For many people, gambling is an occasional pastime or form of entertainment, but for some, it’s a disruptive habit that interferes with their personal, professional, and financial lives. According to the National Council on Problem Gambling, an estimated 2 million American adults meet the criteria for pathological gambling, while another 4 to 6 million are considered problem gamblers, meaning gambling causes problems for them, but not enough for it to be labeled a behavioral addiction.1
What Is Problem Gambling?
According to the American Psychiatric Association, at least 5 of the following symptoms must be present in order for gambling to be considered pathological:2
- Gambling to escape problems or uncomfortable emotions, such as sadness and anxiety
- Attempting to win back past losses by gambling larger amounts of money
- Unsuccessfully trying to cut back on gambling
- Needing to increase amounts spent on gambling to achieve the same level of excitement
- Lying to others about time and money spent on gambling
- Spending a significant amount of time thinking about gambling, such as reminiscing on past gambling experiences or pondering means of obtaining money for gambling
- Borrowing money to cover gambling losses
- Committing crimes to get money for gambling
- Feelings of restlessness or irritability when attempting to quit or cut back on gambling
- Losing a job, relationship, or a beneficial opportunity because of gambling
Pathological gambling is far more than just a financial problem, it can take a serious toll on a person’s professional, emotional, and family life. Many complications can arise out of compulsive gambling, such as:2
- Financial issues.
- Relationship problems.
- Drug and alcohol abuse.
- Suicide attempts.
- Heart attacks in association with the excitement or stress of gambling.
More on Gambling
Gambling can be a fun and exciting, low-risk recreational activity for some people. For others, however, gambling shifts from casual pastime to serious addiction.
Pathological gambling is a serious behavioral addiction that affects the brain in a way similar to drug addiction. There are close parallels between the rewards or highs that some people experience as a result of gambling and those that others may get from drinking alcohol or using drugs. And over time, those with problematic gambling behaviors may develop tolerance similarly to how those abusing drugs would—soon finding that they need to gamble more to achieve the same kind of euphoria they did initially. This can create cravings for the emotional effect gambling provides and may lead a person to be unable to resist acting on the impulse.1
Although gambling addiction is just as prevalent a mental health conditions such as schizophrenia and bipolar disorder, it receives less public awareness or attention from researchers and clinicians. Pathological gambling often goes undiagnosed even in a clinical setting simply because clinicians fail to screen for the behavior in the first place.3 Without a proper diagnosis to begin with, appropriate treatment may be even more difficult to come by.
Acknowledging a problem and seeking treatment for pathological gambling is a key to learning how to stop the problematic behavior. So what kind of help has proven effective in stopping gambling? The following are a few options.
Individual counseling is an important component of gambling addiction treatment because it helps you address how your thoughts and feelings lead to compulsive gambling behaviors. Through therapy, you can become more aware of dysfunctional thought patterns, reduce the urge to gamble, and learn how to appropriately react to cravings for gambling when they arise.
Common therapies used for gambling addiction include:4
- Cognitive Behavioral Therapy (CBT): CBT for gamblers usually consists of about 8 to 15 therapy sessions, with the goal of helping you address the negative thoughts or cognitive distortions that contribute to gambling behaviors. A common cognitive distortion among gamblers is commonly referred to as “gamblers fallacy,” which is when people think they are due to win after a certain amount of losses, when in reality, each gamble is subject to random chance. CBT therapists also teach behavioral techniques to help prevent you from engaging in gambling behaviors, such as limiting financial resources, avoiding casinos, or disconnecting the internet in cases of internet gambling.
- Exposure Therapy: Exposure therapy works by presenting people with stimuli (i.e. images and sounds) that produce an urge to gamble. By exposing them to such stimuli under supervision, they can safely learn strategies to prevent them from acting on the urge and become more confident in their ability to practice self-control in situations that might otherwise promote gambling behavior.
- Psychodynamic Therapy: Psychodynamic therapy for gambling focuses on reducing feelings of guilt and shame that often accompany compulsive gambling; resolving conflicts it has caused or contributed to; and identifying meaning behind gambling addiction. Clients in psychodynamic therapy address their defense mechanisms that contribute to gambling, learn about their motivations to gamble, and find the motivation necessary to engage in an alternative behavior.
