Gambling Addiction: Signs, Symptoms, and Treatment Options
What is Gambling Addiction and Problem Gambling?
Gambling can be a fun, legal form of entertainment, but when the highs and lows of winning and losing become addictive, gaming and betting can take a toll on gamblers and their families.
Compulsive gamblers can lose and win thousands of dollars within a matter of days, or even hours, because they are unable to stop. The rush that accompanies a win can be so exhilarating that gamblers begin to crave it. When gamblers lose, the emotional crash of a loss requires a quick fix to regain that high. The inability to stop gambling, in spite of the negative consequences, is known as gambling addiction, problem gambling, or compulsive gambling.
Gaming, wagering, and betting take many forms, and gambling affects individuals from all walks of life, encompassing all age groups and all genders. The National Council on Problem Gambling (NCPG) estimates that approximately 2.5 million Americans meet the criteria for a severe gambling problem in a given year.1 But gambling addiction is treatable, and professional rehab programs can address gambling addiction’s destructive process and help individuals regain control over their lives.
Signs and Symptoms of Compulsive Gambling
Gambling disorder is identified by a pattern of repeated and ongoing betting and wagering that continues despite negative consequences in several areas of an individual’s life.2 While only a healthcare professional can diagnose the disorder, being able to identify the warning signs of gambling addiction is the first step in getting help. Unfortunately, it is not always easy to detect these red flags, especially if the gambler is in denial about the problem. For many families, the first sign that a loved one has a gambling problem is the sudden loss of a large sum of money. However, there are other signs to watch for that may help prevent serious damage to a family’s welfare.
Warning signs of problem gambling may include:2
- Thinking about gambling frequently.
- Needing to gamble with increasing amounts of money to achieve the desired excitement.
- Trying repeatedly to cut back or stop gambling but being unable to do so.
- Experiencing restlessness or irritability when trying to cut down or stop gambling.
- Gambling to escape problems or negative moods.
- Feeling the need to continue to gamble even after losing an item of value (“chasing the losses”).
- Gambling when distressed.
- Lying to hide the extent of gambling involvement.
- Losing out on important opportunities at work or school or in relationships due to gambling.
- Relying on others to help with money problems caused by gambling.
In addition to the monetary impact of gambling, an individual may also experience psychological and physical effects from gambling, which can include:
- Anxiety.
- Depression.
- Substance use.
- Insomnia.
- Gastrointestinal problems.
- Cardiovascular problems.
The loss of large amounts of money can be devastating to problem gamblers. They may fall into a severe depression, which may lead to suicidal thoughts, self-destructive behavior, or attempted suicide. In order to alleviate feelings of depression and despair, gamblers may use gambling as a way to escape or to fix their problems. Thus, gambling becomes part of a cycle in which the elation or depression that follow an episode leads to greater risk-taking and higher bets.
Causes and Risk Factors
Why does one individual engage in gambling only occasionally, and strictly for entertainment, while another can’t stop betting and taking self-destructive risks with their money? The answer may lie in one or more causes or risk factors, which may include:
- Neurochemistry. Compulsive gambling, also known as pathologic gambling, triggers physical and emotional reactions that are similar to the responses to drug or alcohol use. A big win can trigger the release of naturally occurring chemicals such as dopamine and norepinephrine, creating a rush of pleasure and energy, as well as feelings of power and invincibility. Research suggests that individuals with a gambling problem may have lower than average levels of norepinephrine, a chemical that generates feelings of energy. The high of a gambling win may help to create sensations of elation or power that their natural chemistry does not provide.3
- Family history. If one of more close relatives has a history of compulsive behavior or addiction, your risk of developing an addiction may be increased. This genetic predisposition appears to apply to substance addiction as well as to process addictions, like compulsive gambling.
- Social and environmental factors. Living in an environment where gambling is widely practiced and accepted can increase one’s chances of becoming a compulsive gambler. Other social factors, such as isolation from others, peer pressure to gamble, or the frequent use of drugs or alcohol, may contribute to problem gambling. Some individuals gamble out of loneliness and a need for distraction, while others may gamble out of a need to relieve stress or to gain approval from peers.
