Previously, gambling disorder was known as "pathological gambling" and was classified as an "impulse control disorder." When the DSM-5 was published in 2013, it was renamed gambling disorder and moved to a new category, "addiction and related disorders," due to the biological, behavioral, and emotional similarities with other addictions.1
Gambling disorder is currently the only behavioral addiction (as opposed to substance addiction) included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), although "internet gaming disorder" and others are being considered for this category.23
This article will explore the common signs and risk factors for gambling addiction, and review effective treatment options. Knowing the signs can help ensure that you or someone you love gets help and is on the road to recovery.
Related: The Difference Between an Addiction and a Compulsion
Signs of Gambling Addiction
Not all people who gamble have a problem, and in fact, there are several types of gamblers, including professional and social gamblers that have healthy boundaries with their finances. However, there are certain key characteristics that people with gambling addictions tend to share.
Gambling addiction involves maladaptive patterns of gambling behavior that the individual persists with despite negative consequences. This is consistent with behavior patterns observed in other addictions.
Compulsive gambling takes many forms and can include buying scratch-off tickets, betting on sports, stock market trading, going to casinos, playing slot machines, card games, bingo, and more. Many of these behaviors are considered a legitimate form of entertainment or employment but can be a dangerous trap for some people.
Warning Signs
You might be addicted if:
You are gambling all of your financial resources away (your paycheck, your savings, your retirement, your inheritance), and have borrowed from Peter to pay Paul as well.
You are accruing debt that is out of control, unable to fulfill your financial obligations, and possibly filing bankruptcy (again).
You continue to gamble despite experiencing significant losses (relationships, jobs, and even your home).
You have made gambling a priority over everything and everyone, even neglecting your own hygiene and basic health needs.
Related: Factors Associated With Risk-Taking Behaviors
To be diagnosed with gambling disorder, it will be evident that you have lost control over your gambling behaviors, and this addiction is causing significant distress and dysfunction in multiple areas of your life. The criteria for a diagnosis of gambling disorder are similar to other addictions, and include the following symptoms:24
Take bigger risks as you seek greater wins and bigger thrills, despite potential losses
Chasing losses - similar to chasing a high, you continue to gamble to win back money you previously lost, to get back to where you were when you had your first win
Continue to gamble despite negative consequences, such as loss of relationships and job disruption
Difficulty controlling gambling behavior, and repeated unsuccessful efforts to stop
Financial problems due to gambling, possibly borrowing or stealing money to fund gambling
Hiding your gambling and lying to family and friends about the extent of your involvement with gambling
Preoccupation with gambling, thinking about past wins and losses, planning your next move, and coming up with ways to continue gambling.
What Is Your Why?
Money is central to the experience of gambling. People with gambling addiction, as with most people, attach many different positive attributes to money, such as security, power, comfort, and freedom. Many people share an underlying desire to escape the 9 to 5 grind, to live life more fully, to become a more charitable giver, or to retire early and move to paradise.
Whatever the reason, compulsive gamblers fail to establish appropriate guardrails with their money, putting them at a higher risk of losing all of those desirable attributes and outcomes that more traditional financial planning could bring. Like resisting the laws of gravity, gambling addicts try to circumvent the fact that the odds are disproportionately stacked against them and the "house wins" over 90% of the time for most games.
And when they do win, people with gambling addictions tend to gamble away their winnings quickly because there is always a bigger win to be had.
Risk Factors for Gambling Addiction
A gambling disorder can result from a combination of genetic, environmental, psychological, and social factors, many of which are still being researched. Some of the most common risk factors include:
Age: Anyone at any age can develop a gambling addiction, oftentimes beginning in young adulthood, but could also begin in the retirement years.
Sex: Gambling disorder is slightly more prevalent in men than women; however, the progression to more severe forms of gambling disorder is much quicker in women than in men. Women are quicker to seek treatment.
Genetics: Family history has been found to play a role in pathological gambling, with first-degree relatives of compulsive gamblers more likely to develop a gambling addiction than those with no family history.
