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.
Causes
Compulsive gambling most often begins in early adolescence in men and between ages 20 and 40 in women.
People with compulsive gambling have difficulty 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 (OCD), 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.
Symptoms
People with compulsive gambling often feel ashamed and try to avoid letting others know about their problem. The American Psychiatric Association defines pathological gambling as having five 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 on 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.
Exams and tests
A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions can also help with the diagnosis:
1. Did you ever lose time from work or school due to gambling?
2. Has gambling ever made your home life unhappy?
3. Did gambling affect your reputation?
4. Have you ever felt remorse after gambling?
5. Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?
6. Did gambling cause a decrease in your ambition or efficiency?
7. After losing did you feel you must return as soon as possible and win back your losses?
8. After a win, did you have a strong urge to return and win more?
9. Did you often gamble until all your money was gone?
10. Did you ever borrow to finance your gambling?
11. Have you ever sold anything to finance gambling?
12. Were you reluctant to use "gambling money" for normal expenditures?
13. Did gambling make you careless of the welfare of yourself or your family?
14. Did you ever gamble longer than you had planned?
15. Have you ever gambled to escape worry, trouble, boredom, loneliness, grief or loss?
16. Have you ever committed, or considered committing, an illegal act to finance gambling?
17. Did gambling cause you to have difficulty sleeping?
18. Do arguments, disappointments or frustrations create within you an urge to gamble?
19. Did you ever have the urge to celebrate any good fortune with a few hours of gambling?
20. Have you ever considered self-destruction or suicide as a result of your gambling?
Treatment
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). As one of the most common and best-studied forms of psychotherapy, it combines cognitive therapy and behavioral therapy.The point of cognitive therapy is to form a clear idea of your own thoughts, attitudes and expectations. What we think, how we feel and how we behave are all closely connected and all of these factors have a decisive influence on our wellbeing.
Self-help support groups, such as Gamblers Anonymous, which 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 may help treat the symptoms of pathological gambling. However, it is not yet clear which people will respond to medicines.
When to contact a medical professional
Contact your health care provider or mental health professional if you believe you have symptoms of pathological gambling.
If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
Prognosis
Like any other addiction, pathological gambling is a long-term disorder that tends worsen without treatment. Even with treatment, it's common to relapse and start gambling again. However, people with pathological gambling can do very well with the right treatment.
Possible 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