- Co-occurring mental illness or substance use disorders. Research suggests that compulsive gambling may be more common among people who have a co-occurring mental health diagnosis—such as depression, bipolar disorder, or a substance use disorder. Impulse control disorders and attention-deficit/hyperactivity disorder (ADHD) also increase the risk of problem gambling.4
Gambling Addiction and Substance Abuse
Pathologic gambling frequently co-occurs with alcohol or drug misuse. Free alcoholic beverages are often available at casinos, where drinking is encouraged in order to release inhibitions against spending money. Alcohol or drugs may be used to celebrate a win, console oneself for a loss, or mentally escape from the shame and guilt associated with gambling. In addition, the same neurochemical factors that make some individuals vulnerable to gambling addiction may predispose them to substance addiction. Having a predisposition toward compulsive gambling seems to go hand in hand with a tendency toward other forms of addictive behavior, including drug or alcohol addiction. Problem gambling also coexists frequently with forms of mental illness, such as personality disorders, anxiety, or depression.
A small study of 69 compulsive gamblers found the following:5
- 62% of the gamblers in the study suffered from a co-occurring psychiatric disorder
- 42% met the diagnostic criteria for a personality disorder
- 33% met the criteria for alcohol abuse or dependence
- Study participants with dual diagnoses suffered more negative consequences as a result of their gambling than those who did not have a co-occurring mental illness or substance use disorder.
Alcohol and drug use can worsen the impact of gambling addiction by impairing the individual’s judgment and encouraging the kind of risk-taking behaviors that lead to significant financial losses and negative effects on the individual’s health. Substance misuse also exacerbates the physical and psychological effects of gambling, increasing the severity of conditions such as heart disease, digestive problems, anxiety disorders, depression, and the risk of heart attack or stroke. The longer substance misuse and pathologic gambling go untreated, the greater the risk of serious health consequences as a result of both addictions.
What Types of Programs Are Offered to Treat a Gambling Addiction?
Although gambling addiction is a serious, potentially dangerous disorder, it can be treated with a combination of therapeutic modalities, recovery resources, and supportive psychosocial services. These therapies and services are available through professional treatment programs that specialize in addressing compulsive gambling, with or without a co-occurring substance use disorder. Treatment may take place at an inpatient facility, where 24-hour supervision and support are provided, or at an outpatient rehab program, which offers greater autonomy and flexibility to clients.
An admission assessment will help to determine which level of care is appropriate for the individual and which recovery services should be included in the treatment plan.
Some of the core therapies available through gambling recovery programs include:
- Individual therapy. Working one-on-one with a therapist, the individual strengthens the motivation to stop gambling, identifies triggers and dysfunctional coping strategies, and learns how to deal with stresses and triggers in more effective, productive ways. Therapists utilize modalities such as Motivational Interviewing (MI), a collaborative approach that engages both the individual and therapist in an effort to overcome addiction.
- Group therapy. Group therapy sessions help problem gamblers build a network of supportive peers who are working to overcome the same issues. In group therapy, members exchange personal experiences, coping strategies, and hopes for the future. Mutual-help support groups like Gamblers Anonymous and other 12-Step programs can be an important component of a comprehensive recovery plan.
- Cognitive-behavioral therapy (CBT). CBT addresses the self-defeating thoughts and behaviors that lead to problem gambling. Studies indicate that CBT is especially helpful at correcting the delusional thinking that characterizes compulsive gambling, such as the belief that one can win in spite of repeated, devastating losses.3
- Family or couples counseling. In contemporary therapeutic settings, addiction is viewed as a problem that affects entire families, not just isolated individuals. As a result, the family must be treated as a unit in order for rehab to be successful. Family and couples counseling helps to create a more supportive home environment that is conducive to sobriety and a life free from gambling or substance misuse. This form of counseling also strengthens the bonds among family members, defines boundaries, and reestablishes trust.
In the initial stages of treatment, detox may be required if the individual has an active drug or alcohol problem as well as gambling addiction.
After establishing a foundation for recovery from gambling and/or substance use, individuals in a rehab program may be ready to move from inpatient care to outpatient treatment, or from outpatient treatment to an autonomous life in the community. Gambling addiction programs provide a network of support services that aid the individual throughout the phases of rehab and aftercare.
Frequently Asked Questions About Gambling Addiction
