Gambling, for some people, is a leisure activity that offers a night out on the town enjoying time with friends and family, with a distant possibility of winning money. For other people, the stakes are higher. After all, gambling is a $40 billion dollar industry in the United States. In Las Vegas alone—the unofficial gambling capital of the world—the casinos bring in over 10 billion dollars from people placing bets. Though many of those people only gamble once in awhile, there are people who make gambling the center of their universe. In other words, they are addicted to gambling.
What is compulsive gambling? Compulsive gambling is the uncontrollable urge to keep gambling despite the toll it takes on your life. Compulsive gamblers may continually chase bets, lie or hide the behavior, and may resort to theft or fraud to support the addiction. Common symptoms reported by people with compulsive gambling. Compulsive Gambling Symptoms, Causes and Effects Gambling is one of the most insidious of human vices, as it presents the illusion of easy money yet can quickly lead to financial ruin. The odds are never in your favor whether it is poker, blackjack or anything else; gambling is a successful industry because the house always wins.
The temptations to gamble are everywhere and you don’t need to be in a casino to try your luck. Every state in America, with the exception of Utah and Hawaii, offer some type of legalized gambling—from old-school slot machines to sports-betting apps and everything in between. The accessibility to gambling has only amplified with the Internet. Based on various surveys in recent years, it is estimated that two million people in the US are addicted to gambling. But that figure has the potential to increase at anytime, because those same surveys revealed as many as 20 million people noting that their gambling habit had begun to interfere with their work and social life. That type of behavior falls into the category of “compulsive gambling,” which is the stage before gambling addiction.
What is Compulsive Gambling?
“The shortest version is that compulsive gambling is, as its name implies, a compulsion,” says Lance Dodes, MD, author of THE HEART OF ADDICTION: A New Approach to Understanding and Managing Alcoholism and Other Addictive Behaviors. “Compulsive gambling leads to an addiction, which is a psychological symptom that is well-understood and treatable with psychotherapy oriented toward that understanding. It is not a biological, genetic or moral issue, and it is not fundamentally different from other compulsive behaviors or addictions.”
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Usually, people start out gambling for fun, and then they lose money they didn’t mean to, and they end up chasing that loss until all their money is gone. And in many cases, people are gambling because they have faced emotional and financial losses and they are trying to console themselves.
There is a misconception among many people that problem gambling, another term for gambling addiction, is not a big deal. “Most people don’t realize that problem gambling is a real disorder, just like alcohol or drug addiction,” says Shelia Moran, director of communications and marketing at First Choice Services, a nonprofit agency in West Virginia dedicated to mental health issues and problems. “They think it’s just a bad habit that can be easily ended. The good news is that we find most people who get treatment are able to successfully stop gambling.”
Gambling and Co-Existing Mental Health Conditions
Sadly, it is estimated that over 80% of people who suffer from some type of gambling addiction never seek treatment, no matter how bad their problem is. Other statistics reveal that while there are people who do seek treatment for their gambling addiction, over 70% end up returning to the world of betting. People with this type of disorder are more likely to suffer from other types of mental health and substance abuse issues. Many gamblers also have an alcohol disorder or addiction, and over half were nicotine dependent.
The emotional toll it takes on people is devastating, and in many cases a gambling addiction can also bring bouts of depression, and in extreme situations may lead to suicidal thoughts or tendencies. People with a gambling addiction are also prone to anxiety, high stress and extreme sadness. When a gambler loses everything, their life will suddenly become hopeless and they fear what the future might bring.
Gambling Addiction Symptoms and Signs
As with other addictions, there are warning signs to look out for. These include:
Keeping gambling habits a secret
Having trouble controlling their gambling habit
Continuing to be involved with a gambling habit when they cannot financially afford to do so.
Resorting to illegal activities to pay for their gambling habit
Physical symptoms of excessive gambling include problems sleeping, weight gain or loss, dark circles under the eyes and extreme headaches.
How can you tell if someone has a gambling disorder? The American Psychiatric Association has developed guidelines and says that a person requires at least four of the following issues to take place during the past year:
A person feels the need to gamble with an increasing amount of money in order to achieve the desired excitement.
A person becomes angry, restless or irritable when someone tells them to cut back on their gambling, or to stop it altogether.
A person will have unsuccessfully tried to cut back or stop gambling on their own.
A person has frequent thoughts about gambling, including reliving past gambling adventures, planning their next gambling outing, and thinking of ways to get money to gamble with.
A person will often gamble when they are feeling distressed.
