Gambling Addiction: Signs, Causes & Effective Treatment

What Is Gambling Addiction?

Gambling addiction, also called gambling disorder or compulsive gambling, is a behavioral addiction where a person loses control over their gambling despite negative consequences. It affects approximately 1-3% of the population and is classified as a mental health disorder in both the DSM-5 and ICD-11.

A person with gambling addiction has lost control over their gambling behavior. The gambling negatively impacts important relationships, work performance, or financial stability, and attempts to stop or reduce gambling repeatedly fail. A characteristic feature of gambling addiction is continuing to gamble to try to win back money that has been lost, a behavior known as "chasing losses."

People with gambling addiction commonly borrow money or use funds intended for other purposes to continue gambling. In severe cases, some may even commit crimes to fund their gambling habit. If someone with gambling addiction wins enough money to pay back their debts, they typically continue gambling until those winnings are also lost.

Gambling addiction is distinct from video game addiction (gaming disorder), which involves compulsive use of video games rather than money-based gambling. Both are recognized as behavioral addictions in international classification systems, but they affect different reward pathways and require different treatment approaches.

Anxiety and Depression

For some people with gambling addiction, the primary motivation is not winning money but rather dampening symptoms of anxiety, stress, or depression. Gambling can provide temporary escape from emotional distress, creating a dangerous cycle where negative emotions trigger gambling urges.

Research shows that gambling addiction significantly increases the risk of developing mental health conditions including major depressive disorder and anxiety disorders. The relationship is bidirectional, meaning pre-existing mental health conditions also increase vulnerability to gambling problems.

Gambling Combined with Alcohol or Drugs

The risk of developing gambling addiction increases substantially when alcohol or drugs are used while gambling. Substances lower inhibitions and impair judgment, leading to riskier bets and longer gambling sessions. Alcohol and gambling addiction can reinforce each other, creating a particularly challenging dual addiction that requires integrated treatment.

Many people with gambling addiction experience intense shame and hide their gambling from family and friends. This secrecy can lead to social isolation and avoidance of others. In severe cases, people may develop thoughts of suicide or self-harm. If you are experiencing such thoughts, seek help immediately, as effective treatment is available.

What Are the Signs and Symptoms of Gambling Addiction?

The DSM-5 identifies nine diagnostic criteria for gambling disorder. Meeting four or more of these criteria within a 12-month period indicates gambling disorder. These include preoccupation with gambling, needing to gamble with increasing amounts, failed attempts to stop, restlessness when cutting back, gambling to escape problems, chasing losses, lying about gambling, jeopardizing relationships, and relying on others for money.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, establishes clear criteria for diagnosing gambling disorder. Understanding these criteria helps identify whether gambling has become a clinical problem requiring professional intervention.

To meet the diagnostic threshold for gambling disorder, a person must exhibit four or more of the following symptoms over a 12-month period:

1. Preoccupation with gambling: Constant thoughts about gambling, reliving past gambling experiences, planning the next gambling session, or thinking about ways to get money to gamble
2. Tolerance: Needing to gamble with increasingly larger amounts of money to achieve the desired excitement or "high"
3. Failed attempts to control: Repeated unsuccessful efforts to control, cut back, or stop gambling
4. Withdrawal symptoms: Feeling restless, irritable, or anxious when attempting to reduce or stop gambling
5. Escape gambling: Using gambling as a way to escape problems or relieve negative mood states such as anxiety, depression, guilt, or helplessness
6. Chasing losses: Returning to gamble after losing money in an attempt to win it back, often leading to even greater losses
7. Lying about gambling: Concealing the extent of gambling involvement from family members, therapists, or others
8. Jeopardizing relationships or opportunities: Risking or losing significant relationships, jobs, educational opportunities, or career advancement due to gambling
9. Financial bailouts: Relying on others to provide money to relieve desperate financial situations caused by gambling

Even if you meet fewer than four criteria, you may still have problematic gambling that puts you at increased risk of developing full gambling disorder. Early intervention at this stage can prevent progression to more severe addiction.

