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Gambling Addiction

Gambling Addiction disorder is divided into two sub-categories. Problem Gambling, and the most severe form of addiction, Pathological Gambling. Problem Gambling may be an earlier stage of Pathological Gambling (otherwise called Compulsive Gambling), though problem gamblers may never develop into pathological gamblers. More research is still required in this area. Gambling Addiction behaviors damage the patient’s personal life, their family, their finances and their career. Because the disorder has significant financial consequence to the patient and family, it can devastate the family if left untreated. Patients with gambling addictions are often strong, responsible, intelligent people. Life changing stress, or events like retirement or being fired, can prompt this disorder in people whose personality, heredity, or other predispositions toward addiction.

Under the right conditions, anyone that gambles can develop a problem if they do not understand the risks. Gambling frequency does not define a gambling problem. The patient may go on gambling binges periodically, rather than exhibiting a persistent daily or weekly pattern. Winning or losing a lot of money does not necessarily create a gambling problem. Some studies indicate that games with a faster ‘wager to response time’ may create more gambling problems, but there is still much research to be done on this subject.

The gambler does not ingest any substance, but he gets the ‘high’ just as someone who is addicted to alcohol or drugs. Gambling alters mood and the gambler repeats the behavior to repeatedly achieve this effect. But just as a tolerance to drugs and alcohol prompts the addict to increase the amount of intake, the gambler has to increase activity to achieve the same impact over time.

Some problem gamblers never have problems with any other kind of addiction, though there are some who are also addicted to alcohol or other substance or activity. There is some research to support the idea that family history of dependency disorders may predispose a patient to Gambling Addiction to Alcohol Addiction.

What are the symptoms?

• Preoccupation with gambling, games of chance
• Restlessness, irritability if patient is trying to ‘withdraw’ from the addiction
• In severe cases, patients may exhibit suicidal tendencies
• Unreasonable optimism about ‘winning’
• Feeling guilty or remorseful over gambling
• Losing sleep over gambling
• Gambling until the last dollar is gone
• Difficulty in concentrating on tasks and activities at work and at home
• Continued behavior in spite of serious financial, legal, personal consequences
• Borrowing money to pay financial obligations or for gambling activities
• Using income or savings to spend on gambling instead of paying bills
• Increase in amounts wagered, frequency of gambling, and time spent on gambling
• Repeated, unsuccessful attempts to quit

The Robert L. Custer Three Phase Model of gambling addiction progression defines the symptoms in each phase as follows:

The Winning Phase: Big win or series of wins, unreasonable optimism that winning will continue, great excitement during gambling, increased amount of bets

The Losing Phase: Bragging about previous wins, gambling alone, thinks constantly about gambling and borrowing or stealing money. Lying to family irritability, restlessness, withdrawn, problems at home and at work

The Desperation Phase: Marked increase in time spent gambling, accompanied by remorse, blaming others, alienation of family/friends, hopelessness, alcohol/drug abuse, suicidal thoughts, emotional breakdown

How is it diagnosed and treated?

To be diagnosed as a Pathological Gambler, having a Gambling Addiction, a patient must meet at least five of ten criteria established by the American Psychiatric Association in 1994:

• Loss of control
• Withdrawal
• Gambling to escape problems
• Jeopardizing family, education, job
• Serious financial problems, requiring bank loans or other bailout
• Loss of tolerance
• Increased preoccupation
• Long-term chasing of the ‘win’
• Lying about gambling Distress, anxiety, depression or edginess
• Illegal activities to finance gambling or pay off debt

Most patients enter treatment only with pressure from family, employers or friends. They do not believe they have a problem.

Treatment(s) can include:

• Learning coping skills to deal with urges to gamble
• Medication lie antidepressants
• Family therapy
• Financial ‘workout’ counseling to address debt
• Self-Help Groups like the Gamblers Anonymous 12-Step Program
• Individual psychotherapy
• Group psychotherapy

Family plays an important role in rehabilitation. Their presence and involvement in therapy greatly improves the patient’s response to treatment.

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