Gambling disorder involves repeated, problem gambling behavior. The behavior leads to problems for the individual, families, and society. Adults and adolescents with gambling disorder have trouble controlling their gambling. They will continue even when it causes significant problems.
A diagnosis of gambling disorder requires at least four of the following during the past year:
- Need to gamble with increasing amounts to achieve the desired excitement.
- Restless or irritable when trying to cut down or stop gambling.
- Repeated unsuccessful efforts to control, cut back on or stop gambling.
- Frequent thoughts about gambling (such as reliving past gambling or planning future gambling).
- Often gambling when feeling distressed.
- After losing money gambling, often returning to get even. (This is referred to as "chasing" one's losses.)
- Lying to hide gambling activity.
- Risking or losing a close relationship, a job, or a school or job opportunity because of gambling.
- Relying on others to help with money problems caused by gambling
People with gambling disorder can have periods where symptoms subside. The gambling may not seem a problem in between periods of more severe symptoms.
Gambling disorder tends to run in families. Factors such as trauma and social inequality, particularly in women, can be risk factors. Symptoms can begin as early as adolescence or as late as older adulthood. Men are more likely to start at a younger age. Women are more likely to start later in life.
Some people can stop gambling on their own. But many people need help to address their gambling problems. Only one in ten people with gambling disorder seek treatment.
Gambling affects people in different ways. Different approaches may work better for different people. Several types of therapy are used to treat gambling disorders, including cognitive behavioral therapy (CBT), psychodynamic therapy, group therapy, and family therapy.
Counseling can help people understand gambling and think about how gambling affects them and their family. It can also help people consider options and solve problems.
There are no FDA-approved medications to treat gambling disorders. Some medications may help treat co-occurring conditions like depression or anxiety.
Support from family and friends can be critical to a person's recovery from gambling. However, only the individual can decide to stop the behaviors.
Counseling can help:
- Gain control over your gambling.
- Heal family relationships.
- Deal with your urge to gamble.
- Handle stress and other problems.
- Find other things to do with your time.
- Put your finances in order.
- Maintain recovery and avoid triggers.
Support Groups and Self-Help
Support groups, such as Gamblers Anonymous and Alcoholics Anonymous, use peer support to help others stop gambling. Some research has shown physical activity can help those with gambling disorder. Many states have gambling helplines and other assistance. A National Helpline is available at 1-800-662-HELP (4357).
Strategies to Deal with Cravings
- Reach out for support. Call a trusted friend or family member. Go to a Gamblers Anonymous meeting.
- Distract yourself with other activities.
- Postpone gambling. Giving yourself time may allow the urge to pass or weaken.
- Stop for a moment and consider what will happen when you gamble.
- Avoid isolation.
"Dos" and "Don'ts" for Partners, Friends, or Family Members
- Seek the support of others with similar problems; attend a self-help group for families such as Gam-Anon.
- Recognize your partner's good qualities.
- Remain calm when speaking to the person with a gambling disorder.
- Let them know that you are seeking help for yourself; the gambling is affecting you (and possibly children).
- Explain problem gambling to children.
- Understand the need for treatment of problem gambling and that it may take time.
- Set boundaries in managing money; take control of family finances; review bank and credit card statements.
- Preach, lecture, or allow yourself to lose control of your anger
- Exclude the gambler from family life and activities
- Expect immediate recovery, or that all problems will be resolved when the gambling stops
- Bailout the gambler
Problem gamblers are at increased risk of suicide. It’s very important to take any thoughts or talk of suicide seriously. For immediate attention, call the National Suicide Prevention Lifeline at 800-273-8255. Learn more about suicide prevention here.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. (DSM-5) American Psychiatric Association. American Psychiatric Association Publishing. 2013.
- Gabbard’s Treatment of Psychiatric Disorders, Fifth Edition Edited by Glen O. Gabbard, M.D. American Psychiatric Publishing. 2014.
Note: In the DSM-5, gambling disorder has been placed in a new category on behavioral addictions. This reflects research findings showing that gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology and treatment.
Hector Colon-Rivera, M.D., CMRO