Family therapy may also be an important component of gambling addiction treatment, since gambling often affects many members of a family, not just the person with the gambling addiction. Family therapy helps you identify problematic family dynamics while addressing gambling habits and how they impact the family as a whole. Some of the familial problems that occur because of gambling include: 4
- Relationship conflicts.
- Separation or divorce.
- Domestic violence.
- Dishonesty and trust issues.
- Enabling behaviors.
- Financial problems.
There are many residential treatment centers across the United States that offer gambling addiction treatment. While it is rare to find a treatment center exclusively for gambling addiction, many treatment centers exist that offer gambling addiction services in addition to treatment for other behavioral addictions such as substance abuse and eating disorders.
Inpatient treatment provides care 24 hours a day, 7 days a week for a designated period of time. By residing in the facility full-time, you can focus exclusively on recovery without the opportunity to relapse into gambling behaviors. Residential treatment centers provide daily therapeutic activities that address compulsive gambling from a physiological, psychological, and social perspective, including:
- Individual counseling.
- Group therapy.
- Family therapy.
- 12-step programs.
- Support groups.
- Complementary and alternative therapies.
While there aren’t any medications approved by the U.S. Food and Drug Administration (FDA) for treating pathological gambling, medications may be prescribed for off-label use. Certain medications that have successfully treated substance abuse have also showed promise in treating gambling addiction, including: 3
- Opioid antagonists: Opioid antagonists like naltrexone work by inhibiting the brain’s production of dopamine, which contributes to the euphoric rush you experience when you gamble. By reducing the pleasure and excitement of gambling, it can reduce the intensity and frequency of urges to gamble.
- Mood stabilizers: Mood stabilizers such as lithium have been used in people with gambling addiction who also suffer from bipolar disorder. Limited research has been done, so it is still unclear how effective these medications are at reducing the consequences of problematic gambling.
- Antidepressants: It is hypothesized that antidepressants can reduce pathological gambling by acting on the brain’s serotonin system, which plays a role in impulse control. However, research studies have been inconclusive, not demonstrating a major difference in gambling behaviors in comparison to placebos. Researchers have suggested that people suffering from gambling addiction may require a higher dose. Regardless, those with serious gambling problems may still benefit from taking antidepressants. People may feel less occupied with thoughts of gambling and have improved social and occupational functioning, which may reduce the urge to gamble.
Outpatient treatment allows a person to continue working, going to school, and engage in other activities outside of the recovery environment.
Outpatient treatment is similar to inpatient treatment, except that care takes place on a part-time basis and you live at home throughout the treatment duration. Many intensive outpatient treatment programs exist for gambling addiction, and typically provide 9 or more hours each week of therapy and recovery activities. Outpatient treatment may be used as a step down for those completing inpatient treatment, or alternatively, it may be used to prevent the need for more intensive therapies.
Others may choose outpatient treatment if their gambling addiction is less severe or perhaps they need to remain involved in professional or personal activities throughout the treatment process. Outpatient treatment allows a person to continue working, going to school, and engage in other activities outside of the recovery environment. The same types of treatment and therapies are offered on an outpatient basis as in residential treatment, such as counseling and peer support.
Gamblers Anonymous is a peer support group that follows the traditional 12 steps of Alcoholics Anonymous (AA) with a focus on gambling addiction. 5 Meetings are free to attend, and the only requirement to join is a desire to stop gambling. Gamblers Anonymous provides members with peer support and fellowship as well as a linear, step-by-step process to prevent relapse and obtain long-term recovery. While the fellowship does have a spiritual emphasis of giving oneself over to a higher power, a person does not need to be spiritual or religious to participate.
Gamblers Anonymous promotes complete abstinence from gambling, because it feels that compulsive gamblers cannot gamble normally again. It also believes that while knowing the reasons behind gambling can be helpful, it is not necessary to have this insight to quit compulsive gambling.
- National Council on Problem Gambling. (n.d.). FAQ.
- Rogge, T., U.S. National Library of Medicine. (2016). Compulsive Gambling.
- Grant, J. & Won Kim, S. (2006). Medication Management of Pathological Gambling. Minnesota Medicine, 89(9): 44–48.
- Fong, T. (2003). Types of Psychotherapy for Pathological Gamblers. Psychiatry (Edgmont), 2(5): 32–39.
- Gamblers Anonymous. (n.d.). Questions and Answers about Gamblers Anonymous.