What Every US Resident Should Know About Compulsive Gambling

As many as 10 million Americans suffer from compulsive gambling. Compulsive gambling, or formally known as gambling disorder, is the irresistible urge to gamble. Those suffering from this disorder continue to gamble away their lives, despite the toll it takes on themselves and others.

Gambling is defined as the willingness to risk something of value, hoping to obtain something even more valuable. Unfortunately, most bets, especially in the casino world, don't work out as the gambler would like. But despite significant losses, both financial and personal, a compulsive gambler will simply keep gambling,

Someone who suffers from compulsive gambling constantly chases bets leading to even greater losses. Problem gamblers are also adept at hiding their behavior, including piles of debt and depleted savings accounts. Some gambling addicts even resort to fraud or theft to support their gambling habit.

Compulsive gambling is a serious mental condition that should not be taken lightly. The fact is, for some people, gambling stimulates the brain's reward system in the same way as drugs or alcohol. Sadly, for vulnerable people, this can lead to gambling addiction. And, like any addiction, gambling can destroy lives.

Symptoms of Gambling Disorder

Whether you are concerned about your own gambling habits, or with someone else's, it's important to know the signs and symptoms of gambling disorder. 

Compulsive gambling includes:

• A constant preoccupation with gambling, including planning gambling trips and ways to get more money for gambling.
• To get the same thrill, the compulsion to play with more and more money.
• Unsuccessful attempts to control, limit or stop gambling.
• Feeling irritable and restless when trying to limit or stop gambling.
• Gambling is an escape from real life, or to relieve feelings of guilt, anxiety, depression, or powerlessness.
• Chasing losses (trying to win back losses by gambling more)
• Lying to friends, family, and coworkers to hide the magnitude of your gambling.
• Gambling away relationships, your job, education, or opportunities.
• Engaging in fraud or theft to get money to gamble.
• Asking friends and family to bail you out financially, because you gambled all of your money.

Casual gamblers will set a loss limit, and stop when they begin to lose too much. On the other hand, compulsive gamblers are driven to keep gambling, in an attempt to recover their losses. This is a destructive pattern that increases over time, and also affects everyone around the gambler.

Some compulsive gamblers may experience a remission, in which they stop gambling for a while. However, unless they receive treatment, the remission typically is only temporary.

When to Seek Help for a Gambling Disorder

If you suspect that you need help, you probably do. If you see your own behavior listed in signs and symptoms of gambling disorder, you need professional help.

Also, if your friends, family, or co-workers have expressed their concern about your compulsive gambling, take it seriously. Denial is common for any type of addictive behavior, including compulsive gambling.

It may be hard for you to admit that you have a gambling addiction. Addictions have a way of taking control of the addict's thoughts like a parasite, compelling them to feed the addiction. Separate yourself from the addiction, and listen to your heart; do you have a problem with compulsive gambling? And, do you need professional help?

Seeking help for gambling addiction could be the hardest thing you'll ever do, but you will be grateful that you did.

What Causes Compulsive Gambling?

Like any addiction, the exact cause of compulsive gambling remains something of a mystery. Compulsive gambling likely results from a complex combination of nature and nurture. Genetics, biology and the environment could all play a role. For example, many people who suffer from any type of addiction often have parents who also suffered from addiction. In turn, being raised in a household dominated by a parent's addictive behavior negatively impacts a child.

Even people who do not have addictive behavior in their family background can be susceptible to developing an addiction. High levels of stress, perhaps from school or a job, can drive some people to drink, do drugs, or gamble. Likewise, losing someone, either from death or a breakup, can lead some people to relieve that pain with substances or behavior like gambling.

However, some seemingly harmless activities, such as playing video games, can also lead some people into online gambling addiction. The similarity between some of the video games teenagers play, and real-money casino games can not be denied. The gaming habits developed in adolescence sometimes develop into a full-blown gambling disorder.

Risk factors for Gambling Disorder

While most people who play slot machines or occasionally bet on the horses never develop a gambling disorder, certain factors are associated with compulsive gamblers:

• Addictive disorders: Compulsive gamblers often have problems with substance abuse. A gambling addict is much more likely to also suffer from alcoholism and drug addiction than the average person. Sex addictions are also more common among compulsive gamblers.

• Mental health problems: Gambling disorders are often concurrent with personality disorders, bipolar disorder, depression, and anxiety disorders. Compulsive gambling may be concurrent with obsessive-compulsive disorder and ADHD (attention-deficit/hyperactivity disorder.)