Personality: Various personality traits have been linked with gambling addiction, including being impulsive, energetic, highly competitive, and easily bored.
Mental health: More than 95% of people with a gambling disorder also meet the criteria for a psychiatric disorder, including mood disorders, anxiety disorders, alcohol and drug use disorders, and personality disorders. Rates of alcohol use disorder are roughly five to six times greater among individuals with a gambling disorder.
Military status: Studies show that veterans have higher rates of gambling disorder than the general population, and these rates are even higher if they also have co-occurring mental health conditions like PTSD, substance use disorder, and suicidality
Recap
The exact causes of gambling disorder are not known, but a combination of factors may play a part. Genetics, personality, mental health conditions, and life experiences can contribute to the development of a gambling addiction.
What Is an Addictive Personality?
The Addict's Brain
Like other addictions, the dopamine rush from every win affects the reward center of the brain, causing brief excitement and euphoria. This experience of pleasure reinforces the behavior and encourages more. It is a thrilling experience to win, and you begin to think of all the ways you could enjoy life with even more wins. But it's a trap. More wins bring even more losses, and over time, you can spiral out of control with a devastating addiction.
According to behavioral theorists, gambling is rewarded in unpredictable ways, and it is enough to provide a big thrill at the winning moment and to instill hope for more. This makes people even more likely to continue to gamble because they know there is another win ahead at some point. This is known as the variable-ratio schedule of reinforcement making gambling more addictive and even more challenging to overcome.
Related: Can You Be Addicted to Dopamine?
Cognitive Distortions in Gambling Addiction
Gambling is an ineffective and unreliable way of acquiring money. For someone to become addicted to gambling, their cognitions or thought processes must become distorted to the point where this central truth eludes them.
Some researchers classify the cognitive distortions of gambling pathology into three categories: incorrect understanding of probability, illusion of control, and superstitions.10 Here are a few ways the thoughts of people with a gambling problem are distorted:
Incorrect Understanding of Probability
Causal Attributions: Believing winnings occur as a result of their talents, skills, and efforts and not due to random chance. Losses are attributed to it being a bad day, lack of sleep, looking away, forgetting to do something they normally do, still learning, etc.
Beating the systems: Believing that by learning or figuring out a certain system (a pattern of betting in a particular way), the house advantage can be overcome. In reality, the increased computerization of gambling machinery has ensured that wins are now truly random, so it is impossible to predict a payout, and, of course, it is still heavily stacked in favor of the “house”
Illusion of Control
Chasing losses: Believing they have not really lost the money to gambling, but that it can be “won back” by further gambling
Selective recall: Remembering their wins and forgetting or glossing over their losses
Near-miss beliefs: Reducing the number of losing experiences in their minds by thinking they “almost” won, which justifies further attempts to win; near misses can be as stimulating, or even more stimulating, than actual wins
Superstitions
Magical thinking: Believing that certain thoughts will bring about a win, that random outcomes can be predicted, or that they are special and will be rewarded with a win
Personification of a gambling device: Attributing human characteristics to inanimate objects that are part of the gambling process—for example, thinking that a particular machine is punishing, rewarding, or taunting them
Superstitions: Believing that lucky charms, certain articles of clothing, ways of sitting, etc., may cause a win or a loss
Many of these thought distortions lead to highly ritualized patterns of behavior, which are characteristic of addictions.
Gambling Addiction Triggers
While triggers are not the same for everyone, there are several common ones that can interfere with the road to recovery for someone with a gambling problem, including:
Environmental triggers: Unfortunately, there are many people, places, and things that can tempt you to return to gambling, including stores that sell scratch cards and lottery tickets, bars and clubs with slot machines, online gambling, and wagering sites, as well as friends who you used to gamble with.
Financial trouble: For many, gambling can seem like a quick fix to any debt or financial problems. It can also be tempting when you want to be able to help others out of their financial stresses.
