Gambling involves taking a risk on an unclear outcome or event by risking something of value (usually money) with the intent of trying to win an item of higher value.

Gambling disorder is identified by a pattern of repeated and ongoing betting and wagering that continues despite creating multiple problems in several areas of an individual’s life.

Individuals in any age group may suffer from gambling disorder. Those who suffer from gambling disorder have trouble controlling gambling. Individuals, families, and society may be affected by gambling disorder.

A diagnosis of gambling disorder requires at least four of the following during the past year:

• Frequent thoughts about gambling (such as reliving past gambling or planning future gambling)
• Need to gamble with increasing amounts to achieve the desired excitement.
• Repeated unsuccessful efforts to control, cut back on or stop gambling.
• Restlessness or irritability when trying to cut down or stop gambling.
• Gambling when trying to escape from problems or negative mood or stress.
• After losing an item of value by gambling, feeling the need to continue to get even. (This is referred to as "chasing" one's losses.)
• 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 the extent of gambling involvement.
• Losing important opportunities such as a job or school achievements or close relationships due to 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 problematic during periods that are between those of more severe symptoms.

Younger age and male gender may be risk factors but symptoms for gambling disorder could begin at any age. Men are more likely to start gambling at a younger age compared to women but women can progress to problem gambling much faster. Trauma and social inequality, particularly in women, may also be risk factors. Low income, unemployment, and poverty are also linked to Gambling disorder.

The increase in the number of people with gambling problems has shown to be linked to the increase in the availability of gambling opportunities.

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. Gambling can change parts of the brain that are involved with experiencing reward or excitement. Treatment for gambling disorder can slowly help reverse these pathways to normal brain functioning prior to gambling.

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.

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, 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) (operated by the Substance Abuse and Mental Health Services Administration).

Responsible Gaming Initiatives

Responsible Gaming initiatives involve multiple stakeholders such as government, regulators, gaming industry operators, and consumers. The idea behind responsible gaming programs is to respond to community concerns regarding individual and societal consequences related to Gaming Disorder. Although these are developed to minimize harm, much work and research is still left to do to improve these programs and look at long term effects in reducing harm.

The National Council on Problem Gambling is one example of a responsible gaming initiative. The council operates the National Problem Gambling Helpline (1-800-GAMBLER) which can connect people with a gambling problem to local resources.

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

Do

• 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 and help them recognizing activities that may mimic gambling such as opening “ loot bags” or “packs” in popular video games.
• Understand the need for treatment for 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.
• Try to speak to a professional to discuss local referral resources such as certified gambling counselors or intensive treatment programs in the area.
• Set boundaries in managing money; take control of family finances; review bank and credit card statements.

Don't

• Treat the gambler as someone who is immoral or not an equal member of society – Gambling disorder can affect anyone!
• 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. Gambling disorder has been shown to carry the highest suicide risk out of any other substance use or addictive disorder. Studies show that roughly one in two gamblers will think about suicide and one in five gamblers will attempt suicide.

It’s very important to take any thoughts or talk of suicide seriously. For immediate attention, call 988, text 988, or chat at 988lifeline.org.

Learn more about suicide prevention here.

• Addiction and Substance Use Disorders
• Internet Gaming
• Technology Addictions: Social Media, Online Gaming, and More

Physician Review

Hector Colon-Rivera, M.D., CMRO

Kavita Fischer M.D., DFAPA

May 2024

  References