Problem Gambling in America
Four out of five Americans admit to having gambled at least once in their lives, and it’s easy to see why. Every state but Utah and Hawaii has legal gambling of some kind, and wherever you live in the country, all you need is an internet connection and a phone to gamble right from home. It should come as no surprise, then, that gambling can become a problem behavior for many people. In fact, gambling interferes significantly with the social and work lives of up to 20 million Americans.
What Is Gambling?
From a simple bet amongst friends to off-track betting, high-stakes poker, and lottery scratch cards, gambling takes many forms, but they all share one thing in common: risking something of value in the hope of receiving something of more value.
What Is a Gambling Addiction?
A gambling addiction, also known as compulsive gambling or gambling disorder, is an uncontrollable urge to gamble irrespective of its effects on your life. As with a drug or alcohol addiction, a gambling addiction can destroy not just the life of the person with the addiction but the lives of those around them. Approximately 2 million Americans have a gambling addiction, according to different surveys.
Addiction’s Evolving Classification
The psychiatric community once considered gambling pathologically a compulsion, not an addiction. With a compulsion, the primary motivation for the habit or pattern of behavior is some form of anxiety-seeking relief; with addiction, there is a “craving for intense pleasure” at effect.
When the American Psychiatric Association (APA) updated the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the 1980s, it classified pathological gambling officially as an impulse-control disorder. This is a broad category shared with conditions like pyromania, kleptomania, and hair-pulling.
It wasn’t May 2012 that pathological gambling shifted from the manual’s compulsions chapter to its addictions chapter with the publication of its latest edition, the DSM-5. This was no small or haphazard feat; rather, in what was considered a landmark decision, the change was 15 years in the making. It represents an evolved understanding of how biology influences addiction that transformed how psychiatrists and addiction professionals assist those unable to stop gambling.
How Gambling Addiction Works
Gambling, just like alcohol or a drug, can stimulate the reward system of the brain. Since way back when humans were mere hunter-gatherers and life was solely about survival, the brain produced a chemical known as dopamine that it released to make certain achievements like a successful hunt or foraging quest feel good. This compelled more of that behavior in order to promote survival.
This primitive part of the brain is the same part stimulated to release the same feel-good chemical when a wager is successful; this, in turn, like hunting and foraging for the early humans, compels even more gambling in anticipation of receiving more of that dopamine flood.
When most people gamble, they can feel that dopamine “rush” or “buzz” and then return to their normal life activities; some people, however, get to a state in which those normal activities no longer feel rewarding in themselves, and they require more gambling to feel the same sense of satisfaction and accomplishment that most people feel in their daily lives.
Causes and Risk Factors
Most people who gamble never develop a problem with it. So, what causes an addiction to gambling?
While the exact causes of compulsive gambling aren’t known, it’s likely to stem from any blend of environmental, genetic, and biological factors. What are well-understood, however, are the various risk factors associated with an addiction to gambling.
Age
Younger people and middle-aged people are more prone to compulsive gambling, but if people start gambling in their childhood or during their teens, the risk of developing compulsive gambling behaviors increases. Older adults can also be at risk.
Gender
Men are more prone to compulsive gambling than women. While gambling patterns among genders are increasingly alike, women tend to start gambling later in life and may develop an addiction to gambling quicker and easier.
Personal Influence
If a friend or family member has a problem with gambling, the odds of you having or developing one increase.
Mental Health Disorders
Often, those who gamble compulsively also have anxiety, depression, personality disorders, or problems with substance use. A gambling addiction may also be linked to attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or bipolar disorder.
Personality Traits
Certain characteristics can raise your risk of gambling compulsively, such as a highly competitive nature, being a workaholic, impulsivity, restlessness, or getting bored easily.
Though rarely, certain drugs known as dopamine agonists may also induce compulsive gambling or other compulsive behaviors as a side effect. These drugs are sometimes used to treat restless leg syndrome and Parkinson’s disease.
Symptoms of Compulsive Gambling
There are many signs that you may have a gambling addiction, including:
• A preoccupation with gambling
• Feeling irritable or restless when you reduce your gambling
• Chasing losing bets in order to regain money lost in previous bets
• Gambling to flee problems or alleviate depression, anxiety, guilt, helplessness, or other unwanted feelings
• Needing to increase the quantity of money that you gamble in order to achieve the same level of thrill
• Unsuccessfully attempting to curb, control, or cease gambling
• Lying to family and others close to you to hide your gambling or its extent
• Draining your savings or accruing mounting debt
• Losing or jeopardizing an opportunity such as employment, education, or valued relationships because of gambling
• Asking for financial help from friends or family in order to help you with financial problems your gambling caused
• Stealing or committing fraud to support your gambling
Some people who gamble compulsively may have periods of “remission” where they reduce or eliminate their gambling. Without proper treatment, however, that change is typically only temporary.
Consequences of Compulsive Gambling
Gambling compulsively can pose deep and lasting complications in a person’s life, like:
• Relationship troubles
• Financial hardships or bankruptcy
• Legal difficulties or imprisonment
• Poor job performance or loss of employment
• Poor health
• Suicidal thoughts, suicide attempts, or suicide
Help for Gambling Addictions
Fortunately, there are many tools, resources, and treatment options for helping yourself or someone else with a gambling problem.
