Gambling disorder, also referred to as gambling addiction or compulsive gambling is repeated problematic gambling behavior that causes significant problems or distress. Gambling addiction is a significant problem in the United States, impacting adults of all ages. It affects 1 to 3 percent of adults. Men are more likely to begin at a younger age and women are more likely to begin later in life. Those who gamble may partake in the behavior for different reasons. Some are looking for an escape, or a way to numb difficult feelings they can not handle. Others are seeking excitement or action, that may make them feel alive, which they receive through gambling.
Gambling Disorder Defined
An individual with gambling disorder is someone who is unable to resist his or her impulses to gamble. This leads to severe personal and, or, social consequences. The urge to gamble becomes so great that relief is found in more gambling. As the gambling progresses, the gambler begins to risk more—both personally and financially. If you have a gambling disorder, you may continually chase bets that lead to losses, hide your behavior, deplete savings, accumulate debt, or even resort to theft or fraud to support your addiction. This often leads to severe personal problems, financial ruin and criminal behavior to support the gambling habit. Gambling can stimulate the brain’s reward system similar to the what happens to when taking drugs or drinking alcohol. This reaction in the brain is what can lead to addiction.
Different Types of Gambling Disorders:
There are not separate types of gambling disorders, but there are levels of severity. These levels are based on which criteria is met, which is listed under symptoms.
- Mild: 4-5 criteria met.
- Moderate: 6-7 criteria met.
- Severe: 8-9 criteria met.
Gambling Disorder Causes:
Gambling disorder can be caused by various factors. Many individuals, including young adults and adolescents, are likely able to resolve their gambling disorder over time, bit that is dependent on if the individual suffered from prior gambling problems. Gambling disorder tends to run in families, but environmental factors may also contribute. Gambling disorder is also motor prevalent among first-degree relatives of individuals with moderate to severe alcohol use disorder as compared to the general population. It is also more frequent in monozygotic twins than dizygotic twins. Increased rates of gambling disorder are associated with when it begins, like in childhood or early adolescent. Gambling disorder also appears to aggregate with antisocial personality disorder, depressive and bipolar disorders, and other substance abuse disorders, like alcohol disorders. Stressful situations can worsen gambling problems.
Gambling Disorder Symptoms:
To be diagnosed with a gambling disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the following criteria must be met:
Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12 month-period.
- Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
- Is restless or irritable when attempting to cut down or stop gambling.
- Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
- Is often preoccupied with gambling (e.g. having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
- Often gambles when feeling distressed (e.g. helpless, guilty, anxious, depressed).
- After losing money gambling, often returns another day to get even (“chasing” one’s losses).
- Lies to conceal the extent of involvement with gambling.
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
- Relies on others to provide money to relieve desperate financial situations caused by gambling.
Symptoms of gambling disorder can include:
- Being preoccupied with gambling, such as constantly planning how to get more gambling money
- Needing to gamble with increasing amounts of money to get the same thrill
- Trying to control, cut back or stop gambling, without success
- Resorting to theft or fraud to get gambling money
- Trying to get back lost money by gambling more (chasing losses)
- Lying to family members or others to hide the extent of your gambling
- Feeling restless or irritable when you try to cut down on gambling
- Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or depression
- Lying to family members or others to hide the extent of your gambling
- Jeopardizing or losing important relationships, a job, or school or work opportunities because of gambling
- Asking others to bail you out of financial trouble because you gambled money away
Symptoms of the disorder can begin as early as adolescence or as late as older adulthood.
How to Approach a Loved One:
There is not a perfect way to approach a loved one that you assume or know is struggling with a gambling disorder. The critical sign of problem gambling is often hidden from awareness, with denial. Most people are not aware that they have a problem, so approaching them to tell them that they do have a problem can be difficult. You can not force someone to seek professional care, but you can always offer your support and encouragement. Even though you may not be able to prevent your loved one from developing a gambling disorder, you can still talk with them about treatment options. For more help on how to approach loved ones visit https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder
Types of Gambling Disorder Treatment:
There are effective treatments for gambling disorder. The first step in treatment is being able to recognize that you have have a gambling problem, which can be difficult for most individuals. Many individuals reach this realization at very low point brought upon by the gambling disorder. Even with treatment, there is a probability that you may return to gambling. This is more like occur if you spend time with people who gamble or you’re in gambling environments. If you feel that you’ll start gambling again, contact your mental health professional or sponsor right away to prevent a relapse.
Psychotherapy, also known as talk therapy or psychological counseling is used to identify the patterns of behaviors, thoughts, beliefs, etc. that may impact individuals with gambling disorder.
Behavioral therapy/ Cognitive behavioral therapy: Behavioral therapy systematic exposure to the behavior you want to unlearn and teaches you skills to reduce your urge to gamble. Cognitive-behavioral therapy will often focus on identifying unhealthy, irrational and negative beliefs and replacing them with healthy, positive ones. Another focus of cognitive therapy is to help change distorted beliefs and thoughts that maintain the unhealthy behaviors associated with gambling disorder.
Family therapy: This form of therapy can provide the individual with support, as well as the family in regards to how the gambling behaviors affect the family unit. It can provide the family with skills on how to resolve issues that arise and communicate with each other in a healthy manner.
Self- Help Groups
There are various self-help groups that are options for individuals to attend, such as Gamblers Anonymous. Some people find that talking with others who have a gambling problem may be a helpful part of treatment. Through self-help groups, individuals find a forum of peer support, gaining strength as they share their feelings, and experiences with others who are facing the same obstacles as themselves. Self- help groups can also be helpful because you can have a sponsor that will assist in your continued recovery.
There are medications that can assist in the treatment of gambling disorder. These medications target symptoms that go along with gambling disorders. Antidepressants and mood stabilizers can help if an individual is struggling with depression or OCD. Some antidepressants may be effective in reducing gambling behavior. Medications called narcotic antagonists, are useful in treating substance abuse, so they may help treat gambling disorders as well.
Differences Between Common Disorders:
There are other possible causes that resemble gambling disorder but do not qualify as a gambling disorder. These are common disorders but the differences between them and gambling disorder.
- Non-disordered gambling- Gambling disorder is not the same thing as professional and social gambling. Professional gambling has limited risk and discipline is central. Social gambling usually occurs with friends and/or colleagues and lasts for a limited period of time, with acceptable loss. Some individuals can experience problems associated with gambling (e.g., loss of control and short-term chasing behavior) that do not meet full criteria for gambling disorder.
- Manic episode- During a manic episode, behaviors such as gambling or loss of control do occur, but a diagnosis of gambling disorder is only warranted if not better explained by a manic episode.
- Personality disorders- Problems with gambling may occur in individuals with antisocial personality disorder and other personality disorders. If the criteria are met for both disorders, both can be diagnosed.
- Other medical conditions- Some patients taking dopaminergic medications, like individuals with Parkinson’s disease) are subject to experiencing urges to gamble. If such symptoms no longer exist after a patient is no longer on dopaminergic medications or the dosage is lowered, then a diagnosis of gambling disorder.
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