• Age: Young and middle-aged people are more prone to compulsive gambling compared to older people. Gambling that begins as a child or teenager increases the risk of developing a gambling disorder. However, compulsive gambling can also affect older adults.

• Gender: Compulsive gambling is more common in males than females. Typically, women who compulsively gamble begin later in life. Also, women often become addicted to gambling much more quickly. On the other hand, men often become addicted to gambling during adolescence or as young adults.

• Influence of family and friends: If someone's friends or family members have a gambling problem, they are much more likely to develop a gambling problem.

• Medications used to treat restless legs syndrome and Parkinson's disease: An odd side effect of dopamine agonists is the development of compulsive behaviors. For some people, that means compulsive gambling.

• Certain personality traits: Highly competitive people, such as athletes or sports fans, are more prone to problem gambling. Also, workaholics, “Type-A personalities” are prone to relieve their stress with gambling. Finally, restless, impulsive, and easily bored people have an increased risk of compulsive gambling.

Young Adults are More Prone to Compulsive Gambling

At high risk for developing a gambling problem are young people between the ages of 18-24. While young adults seem fully grown, the truth is, their brains are still developing. Moreover, young people are still emotionally immature, and often do not operate on logic. Their decision-making skills are not yet mature, making young adults, particularly men, more prone to risky and impulsive behavior.

Online gambling is among the biggest predictors of compulsive gambling in young adults. 

18-24-year-olds are more likely to engage in a variety of potentially risky behaviors:

• Young adults are more likely to be binge drinkers and heavy drinkers, compared to adults older than 25.
• People in this age group also have high levels of cannabis use.
• People aged 22-40 years old are more likely to gamble while drunk, increasing the risk.

The link between video games and online gambling becomes blurred with young people. Both can be played on the same devices, are games of skill and chance, and are visually hypnotic. Some video games include loot boxes, a “gambling-like” element. In some countries, loot boxes are considered a form of gambling.

The combination of immaturity, years of playing video games, along with substance abuse, makes some young people vulnerable to gambling disorders.

Women and Compulsive Gambling

Women tend to begin serious gambling at an older age than men; in the 45-64-year-old age group, women problem gamblers outnumber men. And, while young men tend to gamble for the thrill of risk-taking, 95% of older women gamble to escape. Women also tend to engage in fewer forms of gambling compared to men, sticking to their preferred games.

Middle-aged, female compulsive gamblers have often suffered from abusive and broken relationships. Moreover, they suffer from intense feelings of isolation and abandonment.

Women are often attracted to the glitz and glamor of the casino; not only do casinos satisfy a need to feel glamorous, but they are also a safe, public place. The staff is friendly and accomodating, and women are welcome any time of the day or night.

Women fitting this profile gamble to feel anonymous; they play to dull their emotions and forget their troubles, rather than to win. By gambling, they lose awareness of people, time, and money. They enter a sort of suspended sense of reality, where nothing matters but the game.

Stressful situations melt away, as well as the demands made by others. For such women, gambling satisfies their need for autonomy.

While women develop a gambling problem later in life, the addiction often develops much more quickly. However, women typically seek treatment more quickly than men, too.

Although women are more likely to seek treatment, they're less likely to attend Gamblers Anonymous meetings. This is often due to a fear of men flirting with them, fear of being ridiculed, as well as stigma and guilt. Many also find it very hard to share with strangers their family issues and abusive relationships. 

Men and Compulsive Gambling

Men are more than seven times more liable than women to have a gambling addiction. For young men, gambling is often a way to socially fit in; the guys are all watching the big game together, and the betting begins. That sense of camaraderie can continue well into adulthood, with men getting together to bet on a game or to play poker.

Also, men tend to be bigger risk-takers and more impulsive than women, driving the urge to gamble. The hedonistic nature of the casino lifestyle is also a big draw for men. 

In one study, a group of men and women were made to place their hands in ice water, to stimulate the release of cortisol, a stress hormone. Next, the group engaged in gambling. In the control group, which did not place their hands in ice water, there was no difference in the level of risk-taking between men and women. However, in the ice water group, men took many more risks than women. This suggests that men are more likely to react to stress with risky behavior.

However, like women, abusive relationships, especially during childhood, play a part in male gambling addiction. Compared to men who rarely or never gamble, men with a gambling disorder were more than twice as likely to have experienced physical abuse or witnessed violence at home while growing up. Also, they were more than three times as likely to have sustained a serious or life-threatening injury as a child.