After a person loses money, they return to try and “get even” (referred to as “chasing” one’s losses)
A person will not hesitate to lie to hide their gambling activity.
A person will jeopardize or lose a significant relationship, job or educational/career opportunity because of gambling.
A person will begin relying on others to help with money problems caused by their gambling habits.
Treatment Options for Gambling Addicts
If you suspect that someone in your life is addicted to gambling or a compulsive gambler, you should know that there is help. Here are treatment options to consider:
“Behavior therapy and cognitive behavior therapy are recommended for compulsive gamblers,” says Katie Hurley, LCSW. “Behavioral therapy uses systematic exposure to the behavior to teach skills to reduce the urges, while cognitive behavioral therapy focuses on identifying unhealthy and irrational thoughts and replacing them with positive/adaptive ones. Family therapy is another option,” Hurley explains.
Apps can help instill healthy habits and encourage consideration of events and emotions that lead to compulsive behaviors. Addiction AVERT app can help curb cravings. BreakFree can help people who use their smartphones to gamble spend less time on their phone.
Adaptive coping strategies like exercise, deep breathing, progressive muscle relaxation, mindfulness, and meditation are all positive options. There are even meditation apps that can help anyone who doesn’t know where to start.
According to the American Psychiatric Association, as of 2016, there are no FDA-approved medications for the treatment of gambling disorder. There is, however, emerging scientific research that has shown that medications can be effective in reducing the intensity of urges and cravings for gambling.
Finally, Gamblers Anonymous has been beneficial in the lives of people who have an addiction; however, they must first admit they have a problem, which is often times the most difficult thing to do. If someone is unable to find an accessible chapter of Gamblers Anonymous, Alcoholics Anonymous addresses many of the same behaviors.
Just as anyone can become addicted to gambling, anyone can stop.
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Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships.
Compulsive gambling most often begins in early adolescence in men, and between ages 20 and 40 in women.
Compulsive Gambling Symptoms
People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or drugs. Although it shares features of obsessive compulsive disorder, compulsive gambling is likely a different condition.
In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.
People with compulsive gambling often feel ashamed and try to avoid letting other people know about their problem. The American Psychiatric Association defines pathological gambling as having 5 or more of the following symptoms:
Committing crimes to get money to gamble.
Feeling restless or irritable when trying to cut back or quit gambling.
Gambling to escape problems or feelings of sadness or anxiety.
Gambling larger amounts of money to try to make back past losses.
Losing a job, relationship, education, or career opportunity due to gambling.
Lying about the amount of time or money spent gambling.
Making many unsuccessful attempts to cut back or quit gambling.
Needing to borrow money due to gambling losses.
Needing to gamble larger amounts of money in order to feel excitement.
Spending a lot of time thinking about gambling, such as remembering past experiences or ways to get more money with which to gamble.
A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions www.gamblersanonymous.org/ga/content/20-questions can help with the diagnosis.
Treatment for people with compulsive gambling begins with recognizing the problem. Compulsive gamblers often deny they have a problem or need treatment.
Most people with pathological gambling only get treated when other people pressure them.
Treatment options include:
Cognitive behavioral therapy (CBT).
Self-help support groups, such as Gamblers Anonymous. Gamblers Anonymous www.gamblersanonymous.org/ is a 12-step program similar to Alcoholics Anonymous. Practices used to treat other types of addiction, such as substance use and alcohol use, can also be helpful in treating pathological gambling.
A few studies have been done on medicines for treating compulsive gambling. Early results suggest that antidepressants and opioid antagonists (naltrexone) may help treat the symptoms of pathological gambling. However, it is not yet clear which people will respond to medicines.
Like alcohol or drug addiction, pathological gambling is a long-term disorder that tends to get worse without treatment. Even with treatment, it's common to start gambling again (relapse). However, people with pathological gambling can do very well with the right treatment.
Complications may include:
Alcohol and drug use problems
Anxiety
Depression
Financial, social, and legal problems (including bankruptcy, divorce, job loss, time in prison)
Heart attacks (from the stress and excitement of gambling)
Suicide attempts
Compulsive Gambling Symptoms
Getting the right treatment can help prevent many of these problems. Bovada poker review 2015.
Compulsive Gambling Definition
Call your health care provider or mental health professional if you believe you have symptoms of pathological gambling.
Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse.
American Psychiatric Association website. Non-substance-related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:585-589.
Balodis IM, Potenza MN. The biology and treatment of gambling disorder. In: Johnson BA, ed. Addiction Medicine: Science and Practice. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 33.
Weissman AR, Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Compulsive Gambling Disorder Symptoms
Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.