What Happens in the Brain During Addiction?

When you experience something pleasurable or rewarding, the brain's reward system becomes activated. This happens when you eat something delicious, engage in social activities, or experience other positive events. The brain releases neurotransmitters, particularly dopamine, which creates a pleasurable sensation and motivates you to seek the same experience again.

With repeated exposure to addictive behaviors, the brain adapts to the frequent dopamine surges. This adaptation, called tolerance, means that the same amount of gambling no longer produces the positive feelings it once did. The person becomes dependent and now needs larger bets or longer gambling sessions to feel satisfied.

Addiction also affects the brain regions responsible for self-control and evaluating consequences. This impairs the ability to control one's own behavior. The brain creates strong associations between gambling and the feelings of pleasure or excitement it produces, making it extremely difficult to resist urges.

These brain changes can be long-lasting. When someone tries to stop gambling, they may experience intense cravings for the addictive behavior. They may also feel physically and emotionally unwell when unable to gamble, a state called withdrawal. However, research demonstrates that these brain changes are not permanent and can reverse with sustained recovery.

Similarity to Other Addictions

Gambling addiction resembles alcohol or drug addiction because the brain's reward system is affected in similar ways. The neurobiology underlying gambling disorder shares significant overlap with substance use disorders, which is why gambling disorder was reclassified from an impulse control disorder to the addiction category in DSM-5.

The reward system normally regulates natural pleasures and motivations. In gambling addiction, the desire to gamble takes over and competes with other sources of enjoyment. It can feel like gambling is the only thing that provides true satisfaction or relief.

Importantly, the brain changes caused by addiction are not permanent. With proper treatment and sustained abstinence from problem gambling, the brain can heal and normal reward processing can be restored.

Which Types of Gambling Are Most Addictive?

The types of gambling that create the highest addiction risk are those with high stakes and rapid results, where there is little time between placing a bet and learning the outcome. These are called high-risk or high-intensity gambling formats. They include slot machines, online casino games, and internet poker.

Regular participation in high-risk gambling significantly increases the likelihood of developing gambling disorder. The rapid feedback cycle maintains engagement and creates powerful conditioning that reinforces gambling behavior.

The Psychology of Gambling and Excitement

Gambling can feel exciting and stimulating initially. During gambling, many people experience a rush or thrill that they rarely feel elsewhere. This excitement is part of what makes gambling addictive.

One explanation for why gambling produces such strong excitement is that many games involve elements of chance and unpredictability. The human brain is not well-equipped to handle randomness, and the intermittent reinforcement schedule of gambling, where wins occur unpredictably among losses, creates one of the most powerful conditioning patterns known to psychology.

The rush of winning can be so pleasurable that people want to experience it repeatedly. Even the anticipation of winning can produce a dopamine surge, despite losing. This is why people continue gambling even when losing more often than winning.

Gambling as Escape from Problems

Sometimes underlying issues drive gambling behavior. People may gamble because they have problems they cannot cope with or do not know how to solve. Gambling provides temporary escape from difficult emotions or life circumstances.

Some people may have experienced loss or are grieving someone or something important to them. Others may have experienced trauma or crisis that they have not processed. These underlying issues can drive gambling as a maladaptive coping mechanism.

Whatever the underlying cause, effective treatments exist that address both the gambling behavior and its root causes, helping people develop healthier coping strategies.

What Can I Do to Help Myself?

Self-help strategies include using self-exclusion programs to block access to gambling, keeping a gambling diary to identify triggers, limiting access to money, finding alternative activities, talking to trusted people about your struggles, and setting realistic goals for reducing or stopping gambling.

Self-help strategies can be valuable components of recovery, particularly for those with mild gambling problems or as supplements to professional treatment. However, for moderate to severe gambling disorder, professional help is typically necessary.

Use Self-Exclusion Programs

Self-exclusion programs allow you to block yourself from gambling sites and venues for a specified period. This creates a barrier during recovery when willpower alone may not be sufficient.

