Gambling is a recreational activity in which a person places something of value, usually money, on the outcome of an event that has uncertain results. The odds, or probability, of winning are set by the betting company, and are often not obvious to novices. While most people who gamble do so responsibly, a small percentage develop pathological gambling, defined in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) as an irresistible urge to bet more and more money with increasing frequency, despite significant losses. Pathological gambling may lead to serious financial problems, including homelessness and loss of employment.
People who have a gambling addiction often do not recognize the problem, and are reluctant to seek help. They can be defensive about the issue, especially when family members and friends express concern. They also tend to blame their problems on external factors, such as stress, depression, or job pressures. In addition, the stigma associated with seeking help may be high.
The onset of pathological gambling is often triggered by a period of intense or excessive gambling activity. Some people may start gambling as a way to relieve boredom or loneliness, or to self-soothe unpleasant feelings, such as anxiety or anger. Others are more predisposed to gambling, due to genetics, a history of trauma or abuse, or impulsive personalities with risk-taking behaviors.
About 2.5 million American adults (1%) meet the criteria for a severe gambling disorder, and another 5-8 million (2-3%) have mild to moderate gambling disorders. However, many more individuals are impacted by gambling behavior, which can harm relationships and work or school performance, cause substance use issues, increase the risk of suicide, and result in financial problems, such as bankruptcy.
Researchers are working to identify specific pathways that lead to gambling addiction, so that therapists can better target their treatment strategies. For example, some individuals who are vulnerable to developing a gambling addiction may have poor math skills and a predisposition for cognitive distortions. Others may have a history of traumatic or stressful events, and they turn to gambling as a way to avoid dealing with their feelings, or they may be influenced by peers who are engaging in unhealthy behaviors.
The best way to support a loved one who is struggling with gambling addiction is to encourage them to seek professional help. Depending on the severity of their gambling disorder, treatment options include outpatient counseling and residential rehab programs. Some patients with severe gambling disorder are unable to quit without inpatient care. In this case, the best approach is to have them agree to a structured support program such as Gamblers Anonymous, a 12-step recovery program based on Alcoholics Anonymous that provides peer-to-peer support and guidance to overcome their addictive behavior. The family of a gambling addict can also benefit from obtaining support from a counselor or therapist who has experience with gambling addiction. This type of counseling is usually offered through community health centers and behavioral medicine clinics.
