For many people, gambling is harmless fun, but it can become a problem. This type of compulsive behavior is often called "problem gambling."
A gambling addiction is a progressive addiction that can have many negative psychological, physical, and social repercussions. It is classed as an impulse-control disorder.
It is included in the American Psychiatric Association (APA's) Diagnostic and Statistical Manual, fifth edition (DSM-5).
Problem gambling is harmful to psychological and physical health. People who live with this addiction may experience depression, migraine, distress, intestinal disorders, and other anxiety-related problems.
As with other addictions, the consequences of gambling can lead to feelings of despondency and helplessness. In some cases, this can lead to attempts at suicide.
The rate of problem gambling has risen globally over the last few years. In the United States in 2012, around 5.77 million people had a gambling disorder that needed treatment.
Because of its harmful consequences, gambling addiction has become a significant public health concern in many countries.
Some of the signs and symptoms of problem gambling include:
Gambling is not a financial problem, but an emotional problem that has financial consequences.
It also impacts the way in which the person with the disorder relates to his or her family and friends. For instance, they may miss important events in the family, or they might miss work.
Anyone who is concerned about their gambling might ask "Can I stop if I want to?" If the answer is "no," it is important to seek help.
For a diagnosis of gambling addiction, The DSM-5 states that a person must show or experience at least four of the following during the past 12 months:
- Need to gamble with increasing amounts of money to feel excitement
- Restlessness or irritability when trying to stop gambling
- Repeated unsuccessful attempts to stop, control, or reduce gambling
- Thinking often about gambling and making plans to gamble
- Gambling when feeling distressed
- Returning to gamble again after losing money
- Lying to conceal gambling activities
- Experiencing relationship or work problems due to gambling
- Depending on others for money to spend on gambling
Gambling can lead to a range of problems, but the addiction can happen to anyone. No one can predict who will develop an addiction to gambling.
The activity can be described on a spectrum, ranging from abstinence through recreational gambling to problem gambling.
Gambling behavior becomes a problem when it cannot be controlled and when it interferes with finances, relationships, and the workplace. The individual may not realize they have a problem for some time.
Many people who develop a gambling addiction are considered responsible and dependable people, but some factors can lead to a change in behavior.
These could include:
- traumatic circumstances
- job-related stress
- emotional upheaval, such as depression or anxiety
- the presence of other addictions
- environmental factors, such as friends or available opportunities
Some people who are affected by gambling may also have a problem with alcohol or drugs, possibly due to a predisposition for addiction.
The use of some medications has been linked to a higher risk of compulsive gambling.
Secondary addictions can also occur in an effort to reduce the negative feelings created by the gambling addiction. However, some people who gamble never experience any other addiction.
Some factors increase the risk. These include:
- depression, anxiety conditions, or personality disorders
- other addictions, such as drugs or alcohol
- the use of certain medications, for example, antipsychotic medications, and dopamine agonists, which have been linked to a higher risk of a gambling addiction
- sex, as it is more likely to affect men than women
For someone with a gambling addiction, the feeling of gambling is equivalent to taking a drug or having a drink.
Gambling behavior alters the person's mood and state of mind.
As the person becomes used to this feeling, they keep repeating the behavior, attempting to achieve that same effect.
In other addictions, alcohol, for instance, the person starts developing a tolerance. An increasing amount of alcohol is necessary for the same "buzz."
A person who has an addiction to gambling needs to gamble more to get the same "high." In some instances, they "chase" their losses, thinking that if they continue to engage in gambling, they will win back lost money.
A vicious circle develops, and an increased craving for the activity. At the same time, the ability to resist drops. As the craving grows in intensity and frequency, the ability to control the urge to gamble is weakened.
This can have a psychological, personal, physical, social, or professional impact.
Neither the frequency of gambling nor the amount lost will determine whether gambling is a problem for an individual.
Some people engage in periodic gambling binges rather than regularly, but the emotional and financial consequences will be the same.
Gambling becomes a problem when the person can no longer stop doing it, and when it causes a negative impact on any area of the individual's life.
In general, treatment is split into three types:
- Therapy: This could be behavior therapy or cognitive behavioural therapy (CBT). Behavior therapy helps an individual reduce the urge to gamble by systematically exposing them to the behaviour. CBT helps change the way in which the individual feels and thinks about gambling.
- Medications: Mood stabilizers and antidepressants can help reduce symptoms and illnesses that sometimes appear with gambling addictions. Some antidepressants may reduce the gambling urge, too. Narcotic antagonists — drugs used to treat drug addictions — may help some compulsive gamblers.
- Self-help groups: Some find it helpful to speak with others in a similar situation.
Casinos and lotteries provide the opportunity to gamble. A gambling addiction occurs when a person can no longer control the compulsive behavior.
Any type of gambling — whether racing, bingo, card games, dice games, lottery, slots, and sports betting — can become problematic. However, some types of gambling have particular characteristics that may intensify the problem and the consequences.
Reports indicate that a significant risk factor may be a fast speed of play. Types of games where there is a short time between placing a bet and seeing the results present a higher risk for players. This happens with slot machines, for instance.
Gambling is widespread. Increased accessibility, for example, through online gambling, calls for greater awareness and appropriate legislation.
Anyone who provides gambling services has a responsibility to develop policies and programs to address underage and gambling addictions.
Research, treatment, and prevention of problem gambling should be encouraged.
If a person suspects they might have a gambling problem, there are a variety of self-tests available on the internet.
Those tests will not give a diagnosis and do not replace a face-to-face evaluation with a trained clinical professional, but they can help people decide whether to seek formal evaluation of their gambling behavior.
A clinical professional will provide a detailed assessment and develop an adequate treatment plan, based on the individual's needs.
Treatment and assistance may need to address various aspects of the person's life, family, education, financial issues, any legal problems, and professional situation.
Anyone who suspects that they have a gambling addiction should seek help. A health provider will be able to refer the person to an appropriate treatment provider.
Advice from the APA for those who care for a person with a gambling addiction includes the following:
- seek support, for example, through self-help groups
- recognize the person's good qualities and avoid excluding them from family life
- remain calm when discussing gambling with the individual and refrain from preaching, lecturing, or getting angry
- be open about the problem, including with children
- understand that treatment is necessary and can be time-consuming
- set boundaries regarding family finances and avoid paying off the individual's gambling debts
Anyone who is concerned about problem gambling can obtain confidential support 24/7 through the National Problem Gambling Helpline on 1-800-522-4700.