Gambling Disorders: Diagnosis and Treatment

In the United States gambling is a common recreational activity. About 80 percent of adult Americans have gambled at least once in their lives, and the statistics on adolescent gambling reveal similar levels of participation.

Primarily because it is so profitable, gambling has now been legalized in one form or another in 48 out of 50 states (Utah and Hawaii are the exceptions).  Meanwhile, the rapid proliferation of online waging websites has made this popular pastime more accessible than ever before. Gambling worldwide is a multi-billion dollar industry and its growth has shown no signs of slowing down.

The majority of people who gamble are able to do so without negative consequences. Their wagering is voluntary, irregular and practiced with restraint. Nevertheless, gambling can be highly addictive and many people who start casually are eventually unable to control their behavior.

A Stealth Disorder in Action

The descent from problem gambling to pathological gambling is steady and progressive. In its final stages, a gambling disorder can be every bit as overwhelming and disabling as drug or alcohol addiction.

No matter how many personal, professional and financial problems they encounter as a result of their gambling, pathological gamblers find it virtually impossible to stop. Gambling slowly but surely takes over their minds and bodies until no aspect of their lives is left untouched by their insidious addiction.

If this sounds like your story, you should know you are not alone. About 1 percent of all American adults (two million people) have a pathological gambling condition, while another 2 to 3 percent are problem gamblers whose activities are causing them severe difficulty.

Getting a Diagnosis

At one time, the psychiatric profession classified pathological gambling as an impulse control disorder. Things changed, however, in 2013 when the American Psychiatric Association released the latest edition of its definitive Diagnostic and Statistical Manual of Mental Disorders, the DSM-5. For the first time, pathological gambling was categorized as a true form of addiction, in recognition of the similarities it shares with substance abuse disorders.

The DSM-5 lists nine criteria that can be used to identify a gambling disorder. According to these evidence-based standards, you may have a clinically diagnosable gambling problem if:

  • You are preoccupied with gambling to the point where you plan other life activities around it.
  • Your tolerance levels have increased, meaning you need to gamble more frequently and/or with larger sums of money to experience the same excitement.
  • If you try to quit gambling you experience withdrawal symptoms (anxiety, insomnia, obsessive gambling-related thoughts, mood swings and so on).
  • You have experienced severe financial difficulties and frequently ask friends or relatives for money.
  • You have been lying to your loved ones about how often you gamble or how much you have been losing.
  • You have lost your job, damaged important relationships or squandered promising educational or employment-related opportunities at least in part because of your gambling.
  • While gambling you frequently find yourself “chasing losses” (making larger and larger bets in an effort to make up for past losses).
  • You often gamble to escape negative emotions, interpersonal conflicts or persistent mental health issues like depression, anxiety or PTSD.
  • You have tried to stop numerous times but your efforts have always ended in relapse.

If you meet four to seven of these criteria, a psychiatrist would diagnose you as a mild-to-moderate problem gambler. But if you meet eight or all nine, you would be classified as a pathological gambler, meaning you suffer from a true gambling addiction.

Approaches to Treatment

Research has discovered that gambling disorders cause changes in the operation of the brain’s reward circuitry that mimic the effects of drugs or alcohol. This is why gambling disorders are the first type of compulsive behavioral problem to be officially classified as an addiction.

In recognition of their redefined status, problem and pathological gambling disorders are treated with methods similar to those used to rehabilitate men and women with drug or alcohol addictions. This approach is getting results and can provide a route of escape for anyone struggling to overcome gambling dependency.

Inpatient treatment programs usually include a combination of individual counseling (with cognitive-behavioral therapy prominently featured), family therapy, peer-group discussions, specialized training in self-help strategies and alternative therapies like yoga, meditation or massage, which reduce stress and help encourage a more peaceful state of mind.

While it is not standard practice and is often done only as a last resort, medications used to control substance abuse disorders are occasionally administered to pathological gamblers. This approach has achieved positive results in at least some instances.

Most problem gamblers also suffer from co-occurring medical conditions, including drug and alcohol addictions, mental health problems and personality disorders. Treatment regimens for gambling addiction will be customized to include intervention and rehabilitation for these conditions when they are present, to make sure problem gamblers get the full package of treatment services they require.

Pathological gambling is a notoriously difficult addiction to control, which is why a strong aftercare program must be incorporated into your recovery regimen. Your aftercare will likely include more individual counseling and family therapy, plus active participation in peer-group meetings like those offered through Gamblers Anonymous, a 12-step program modeled after AA.

Stop Gambling With Your Life—Ask for Help Today

Here is a sad and shocking statistic—only one in five people with a serious gambling problem will ever seek treatment for their condition. This is tragic, because an untreated gambling problem can ruin your relationships, your health, your finances and your future.

At this time, most addiction treatment centers do not include gambling disorder intervention on their list of available programs. However, we can put you in touch with treatment facilities that do offer customized rehabilitation services for problem and pathological gamblers.

If you or your loved one can no longer control your gambling, please contact us immediately. We can help you deal with this serious disorder before it sweeps away your hopes, your dreams and your freedom.