Most jurisdictions with regulated gambling require operators to offer self-exclusion options. Many countries have centralized self-exclusion systems that apply across all licensed gambling operators. Additionally, various software programs can block gambling websites on your devices.

Some people find it helpful to temporarily remove computers or smartphones that provide gambling access. While this can feel difficult, it may be necessary during the initial recovery period.

Keep a Gambling Diary

Maintaining a gambling diary helps identify patterns and triggers. Record when you gambled, what prompted the urge to gamble, how much you bet, and how long you played. Also note how you felt before, during, and after gambling.

When you successfully resist gambling urges, write down what helped you avoid gambling and how it felt. This diary becomes a valuable tool for understanding your triggers and developing effective coping strategies.

Limit Access to Money

Restricting access to funds is a practical strategy for many people in recovery. This might involve giving financial control to a trusted family member and keeping only small amounts of cash.

Creating a near-term budget and allowing a trusted person to monitor bank accounts can help prevent impulsive gambling. It's important to understand that borrowing money to pay gambling debts, while seemingly helpful in the short term, typically enables continued gambling and is not a sustainable solution.

Find Alternative Activities

Setting realistic, achievable goals is essential. Initially, your goal might be to avoid gambling for the next week or month. Gradually, you can extend these goals as you build confidence in your recovery.

Be aware that replacing one addiction with another is common. When stopping gambling, avoid turning to alcohol, drugs, medications, or other potentially addictive behaviors.

Engaging in enjoyable, meaningful, or personally fulfilling activities provides healthy alternatives to gambling. Finding activities that redirect your focus away from gambling is one of the most important strategies for reducing gambling problems.

Talk to Trusted People

Discussing your struggles with trusted family members or friends is important. They can provide crucial support during recovery, helping you limit access to money or supporting you when gambling urges arise.

Many people with gambling problems feel ashamed and keep their gambling secret. Some lie about their gambling even when they don't want to. Others think they should resolve their situation before telling anyone.

This approach is often counterproductive because support from others is frequently necessary to resolve the situation and gain control over gambling. Opening up to trusted people is usually an essential step in recovery.

When Should I Seek Professional Help?

Seek professional help if gambling is affecting your relationships, finances, work, or mental health. Contact a healthcare provider, mental health professional, or gambling helpline if you've tried to stop but can't, if you're experiencing depression or anxiety related to gambling, or if you're having thoughts of self-harm. Emergency services should be contacted immediately if you're in crisis.

Professional help is recommended when gambling significantly impacts your life or when self-help strategies have been insufficient. Healthcare providers can assess your situation and recommend appropriate treatment options.

You can seek help through various channels including:

• Your primary care physician or general practitioner
• Mental health clinics or addiction treatment centers
• Gambling-specific helplines (available in most countries)
• Social services in your community
• Occupational health services if provided by your employer

Where Can I Find Help and Support?

Support is available through national gambling helplines (free and confidential), mental health services, peer support organizations like Gamblers Anonymous, and online treatment programs. Many countries have dedicated gambling support services with trained counselors available by phone, chat, or email.

Multiple sources of help exist regardless of where you live. Most developed countries have national gambling helplines that provide free, confidential support and can refer you to local treatment options.

Peer Support Organizations

Various peer support organizations worldwide offer support to both people with gambling problems and their families. These include Gamblers Anonymous, which uses a 12-step recovery model similar to Alcoholics Anonymous, and other gambling-specific support groups.

Peer support can be valuable because it connects you with others who understand gambling addiction from personal experience. You don't need to be a member to contact these organizations, and you can choose whether to remain anonymous.

Help with Financial Problems

Social services and financial counseling agencies can help with budget planning and debt management. If gambling has led to significant debt, specialized debt counseling services may be able to help with debt restructuring or management plans.

How Is Gambling Addiction Treated?

