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updated 5/18/2006 2:28:53 PM ET 2006-05-18T18:28:53

Dear Gail: Some family members feel that my 30-year-old brother may be addicted to computer games. Some are violent games. He ignores his wife and kids, he's late for work, and he won’t answer the phone when he's gaming. He gets defensive and tends to blame others. I think he may be depressed and is trying to escape. When we casually question what he's been up to, he either ignores us or gives us snippy replies. How can we address this? — Cyber Sis

Dear Cyber Sis: You cannot force anyone to change, so there is no easy solution to your brother’s computer addiction. As you know, some people are mesmerized by computer games. They find great pleasure in these games, which can be utterly absorbing, partly because they hold out the tantalizing possibility of winning. They give players Pavlovian reinforcement — every time you win, you get a high.

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Gamblers experience a similar high. A component of this high is mediated by chemicals in the brain, such as dopamine. So there is a biological explanation for your brother’s behavior, even though he’s not an addict in the sense that if he quits he’ll exhibit obvious physical withdrawal symptoms, like sweating or heart palpitations.

Addiction to computer games and other such compulsive preoccupations often mask depression and anxiety. Playing games, like watching endless television, is definitely a means of escapism. Your brother might feel angry and burdened — feelings he might not even acknowledge to himself — by the responsibilities of his life. While killing the online enemy, he is not responsible for a family, a mortgage, an annoying boss, or a child’s tantrum.

Unfortunately, this behavior is interfering with his life. Your brother is becoming dysfunctional in terms of his job and relationships. This won’t go away on its own. It might even worsen. I suggest you broach this topic in a delicate way, not a confrontational one. You, or your sister-in-law, can say that you sense something is bothering him or he seems stressed out. Tell him you feel the computer is pushing you away from him.

Don’t let him brush you off. Chisel away at this topic. Sometimes a little of what you are saying seeps in. If this doesn’t work, and the situation does worsen, you can stage a “makeshift intervention,” where a group of his relatives gathers to express their concern, telling him “we love you and won’t let you keep doing this” and helping to arrange for treatment. In the end, however, this is something where you can’t help someone who will not help himself.

Dr. Gail’s Bottom Line: Video game addiction is very real. Sometimes people need to hit a personal rock bottom before they can take action to improve.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to “Today.” Her latest book is “Anatomy of a Secret Life: The Psychology of Living a Lie,” by Dr. Gail Saltz. She is also the author of "Amazing You! Getting Smart About Your Private Parts," which helps parents deal with preschoolers' questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, www.drgailsaltz.com.

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