Gambling Disorder

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KEY POINTS

• A gambling disorder is an addiction to the excitement and risk created by gambling.
• If your gambling is causing personal, social, family, work, or legal problems, it is time to get help.
• Treatment may include medicines, therapy, support groups, and learning ways to manage stress.

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What is gambling disorder?

A gambling disorder is an addiction to the excitement and risk created by gambling. Without treatment, people who are pathological gamblers cannot stop even though it causes personal, work, or legal problems.

Many people enjoy gambling once in a while. However, pathological gambling can ruin your life as well as the lives of your family.

What is the cause?

The exact cause of this disorder is not known. The cause may be due to one or more of the following:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• A trigger, which can be stress, a drug or a thought, may cause changes in the brain chemicals. Those chemical changes may lead to urges to do something. There is usually a link between doing something and getting a good feeling. In gambling disorder, the urge is to gamble, even if it is harmful. The thoughts that link gambling to good feelings may be learned from things that happened when you were young or from recent experiences. Wanting the good feelings can trigger the same behavior in the future.
• Gambling disorder may be related to other mental disorders such as addiction, anxiety, or depression. Substance abuse is also common in people with gambling disorder.
• It may be a problem with genes that are passed from parents to children. The disorder may begin as early as age ten.
• Stressors, such as major losses, may also lead to gambling disorder. More men than women suffer from this disorder, and men are more likely to seek treatment for it.

Most problem gamblers start gambling, on average, at age 10. People may start gambling in order to:

• Feel successful
• Rebel or release anger
• Be accepted by other people
• Escape from painful feelings
• Feel like a winner
• Solve money problems

What are the symptoms?

Pathological gamblers have at least 5 of these signs. They:

• Cannot stop thinking about gambling
• Need to gamble with more and more money in order to feel excitement
• Try and fail to control, cut back, or stop gambling
• Feel restless or in a bad mood when they try to cut down or stop gambling
• Gamble as a way to escape from problems or to feel less helpless, guilty, anxious, or depressed
• Try to make up money lost in gambling by gambling to break even ("chasing" losses)
• Lie to people about how much time they spend gambling
• Commit crimes such as forgery, fraud, theft, or embezzlement to pay for gambling
• Have school, job, or relationship problems because of gambling
• Try to get other people to cover financial problems caused by gambling

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests to help make a diagnosis.

You may also be asked to complete a questionnaire called the South Oaks Gambling Screen (SOGS). This helps to measure how serious your gambling problem may be.

How is it treated?

If your gambling is causing personal, social, family, work, or legal problems, it is time to get help. A good treatment program should include counseling for you and your family members.

Several medicines can help treat pathological gambling. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

Treatment can help. Many different programs exist, ranging from Gamblers Anonymous to inpatient treatment centers. There is no one program that is right for everyone.

What can I do to help myself stop gambling?

• Get support. If you have the urge to gamble, stop and call someone. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Find something else to do right away, such as exercise, to help yourself stop thinking about gambling. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Change the way you handle money. Keep a limited amount of cash on you at any given time. Let someone else handle your money, for example, arrange for the bank to make automatic payments for you. Don’t carry or use a debit card.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others.