There is a growing body of evidence that childhood trauma is a significant, contributing factor to all types of addiction. 

Consequences of Compulsive Gambling

Like any addiction, there are severe and far-reaching consequences to compulsive gambling. While gambling addiction is easier to hide than substance abuse, the fallout can be equally devastating.

Common consequences of compulsive gambling include:

• Difficult and broken relationships
• Financial problems and bankruptcy
• Legal issues, including prison
• Problems at work, including unemployment
• Poor general health
• Suicidal thoughts, suicide attempts, or suicide

However, compulsive gamblers are also at greater risk of developing stress-related health conditions. This can include hypertension, cardiovascular disease, sleep deprivation, and ulcers. Also, gambling addicts often suffer from substance abuse problems, which also lead to a wide variety of health issues.

Studies show that annually, over $6 billion have been lost  to compulsive gambling. That figure encompasses gambling losses, bankruptcy, forced home sales, and much more.

The gambler is not the only one at risk for serious consequences, due to their behavior; family, friends, and coworkers are also affected. Children of gambling addicts often suffer from emotional abandonment, and sometimes, physical abandonment. Ultimately, the stress of living with an addicted parent leads children to become addicts themselves.

A compulsive gambler not only ruins their own life but also, the lives of those around them. The fallout can be quite extensive, from a lost job to divorce, to bankruptcy and even suicide.

Preventing Problem Gambling

While there is no guaranteed way to prevent a gambling problem, education targeting vulnerable individuals and groups could be helpful. For example, the children of gambling addicts could benefit from programs educating them not only about gambling, but also teaching them positive life skills. Programs providing a safe environment in which these children can develop healthy relationships and self-esteem could be beneficial.

Also, parents of children and teens who spend hours playing video games need to pay attention; online gaming has a way of leading to online gambling. Parents need to track what their kids are doing online and set gaming limits. The immersive, hypnotic quality of video games is very similar to online slot games. Once a kid gets hooked, breaking the addiction can be very difficult.

Anyone with risk factors such as a substance abuse problem, emotional issues, or a personality disorder, should avoid gambling altogether. Also, they should avoid places where people are engaged in gambling, such as casinos and sports bars. While socializing is a good thing, hanging out with friends who gamble, or have substance abuse problems, can lead to disaster.

Find healthful ways to relieve stress and boredom; getting outdoors has many benefits, spiritually, mentally, emotionally, and physically. Rather than resorting to gambling, alcohol, or drugs, find ways to get outside in nature.

While gambling can be a diversion, it can also ruin lives. At the earliest indication of a gambling problem, pull back, and seek help. This can prevent problem gambling from getting worse.

Diagnosing Gambling Disorder

If you know that you have a problem with your gambling, seek help from your doctor, or, mental health professional. Early treatment can help avoid some of the consequences associated with compulsive gambling.

To evaluate your gambling problem, your primary care physician or mental health professional will:

• Ask detailed questions about your gambling habits. They may ask how often you gamble, where, and how much money you usually spend. They may also ask for your permission to speak with your family, friends, coworkers, or employer. But, HIPAA regulations forbid your doctor from revealing any information concerning you without your written permission.

• Review your medical records. Dopamine agonist drugs can have the rare side effect of causing compulsive behavior. This can include gambling. A physical examination may reveal issues with your health occasionally associated with compulsive behaviors.

• Conduct a psychiatric evaluation. The evaluation will include questions about your behavior patterns, thoughts, feelings, and other symptoms related to your gambling. You may also be evaluated for other mental health disorders related to compulsive gambling.

• Use the Diagnostic and Statistical Manual of Mental Disorders. The DSM-5 lists all of the criteria for diagnosing all types of mental and personality disorders, including gambling disorders.

Once all of these steps are completed, your doctor or mental health provider can say whether or not you do have a gambling disorder. Other disorders may also be diagnosed. Once the psychiatric evaluation is complete, a treatment plan can be worked out.

Gambling Disorder Treatment

While treating gambling disorder presents many challenges, professional treatment has helped many people to recover from compulsive gambling. Part of the challenge is because compulsive gamblers have a difficult time acknowledging that they have a problem. However, a big part of treatment is admitting that you're a problem gambler. Until the problem is acknowledged, no work can be done.