Self-help for Compulsive Gambling
As with any addictive behavior, recognizing that you have a gambling problem is the first and most important step to dealing with it. This can take a great deal of courage and inner strength to realize and accept, particularly if you’ve already lost a great deal in terms of money, relationships, or status in the process.
Whatever you do, don’t be down on yourself, and don’t try to deal with it alone. You’re not alone, and many others like you have successfully treated their addiction and rebuilt their lives.
Self-help Strategies
Here are some ways to help yourself address gambling addiction:
• Finding healthier ways to alleviate undesired feelings
• Avoiding being isolated
• Building up your network of support
• Joining a peer group
• Getting help for underlying mental health disorders
Note that these tips are not meant to replace professional counseling and treatment. Rather, they can provide assistance and empowerment as you go through treatment.
How to Deal With Gambling Cravings
When you feel the urge to gamble, there are certain things you can do to deal with the urge besides give in to it, such as:
• Reaching out for support
• Engaging in healthy activities to distract yourself, such as exercise
• Delaying gambling while you wait for the compulsion to weaken or pass
• Pausing before you gamble to consider the consequences
Helping Someone Else With a Gambling Addiction
If someone you know is struggling with compulsive gambling, there are ways that you can help that person independently of their decision on whether or when to seek treatment.
Seek out others who share similar experiences for support. Attend a support group for families of compulsive gamblers. Recognize your loved one’s good characteristics. Let them know that you are seeking out support for yourself, too and that their gambling is impacting you. Stay calm when talking with them about their condition. Establish boundaries as needed to protect yourself and your family. Finally, recognize that treatment may be necessary and that it can take time and, therefore, require patience on your part. Avoid the following counterproductive behaviors:
• Preaching
• Lecturing
• Losing control of your emotions
• Excluding the compulsive gambler from life events
• Bailing them out
Most importantly, perhaps, avoid expecting them to recover immediately, completely, and permanently and resolve all their problems or your problems with them. As just mentioned, treatment takes time, and recovery does too.
Compulsive Gambling Treatment
Of course, sometimes, professional treatment may be necessary to fully address and overcome a gambling addiction, and even when it isn’t necessary, it can be tremendously helpful. There are three main approaches gambling treatment may include.
Medications
The FDA has not approved any medications to treat compulsive gambling, but some medications can help treat conditions often co-occurring with compulsive gambling, like anxiety, depression, obsessive-compulsive disorder (OCD,) or attention-deficit hyperactivity disorder (ADHD.) Certain antidepressants have been found effective in curbing compulsive gambling behavior in some cases. Narcotic antagonists, commonly used in substance-abuse treatment, may also help reduce problem gambling.
Therapy
Several therapies have been used effectively to treat the disorder, including family, group, psychodynamic and cognitive-behavioral therapy. Behavior therapy systematically exposes you to your gambling behavior while teaching you better strategies for dealing with those urges; CBT helps you identify unsupportive, unhealthy, and irrational beliefs and replace them with positive, healthy alternatives. Treatment may also include work on co-occurring problems like anxiety, depression, substance use, or other mental health disorders. Inpatient and outpatient treatment options are available.
Self-help Groups
Many individuals find speaking with other people with problem gambling a useful form of treatment. There are groups like Gamblers Anonymous that can help you deal with your feelings and build a support group of people who can help you on your journey to recovery.
Finding Alternatives to Gambling
How effective the activities you choose to replace gambling are at fulfilling your urge to gamble depends on the reasons why you gamble. If you gamble for excitement or an adrenaline rush, consider sports or challenging activities, such as rock climbing or endurance sports.
If you gamble for the social element in order to avoid loneliness, isolation, or shyness, consider joining a social group, enrolling in a class, connecting with friends and family, and participating in group therapy.
You may gamble to avoid your problems, numb unwanted emotions, relieve boredom, relax from stress, or solve financial problems. Whichever of these reasons applies to you, find an activity to replace gambling that meets the same needs.
Avoiding Relapse
Many compulsive gamblers find that stopping gambling is not as hard as remaining in recovery and maintaining a commitment not to gamble. That’s why you’ll also learn strategies in treatment for avoiding relapse.
Counseling for Compulsive Gambling
In counseling, a compulsive gambler can explore why they gamble and how it affects them and those around them. Counseling can also aid them in identifying ways to resolve the problems that prompt or perpetuate their gambling.
Benefits of Counseling
Counseling offers many potential benefits for compulsive gamblers, including helping you:
• Take control over your gambling
• Manage your compulsion to gamble
• More healthily and proactively deal with stress
• Find other activities to enjoy with your time
• Get your personal finances in order
• Heal relationships with loved ones
• Continue committing to recovery and avoiding triggers
If you or someone you know struggles with an addiction to gambling, there is help. Many others have benefitted from professional treatment for compulsive gambling. The sooner treatment starts, the easier it will be to get your life back.
