Gambling Addiction: What is it, symptoms and knowing when to stop
A gambling addiction, also known as pathological gambling, compulsive gambling, or problem gambling is the uncontrollable urge to keep gambling despite the toll it takes on your life, or any harmful, negative consequences. In this case, gambling means that you are willing to risk something of value in the hope of getting something of even greater value.
What is a gambling addiction
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) has re-classified a gambling addiction as an addictive disorder, and the sufferers exhibit many symptoms similar to those who have substance addictions. Gambling can stimulate the brain’s reward system much like drugs or alcohol can, leading to addiction. However, previously compulsive or pathological gambling was considered by the American Psychiatric Association (APA) to be an impulse control disorder rather than an addiction. An Impulse Control Disorder, is where the “essential feature is the failure to resist an impulse, drive or temptation to perform an act that is harmful to the person or to others.”
Several psychological mechanisms are thought to be involved in the development of a gambling addiction, but the causes of gambling addictions still aren’t well-understood. Like many problems, compulsive gambling may result from a combination of biological, genetic and environmental factors. Deficiencies in serotonin might contribute to compulsive behavior, including a gambling addiction. Problem gamblers suffer from several cognitive biases, including overconfidence, the illusion of control, and unrealistic optimism. The gambler’s fallacy is known as the incorrect belief that a series of random events will tend to self-correct so that the frequencies of winning vs losing will balance each other out. This causes the symptom of “chasing losses,” which is trying to gain back money lost because of the belief that they will win back their money eventually.
There are some risk factors that are more often associated with a gambling addiction. These include mental health disorders, age, sex, a family for friendly influence, some medications, and some certain personality characteristics.
- Mental Health Disorders – People with a gambling addiction also often have substance use problems, personality disorders, depression, or anxiety. As mentioned earlier, gambling problems may additionally be associated with bipolar disorder, obsessive-compulsive disorder (OCD), obsessive thoughts or attention-deficit/hyperactivity disorder (ADHD).
- Age – A gambling addiction is more commonly found in younger and middle-aged people. If the person begins gambling during the childhood or teenage years, it does increase the risk of developing a gambling problem.
- Sex – Gambling addictions are more common in men than women. However, women who gamble typically start later in life and they may become addicted and develop a problem more quickly. But more recently, gambling patterns among men and women have become increasingly similar.
- A Family or friend influence – If any family members or close friends have a gambling addiction, the chances are greater that you will, too.
- Medications – Some medications have a rare side effect that may result in compulsive behaviors, such as compulsive gambling, in some people. These drugs are called dopamine agonists, and are used to treat Parkinson’s disease or restless leg syndrome.
- Personality characteristics – Some personality characteristics such as being highly competitive, being a workaholic, poor impulse control, or being restless or easily bored constantly may increase your risk of developing a gambling addiction.
Gambling addictions and other mental health disorders
Pathological gambling is similar to many other impulsive behavior disorders, such as kleptomania. More current information actually shows a closer relationship between pathological gambling and substance use addictions than exists between a gambling addiction and obsessive-compulsive disorder, but OCD is considered to be a risk factor for a gambling problem. This is largely because the behaviors in a gambling disorder and most primary substance use disorders seek to activate the brain’s reward mechanisms while the behaviors characterizing obsessive-compulsive disorder are instead prompted by overactive and misplaced signals from the brain’s fear mechanisms and structures. Gambling can be seen as an example of risky decision making, and gambling games can provide a paradigm for the investigation of human choice behavior and irrationality.
Gambling addictions: Signs and Symptoms
Unlike most gamblers who play only occasionally, and who are able to stop when losing or set a loss limit, people with a gambling addiction problem are compelled to keep playing to recover their money, and set a pattern that becomes increasingly destructive over time. Signs and symptoms of compulsive gambling (gambling disorder) include:
- Being preoccupied with gambling, such as constantly planning how to get more gambling money
- Needing to gamble with increasing amounts of money to get the same thrill
- Trying to control, cut back or stop gambling, without success
- Feeling restless or irritable when you try to cut down on gambling
- Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or depression
- Trying to get back lost money by gambling more (also known as chasing losses)
- Lying to family members or others to hide the extent of your gambling
- Jeopardizing or losing important relationships, a job, or school or work opportunities because of gambling
- Resorting to theft or fraud to get gambling money
- Asking others to bail you out of financial trouble because you gambled money away
Gambling addictions: Treatments
A gambling addiction or disorder is a serious condition that can destroy lives. As gambling disorders are increasingly recognized, treatment has fallen within the realm of addiction services, however many people refuse to admit that they have a problem. Most treatment for gambling addiction issues involves counseling, peer support groups, step-based programs, self-help, medication, or a combination of all of the methods. However, no one treatment is considered to be most efficacious and no medications have been officially approved for the treatment of gambling addictions. Although treating a gambling addiction can be challenging, many people who struggle with compulsive gambling have found help through professional treatment. Cognitive behavioral therapy is often used in treating gambling addictions. Cognitive behavioral therapy uses systematic exposure to the behavior you want to unlearn, such as gambling, and teaches you skills to reduce your urge to do so. CBT focuses on identifying the unhealthy, irrational and negative beliefs that go along with compulsive gambling, and seeks to replace them with healthy, positive ones.
Antidepressants and mood stabilizers may help any problems or risk factors that often go along with compulsive gambling, such as depression or OCD. Since feeling depressed or anxious often worsens a gambling addiction, treating these disorders may make it easier to break the cycle and get back to normal life. Additionally, since substance abuse also often accompany gambling addictions, some medications called narcotic antagonists which are used often in treating substance abuse issues, may also help treat gambling addictions.
A growing method of treatment is peer support groups, such as Gamblers Anonymous. Gamblers Anonymous is modeled after Alcoholics Anonymous and uses a 12-step model that emphasizes a mutual-support approach. As online gambling has grown in popularity, many gamblers with addiction problems use online peer-support groups to aid their recovery.
References:
American Psychiatric Association. What is gambling disorder? https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder.
Gambling disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. https://www.psychiatryonline.org.
Clark, L., Averbeck, B., Payer, D., Sescousse, G., Winstanley, C. A., & Xue, G. (2013). Pathological choice: the neuroscience of gambling and gambling addiction. Journal of Neuroscience, 33(45), 17617-17623.
Domino FJ. Overview of gambling disorder. https://www.uptodate.com/home.
Eades, John (2003). Gambling Addiction: The Problem, the Pain, and the Path to Recovery. Vine Books.
Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 29, 2016
Hudgens-Haney, Matthew E; Hamm, Jordan P; Goodie, Adam S; Krusemark, Elizabeth A; McDowell, Jennifer E; Clementz, Brett A (2013). “Neural Correlates of Perceived Control and Risky Decision Making in Pathological Gamblers”. Biological Psychology. 92 (2): 365–372. doi:10.1016/j.biopsycho.2012.11.015.
Gobet, Fernand; Schiller, Marvin, eds. (2014). Problem gambling: Cognition, prevention and treatment. London: Palgrave Macmillan.
Maniaci, G., Picone, F., van Holst, R. J., Bolloni, C., Scardina, S., & Cannizzaro, C. (2016). Alterations in the emotional regulation process in gambling addiction: The role of anger and alexithymia. Journal of Gambling Studies, 1-15.
Elsie is a public health professional working in education and research. She is a lifelong learner, and is especially interested in mental and behavioral health. She loves travelling and spending time with her dog.