If a compulsive gambler's family or job pressures them into therapy, they often resist treatment. But, in order for treatment to be effective, active participation on the part of the gambler is essential. The fact is, treating a gambling problem helps the gambler regain a sense of self-control. It can also help to mend damaged relationships and get finances back on track.

Treatment options for gambling disorder can include the following approaches:

• Behavior Therapy: Behavior therapy is a method using systematic exposure to unwanted behavior, such as gambling. This method teaches new skills to help reduce the urge to gamble. Systematic exposure could involve trips to a casino, sports bar, or racetrack. There, skills are taught and practiced that reduce the desire to gamble.

• Cognitive-behavioral therapy: Placing the focus on identifying unhealthy, illogical, and negative beliefs that lead to gambling. Once identified, they are replaced with healthy, positive beliefs. For example, a belief that there is never enough could be replaced with the belief that the Universe is abundant, and that there is always enough.

• Family therapy: Since family dynamics sometimes play a part in compulsive gambling, family therapy can be helpful. Also, gambling negatively affects the entire family, so all members may need to be involved.

• Psychiatric medications: Antidepressants, anti-anxiety medications, and mood stabilizers could help. Often, mood disorders play a role in compulsive gambling. Some of these medications might be effective in reducing the cause of compulsive gambling behavior. Also, medications used for treating substance abuse, called narcotic antagonists, may help with gambling disorder.

• Self-help groups: Quite a few people find talking with others who have a similar problem is cathartic. Groups such as Gambler's Anonymous can be a big part of recovery. Also, joining a self-help group is a good way to make new friends, with a similar goal of recovery. Ask your mental health professional for advice on where to find such self-help groups, as well as other resources.

Treatment for gambling disorder also involves outpatient programs, inpatient programs, and even residential treatment programs. This all depends on your financial resources and personal needs. Treatment for mood disorders and substance abuse may also be part of your treatment for gambling addiction.

Preventing Relapse

Despite treatment, some people invariably return to gambling. This is particularly true for anyone who spends time with gamblers or in gambling establishments. While painful, breaking ties with the people and places associated with your former life as a gambler might be necessary.

If you feel as if compulsive gambling is taking hold of you, contact your 12-step sponsor or mental health professional immediately, to stop a relapse.

Coping with Problem Gambling and Seeking Support

The following recovery skills can help you to resist the irresistible urge to gamble:

• Remain focused on your top priority: not gambling.
• Remind yourself that gambling is simply too risky. Do not gamble at all. One wager invariably leads to more.
• Sheer willpower is usually enough to resist the urge to gamble. Allow yourself to ask for help. Ask a friend or a family member to help you to stick to your treatment plan.
• Recognize and avoid situations that trigger your compulsion to gamble.

Even when a compulsive gambler is unwilling to go to therapy, their family members can benefit from counseling.

You've Decided to Seek Treatment. Now, it's Time to Prepare for Your First Appointment

Congratulations, you've decided to seek treatment for a compulsive gambling problem. This is a very important step in your recovery.

Before your appointment, sit down and list:

• All of the feelings you have, even if they seem unrelated to your gambling problem. List the feelings that trigger your compulsive gambling.

• List the times you tried to resist gambling, and how you reacted. What emotions did you have?

• List the ways that gambling has affected your life. Note both the good things and bad things.

• Personal information, including any recent changes in your life, or key stressors.

• All medications, including vitamins and herbal supplements, including the dosages.

• Other mental or physical health disorders that you have, as well as any treatments you've received.

• A list of questions to ask your doctor.

Key Questions to ask your doctor:

• What is the best treatment for my gambling problem?
• What are the alternative treatments?
• Should I see an addiction counselor, psychologist or a psychiatrist? Or, should I see a different type of mental health professional?
• Will my insurance cover this?
• Do I need inpatient or outpatient treatment?
• Can you give me any brochures or booklets?
• Do you recommend any websites?

These are just a few key questions. Feel free to ask anything else during your appointment.

Questions to Expect at Your First Appointment

Your doctor will ask you many, personal questions. Be ready with the answers, to save some time to go over things with your doctor.

Your doctor will probably ask:

• When did you first start gambling?
• How many times per week do you gamble?
• In what ways has gambling affected your life?
• Are other people worried about your gambling?
• How much do you usually bet when you gamble?
• Have you ever tried to quit gambling? How did that go?
• Have you previously been treated for problem gambling?
• Are you ready to get treatment now?

Remember, change doesn't happen overnight. But with time and effort, your life will be changed for the better.