one hour a week of therapy help someone who is 25 years old, living at home, poor job prospects, atrophied social skills, difficulty with motivation, and crippling loneliness? This isn’t something that I thought could be fixed with a pill or even weekly psychotherapy. Gamers needed a way to detox their brains and re-engage in life.
While there were trials on psychotherapy or medications for gaming addiction, I hadn’t seen anyone else tackle the scope of the problem the way I thought it needed to be done. My journey to overcome addiction took the better part of a decade, and it involved traveling to ashrams in India, Korea, and Japan. Most gamers don’t have that option. So, I decided to build something that would help gamers in as many dimensions as I could — by empowering them with the latest in neuroscience and psychology, by teaching meditation, and even by helping them practice asking out their crush. The goal was to help them re-integrate into the real world, which is the ultimate cure for gaming addiction. You have to have a life worth living, one that is more enjoyable than a video game. Then the game just becomes recreation.
My journey started with video game addiction. My parents were wonderful — they were loving, caring parents. They’re both doctors, actually, so they understood medicine and, to a certain degree, addiction, but they were just outgunned. Technology has grown so much and has become so invasive and incredibly addictive. I ended up basically failing out of college. After one year, I was on academic probation. After the second year, things were not very optimistic.
My parents tried everything — they tried tough love, they tried love-love — but nothing was working. My dad told me to go to India, and I wasn’t quite sure what I would find there. I ended up staying at an ashram for about three months, where I was introduced to meditation. I fell in love with it and decided to become a monk.
I spent seven years studying to become a monk, which really helped me overcome my addiction. But I ended up meeting my wife, so the whole monk thing didn’t work out. I had to figure out what to do with my life. I was 27 or 28 years old at that point and decided to go to med school. So, I became a psychiatrist, trained at Harvard, and was on faculty there for a couple of years.
When I was training about 10 years ago, around 2015, I asked my mentors — brilliant leaders in the field of psychiatry — what they thought about video game addiction. They said they weren’t really too sure about it. I realized that they’d never played a video game, so they didn’t have firsthand experience with the problem.
That’s when I started really focusing on tech addiction and combining my lived experience of struggling with addiction and failing out of college with some of the Eastern concepts I had learned, like mindfulness. My goal was to help gamers, particularly younger versions of myself — teenagers, young adults, 25-year-olds living in their parents’ basements who hadn’t had a job and played video games all day.
That’s where we started. Over time, as we grew in that community (which is now the majority of our audience), their parents started reaching out, too. At the time, there wasn’t even a formal diagnosis, and even today in the United States, there isn’t one. The World Health Organization has a kind of prospective diagnosis. So, I started just talking to gamers, working with people who were like younger versions of myself, predominantly young men in their late teens and early 20s, struggling to get life on track. I worked with hundreds of gamers over the next couple of years.
Eventually, I started streaming on Twitch, providing education about technology, how your brain works, and how to control your mind. We became the fastest-growing stream on Twitch for about three months. Now, we’re watched by 10-15 million people a month.
What mental health practices do you recommend for men who struggle with self-worth and motivation?
In order to understand what I recommend, we have to start by understanding how it works. Our self-worth is inversely correlated with the degree of judgment we face. When I’m judged harshly and constantly, like by overly critical parents, my self-worth will drop. The more we get judged, the lower our self-worth drops. When we use social media, there is a constant, implicit judgment. You see people who make more money than you do, who are more fit than you are, who are dating women who are out of your reach. Each time you see this, there is a subconscious comparison, and your self-worth will drop. There are numerous studies that show that social media usage correlates with low self-esteem and higher rates of conditions like body dysmorphia. So, the most important thing to do is limit your social media — 30-60 minutes, once a day. Checking throughout the day is terrible for your mental health.
For motivation, the most important thing to do is to avoid dopaminergic technology for the first 1-4 hours after you wake up. When we use technology, our dopamine stores get depleted. Once our dopamine is depleted, our drive to act drops. Once our motivation drops, the natural desire to be productive gets substituted with willpower, which also drains over time. Dopamine gives us 3 things: pleasure, cravings, and behavioral reinforcement. So when we release a bunch of dopamine through technology, we crave technology, and we use more technology. On the flip side, if we avoid tech usage for the first 1-4 hours of the day, when we work, we will have more dopamine released. Work will feel more pleasurable, we will even start to crave work. We want to feel productive again. We love feeling productive. If this sounds hard to believe, think about this: What is more fun, working for four hours and then gaming, or gaming for four hours and then working? The difference is the way our dopamine is depleted.
How do we begin to redefine masculinity in a way that includes vulnerability and self-compassion?
If we want to redefine masculinity, we have to understand how things are defined in the first place. One brutal lesson I’ve learned as a psychiatrist is that we learn how to be compassionate toward ourselves by how compassionately we are treated. A child learns to be proud of themselves because their parents are proud of them. When others treat us with compassion, we follow that modeling and treat ourselves with compassion. One of the biggest mistakes I see in how we treat masculinity is that it is viewed as a problem for men to solve by themselves, not a problem that all of society is responsible for. Self-compassion, unfortunately, comes from the outside.
How do we build more emotionally supportive communities for men, both online and in real life?
The biggest thing we need is communities that can hold and not overly react to a man’s emotions. There is research that shows that even therapists have difficulty handling a man’s emotions, especially anger. Men are taught that one emotion is acceptable — anger. If someone takes advantage of you, don’t cry in the corner like a little bitch. Get pissed and make it right. Righteous anger is the ideal of manhood. A man doesn’t play the victim. A man takes responsibility, makes things right. That emotion is anger. Yet, when men become angry, they are seen as predators. If we want emotionally supportive communities for men, we need to support them with their emotions, not just pick and choose which emotions are okay and not okay.
What do you believe is missing from the current mental health conversation for men?
Men are seen as being the problem, not having problems. Men are faced with impossible expectations. We want them to be vulnerable and compassionate, but we don’t teach them how to understand or regulate their emotions. Most women want men who earn more than they do, but college graduates are becoming predominantly women. Society sets high expectations for men, but it doesn’t help them in achieving these expectations. What we’re left with is a minority of men who excel, and the majority who are left behind. Mental health for men is a societal problem, not a men’s problem. We see real change when society as a whole acknowledges and takes responsibility for problems.
