What is problem gambling?
Problem gambling is any type of betting activity that causes a person to suffer any form of self-harm. This includes emotional distress, financial problems, withdrawal from friends and family, and even physical symptoms like irritability, restlessness, and anxiety. If left unchecked, problem gambling can evolve into pathological gambling, a severe disorder which is now recognized as an addiction by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Although every problem gambler is different, many share common traits that separate them from those who are able to gamble within their means. One such characteristic is an inability to stick to limits. Most gamblers use some form of loss limit and/or time limit to ensure that they do not encounter any problems. Problem gamblers do not have the self-control to do this successfully and almost always end up spending more or playing longer than originally intended.
Problem gamblers also tend to lie about the extent of their problem, something that is common with other addictions and impulse-control disorders. A problem gambler may understate the amount of her losses, make excuses for time spent at a casino or sportsbook, hide bank statements, or do anything to prevent others from knowing about her gambling disorder.
Many problem gamblers also believe in the gambler’s fallacy. A person with this belief holds that if black comes up several times in a row on a roulette wheel, they are more likely to win the next spin if they bet on red. However, almost all games of chance have independently random outcomes. As such, previous results do not influence the future, and nothing is ‘due’ simply because it has not happened recently.
Although every gambling addict makes wagers for different reasons, most will fall into one of two categories: an ‘action gambler’ or an ‘escape gambler’. Action gamblers are usually men who begin gambling in adolescence who seek a rush out of their games. They are most likely to play games that involve some element of skill (or perceived skill), such as blackjack, poker, and sports betting. Action gamblers usually must increase their bets over time to get the same rush out of their games.
Escape gamblers are usually women who begin gambling during early-to-mid adulthood. These people see gambling as a means of getting away from their day-to-day lives and to relax, but end up spending substantially more amounts of money and time as their problem progresses. Escape gamblers usually prefer games with minimal social interaction and repetitive play, such as slot machines, keno, and video poker.
Problem gambling is a complex issue that does not have a singular cause. Modern psychology looks to several biological, environmental, and social factors to diagnose and treat problem gamblers.
On a biological level, problem gambling may be linked to certain dysfunctions of mental and hormonal systems. Several studies have found that those who suffer from various substance use and impulse-control disorders, from alcoholism to problem gambling, share common characteristics:
- Decreased serotonin production, which may lead to abnormally low inhibitions
- Dopamine interference, which may increase a person’s pleasure threshold
- Increased levels of cortisol, which may correlate to higher levels of stress
- A dysfunctional prefrontal cortex, which can impair decision making
Problem gambling also tends to correlate with certain social and environmental factors. For some, these are one-time events that trigger a problem gambling response, such as the death of a loved one, divorce, job loss, trauma, or other personal or financial crisis. Problem gambling also correlates strongly with a low socioeconomic status, prevalence of gambling services in a particular region, substance abuse, and mental and emotional disorders like depression, anxiety, and bipolar disorder.
Although most people are able to gamble without any problems, problem gambling affects a sizeable portion of the population. In most developed countries with legalized gambling, anywhere from 0.5% to 3% of their citizens have some level of a gambling disorder. This figure varies depending upon the criteria used and research methodology, as well as the prevalence of gambling services from region to region.
If problem gambling is not managed, it tends to progress into full-scale pathological gambling. Once a person reaches this stage, their brain has developed an addiction to games of chance. Like a drug addict, a pathological gambler will develop a tolerance to the action and must increase his bets to keep his brain satisfied, despite serious financial, emotional, legal, and social consequences. Eventually, pathological gambling can lead to imprisonment or cause a person to commit suicide.
In fact, research indicates that pathological gambling has the highest suicide rate of all addictions (both substance and non-substance). A recent study conducted by the US National Council on Problem Gambling found that 1 in 5 problem gamblers have attempted or will attempt suicide. This is about twice as high as most other addictions.
The American Psychiatric Association classifies problem gambling as a treatable disorder, which means that a combination of therapy, participation in support groups, and/or medication can give problem gamblers the ability to manage their disorder and lead a better life. The UK National Health Service has found that one of the most successful treatments is cognitive-behavioral therapy (CBT), a type of talk therapy where a psychologist or other licensed counselor helps the problem gambler identify and challenge harmful behavior patterns that precede gambling episodes and develop ways to combat them. Problem gamblers may find other types of counselling useful, as well to confront and deal with the effects of their addiction, such as couples therapy and financial advising.
Support groups, such as Gamblers Anonymous, provide another form of treatment. During meetings, members discuss the thoughts and actions associated with their gambling, the effects it has had on their lives, and ways they have found useful to combat urges. Gamblers Anonymous and most support groups operate in a 12-step or similar framework, which offers a goal-oriented, social approach to recovery.
Gamblers who suffer from mental disorders like depression or anxiety may also benefit from certain medications, such as SSRI antidepressants. However, their usefulness has only been proven for those suffering with mood problems independent of problem gambling. Current research has not conclusively found any drug that has shown long-term benefits for reducing gambling urges, although more studies are being conducted.