Negative emotions: Many people gamble as a way to cope with negative emotions like anger, frustration, stress, loneliness, boredom, or disappointment. Playing certain games can be "mind-numbing" and a form of escape.
Fantasy: Some forms of gambling can be laden with the fantasy of how special or talented you are, or how supernatural forces will help prosper you if you have the right thoughts. If this is your way of thinking, it may be harder to resist the urge to gamble.
Substance use: Using drugs or alcohol can impair judgment and reduce impulse control, making it hard to resist gambling.
Treatment for Gambling Addiction
Recovering from a gambling addiction takes hard work, however, there are several treatments that have been found to be effective, including:
Psychotherapy
Cognitive behavioral therapy and behavioral therapy are often used to help change the thoughts and behaviors that lead to gambling. Learning to identify distorted thinking patterns that maintain unhealthy behavior is the first step. Breaking the schedule of reinforcement for gambling behaviors and establishing appropriate financial goals. Family therapy may also be encouraged if the gambling has caused relationship conflicts.
Medication
Although there are no FDA-approved medications for gambling disorder, antidepressants and mood stabilizers have been found helpful for those with other psychiatric disorders that often accompany a gambling problem, such as anxiety disorders, mood disorders, and personality disorders. In addition, if there are co-occurring substance use disorders, narcotic antagonists have been found useful in treating chemical addictions.
Support Groups
Support groups like Gamblers Anonymous (Gam-Anon), are often used as part of treatment and to prevent relapse. In addition to offering important social support, talking to others who have similar experiences can be a way to gain information, tips, and encouragement.
SMART Recovery is a CBT-based alternative to 12-step programs. The program focuses on helping people improve their motivation to quit, deal with urges to gamble, address other problems that contribute to gambling, and find balance in their lives. The group also has an online community that offers support, local in-person meetings, and online meetings.
Related: Self-Help Groups for Shopping Addiction
Financial Counseling
Talking to a financial counselor can also help you sort out any difficulties you have with money as a result of your gambling, develop a solid financial plan to get out of debt, and start saving money.
Gambling Addiction Controversies
Like other behavioral addictions, gambling addiction is a controversial idea. Many experts balk at the idea that gambling can constitute an addiction, believing that there has to be a psychoactive substance that produces symptoms, such as physical tolerance and withdrawal, for an activity to be a true addiction.
Gambling, however, is by far the best-represented behavioral addiction in research literature and treatment services. This is why pathological gambling has the most credibility among the behavioral addictions.12
This is partly due to financial input from the gambling industry, whose contribution is tiny compared to the massive profits they make but greatly exceeds funding for research or treatment of any other behavioral addiction. This funding has greatly increased public awareness of gambling problems and treatment services, but there is a potential conflict of interest when funding comes from a source that makes a profit from gambling addiction.
A Word From Us
A gambling addiction can have devastating effects on individuals and families, but recovery is possible. If you believe that you or someone you love has a gambling disorder, talk to your doctor or mental health professional about your treatment options.
Gambling is addictive because it stimulates the brain's reward system. Similar to alcohol and drugs, gambling activates the brain's reward system, which leads to feelings of satisfaction and pleasure. Continued exposure causes the brain to respond less to rewards, so it takes more stimulation to continue producing the same pleasurable effects.
Talking about the problem and encouraging them to get help are important first steps. Emphasize that you are concerned, that you care, and that you can help them find the support they need to address their gambling addiction. While you cannot force them to seek treatment, you can offer to go with them to therapy appointments or support group meetings.
Learn More: How to Help Someone With an Addiction
Self-help strategies and support groups can also be beneficial. As you are recovering, find ways to avoid your gambling triggers and look for alternatives to gambling. Utilize distractions when you feel the urge to gamble or enlist the help of a friend who can talk to you until the urge passes. If you are still struggling, reach out to a therapist. Effective treatments are available that can help you overcome a gambling addiction, including psychotherapy and medication.
Learn More: How to Overcome an Addictionn