Cognitive Behavioral Therapy (CBT) is the most evidence-based treatment for gambling disorder, helping identify and change unhealthy thought patterns and behaviors. Treatment may also include Motivational Interviewing, medications like naltrexone in some cases, and peer support through groups like Gamblers Anonymous. Online CBT programs have also shown effectiveness.

The treatment with the strongest evidence base for gambling disorder is Cognitive Behavioral Therapy (CBT). For treatment to be effective, the therapist should have specific training in gambling and gambling addiction, as it differs from other addictions in important ways.

CBT for gambling addiction typically focuses on identifying and challenging distorted beliefs about gambling (such as superstitious thinking or overconfidence in gambling skills), developing coping strategies for gambling urges, addressing underlying emotional issues that drive gambling, and building alternative behaviors and activities.

Sometimes CBT is combined with Motivational Interviewing, a therapeutic approach that helps strengthen commitment to change. Both approaches have strong research support for treating gambling disorder.

Online Treatment Options

CBT can be delivered effectively through online programs, allowing treatment via computer, tablet, or smartphone from any location. Online treatment programs typically run for 8-12 weeks and are accessible regardless of geographic location. Research shows that online CBT can be as effective as in-person therapy for many people.

Medication Options

While there are no medications specifically approved for gambling disorder, some medications used for other conditions may help certain individuals. Naltrexone, an opioid antagonist also used to treat alcohol dependence, has shown promise in reducing gambling urges in some studies. Antidepressants may be helpful when depression co-occurs with gambling disorder.

Medication decisions should always be made with a healthcare provider who can assess your individual situation and any other health conditions.

When More Intensive Support Is Needed

If you are struggling to manage daily life due to gambling or related mental health issues, more intensive treatment may be necessary. This might include psychiatric evaluation, intensive outpatient programs, or in some cases, residential treatment.

Gambling addiction typically affects the entire family. Social services can often provide support to family members, including specialized support for children in affected households.

How Can I Help a Family Member with Gambling Addiction?

Supporting a family member involves setting healthy boundaries without enabling their gambling, protecting your own finances, encouraging professional help, and taking care of your own wellbeing. Never pay gambling debts or loan money to someone with gambling addiction. Support groups for families of people with addiction can provide valuable guidance and emotional support.

Being close to someone with gambling addiction is challenging and emotionally draining. You may feel guilt or blame yourself for not recognizing the problem earlier. Remember that you are never responsible for another person's addiction, though you are responsible for your own wellbeing and that of any children involved.

Set Healthy Boundaries

Do not provide financial help to someone with gambling addiction beyond supporting necessities like food, transportation, or clothing that keep them engaged in life outside of gambling.

Allow the person with gambling addiction to take responsibility for repaying their own debts. While this may seem harsh in the moment, it is the only approach that supports long-term recovery.

Practical Guidance for Family Members

Here are important principles for family members of someone with gambling addiction:

• Communicate calmly: Talk to the person about your concerns without accusation. Explain how their behavior affects you and set clear expectations
• Protect your finances: Make it difficult for the person to access your money or financial accounts
• Never loan money: Even if they promise to stop gambling once debts are paid, loaning money enables continued gambling
• Accept no abuse: Physical, verbal, or emotional abuse is never acceptable. Threats are also unacceptable
• Encourage professional help: Support them in seeking treatment through helplines or healthcare services
• Set limits on your help: Offer support while being clear about what you are and are not willing to do

Seek Support for Yourself

Helpline counselors have extensive experience supporting family members and can provide valuable guidance. Social services may also offer support specifically for family members of people with addiction.

Connect with Others in Similar Situations

Speaking with others who share similar experiences can be helpful. Organizations like Gam-Anon (for family members of people with gambling addiction) provide peer support from people who understand what you're going through.

Take Care of Yourself

Focus on activities that support your own wellbeing. Engage in things you enjoy, maintain connections with supportive friends, ensure you're eating and sleeping well, and stay physically active.

Spending time with people you enjoy being around helps maintain your emotional resilience so you can better support your family member. Seek professional help for yourself if you're struggling, as caregiving for someone with addiction takes a significant toll.