Dr. Alok Kanojia, known as Dr. K, is a Harvard-trained psychiatrist specializing in addiction. He addresses mental health issues within the Twitch audience, which is largely made up of gamers.

Transcript

RACHEL MARTIN, HOST:

All right. So there's a long history of giving personal advice using the mass media. Dr. Joyce Brothers was a psychologist on TV starting in the 1950s. She opened the door for others, Dr. Ruth, Dr. Phil, Dr. Drew. And now, on the livestreaming platform Twitch, there's Dr. K. NPR's Andrew Limbong looks at how Dr. K addresses mental health for an online community. Just a warning, this piece addresses mental health issues, including suicide.

ANDREW LIMBONG, BYLINE: Dr. K is on Twitch talking to a streamer who goes by Hafu.

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HAFU: My entire gaming career, I've always had people tell me I don't deserve it. And...

LIMBONG: She's talking about insecurities she's faced being a woman in the male-dominated space of video games and then feeling bad for feeling insecure. Dr. K offers this.

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ALOK KANOJIA: So I think that what you have is this ball of undigested emotion.

LIMBONG: Dr. K says emotions and hurt from Hafu's past feed into how she reacts to things today.

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KANOJIA: And what I'm telling you is that it's in my experience - and I feel pretty confident about this - you can digest that emotional energy. And once that emotional energy has been digested, the insecurity is gone.

LIMBONG: Unprocessed emotions are a common theme in the HealthyGamer_GG Twitch channel, where Dr. K will talk to guests in front of his more than 400,000 followers and ask them about their mental health. Dr. K is Dr. Alok Kanojia, a Harvard-trained, licensed, practicing psychiatrist specializing in addiction. But he thinks the mental health care system isn't equipped to handle a glut of new challenges, apps being designed to keep us scrolling, games built to never end, trolling, burnout. On his stream, Kanojia encourages listening, letting yourself be vulnerable and cry. And he guides people through meditation techniques.

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KANOJIA: So close your eyes. And I want you to feel the space between your hands.

LIMBONG: HealthyGamer was co-founded by Kanojia and his wife Kruti years before their Twitch stream started. As an undergrad, Kanojia played a lot of video games - Starcraft, Diablo II, Warcraft III. And he told me it got to be too much.

KANOJIA: And so the more overwhelmed I would feel, the more I'd play video games. And the more I would play video games, the more overwhelmed I would feel. And it turned into a vicious cycle.

LIMBONG: He found his way out of the cycle after studying meditation and yoga in India. A few years later, Kanojia was training to be a psychiatrist and asking teachers and mentors about gaming addiction and how to solve it. Nobody had the answers. So he asked his gaming peers about their mental health and found a few common threads.

KANOJIA: Challenges around social anxiety. They have challenges around confidence, lacking purpose or meaning.

LIMBONG: He talked to groups of them informally, teaching them about meditation and mental health care. This grew into what HealthyGamer is now, not just the Twitch stream. They also offer a program where you can talk to a trained peer counselor. Twitch actually partnered with HealthyGamer to offer the peer counseling to some of its biggest gamers, like Addie Nicole Amick. She sings for the band Halocene, which has been on Twitch for years playing songs, interacting with fans.

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HALOCENE: (Singing) Not sure why I feel this way. But I'm going to let it rain.

LIMBONG: Being on Twitch is the thing that provides her income. But having to be on all the time in front of thousands of people takes its toll. She says HealthyGamer demystified mental health and therapy for her.

ADDIE NICOLE AMICK: This is for people that just are struggling with everyday stuff. And it's not that scary. It's not that weird.

LIMBONG: Dr. K is careful to say that his streams on Twitch aren't therapy.

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KANOJIA: Just a reminder that everything we talk about on stream is for educational purposes only.

LIMBONG: And participants give written consent before they appear. But being a licensed psychiatrist and having talks that look a lot like therapy on Twitch puts him in a hazy ethical position. Here's Rachel Kowert, a psychologist and research director for Take This, a mental health nonprofit serving the gaming community.

RACHEL KOWERT: For me, the line is that mental health advocates do not generally provide direct recommendations or opinions about individual cases, whereas mental health professionals do.

LIMBONG: And sometimes, it's unclear which role Kanojia's playing. For instance, here's an exchange from 2019 with popular e-sports player Byron Bernstein, known as Reckful. Bernstein tells Dr. K he'd been diagnosed with bipolar disorder and depression.

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KANOJIA: You may have clinical depression. But I think what you're describing is not clinical depression.

LIMBONG: For Kowert and other critics, this stream crossed the line from advocate to professional. Kanojia told me he chose his words very carefully here to not contradict from Bernstein's previous diagnosis. Last summer, sadly, Bernstein took his own life. After Dr. K heard the news, he went on stream.

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KANOJIA: And I can do a lot, guys. I really can. And I tried with Reckful, I really did.

LIMBONG: Then he asked his audience to help him and each other.

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KANOJIA: You be vulnerable. You share. Don't worry alone. Remember that your struggles are a multiplayer game, too. If you want to help someone else, start by asking for their help.

LIMBONG: Because, he said, he couldn't do it alone.

Andrew Limbong, NPR News.

(SOUNDBITE OF LIAM THOMAS' "BITTER FEELING")

MARTIN: If you or someone you know is having suicidal thoughts, reach out for help. The National Suicide Prevention Lifeline is open 24 hours a day, 800-273-8255.

(SOUNDBITE OF LIAM THOMAS' "BITTER FEELING") Transcript provided by NPR, Copyright NPR.