The Grip of Gambling Addiction

“It’s like crack, only gambling was worse for me, because it’s mental,” said a 37 year-old professional woman from New York. “It creeps up on you, the impulse. I lost my law practice, apartment and parents’ home, and owe the IRS back taxes.” This young woman even considered swerving into oncoming traffic to kill herself. She put everything she had towards her gambling habit and lost everything. 

In 2019, a Canadian man filed a lawsuit suing a casino for allegedly letting him lose more than $260,000. He stated the casino took advantage of his status as a compulsive gambler. “Each time he made a bet, he chose the amount of money he wanted to play in full knowledge of the risks associated with that wager,” defense lawyers said in a statement. 

Obsessed with winning a gambler no longer thinks clearly. They’re in the grip of such a powerful mental obsession, they can’t discern between right and wrong. They bet their pay checks, mortgage their home and sell valuable possessions for money; borrow from family, friends and loan sharks; embezzle from their workplace, steal from the kids’ piggy banks, cash in bonds and retirement savings, max out credit cards and can still deny there’s a problem. In extreme cases, there is nothing left for food, clothes, rent or mortgage payments. Families can go without the basics.

What is Gambling?

Gambling means to play for money or property; to bet on an uncertain outcome; to stake something on a contingency: take a chance; or placing something of value at risk for the chance of obtaining something of greater value. It can become an addiction.

While the term addiction usually applies to the use of mind-altering substances, in recent years, there has been a better understanding of non-substance related addictions. With these conditions, there is an overriding desire to engage in a range of behaviors, even when significant risk presents.

Few gamblers see how their behavior contributes to their mounting problems. The constant inner tension a compulsive gambler lives with is crushing. Many drink in an effort to reduce this tension. Many “blow up” to relieve the pressure.

They are masters at blaming external circumstances and other people for their troubles — often a spouse or significant other is a prime target for blame. Living with a compulsive gambler is like walking blind in a minefield, never knowing when you’re going to step on a bomb. Family and friends never know from one day to the next what a gamblers mood and temper will be, and they live in fear. 

Sometimes rage leads to verbal abuse: name calling, harsh criticism, and out-of-control yelling. After the storm has passed, the gambler is always very sorry, and promises never to do it again. Then a few normal days follow — until the next time, there’s always a next time.

Symptoms and Signs

Without knowing the symptoms and signs of this disorder, someone may not realize the entire impact gambling is having on their life. Not all gambling is addiction. There are those who can  and do play responsibly.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) list’s criteria for every recognized mental health disorder. For gambling addiction, the criterion begins with “persistent and recurrent” gambling behaviors that have been problematic and result in significant distress. If a person agrees this is true for them, they can move to the next nine symptoms.

Behaviors

• Need to gamble more often with larger amounts of money to find the desired level of thrill and enjoyment.
• Make repeated, unsuccessful attempts to cut back, end, or control their gambling.
• Feel restless, irritable, and uncomfortable during these attempts.
• Find themselves always thinking about gambling by:
• Reliving past wins and losses,
• Preparing for the next gambling scheme,
• Planning ways to get more money,
• Gambling when feeling sad, nervous, helpless, or guilty,
• Feel the need to get even after a loss by attempting to win back money
• Lies to minimize the true state of the gambling,
• Risks relationships, career, or education,
• Depends on others to bail them out of dangerous financial situations caused by gambling.

When looking for these signs and symptoms, an individual only need four out of the nine to meet criteria for gambling disorder. The current severity of the condition is determined by the number of symptoms they relate to.

• A mild disorder is either four or five symptoms.
• Moderate disorder is six or seven symptoms.
• Severe disorder is eight or nine symptoms.

Some with gambling disorder will experience their symptoms consistent with a steady rate of gambling. This is called persistent gambling disorder.

Others gamble in bursts that can last for hours, days, weeks, or months — followed by a period without symptoms lasting for several months. This is episodic gambling disorder.

Accurately Assessing Gambling Habits

People with addictions often minimize their symptoms. Gamblers frequently downplay the amount of money they spend; the number of losses compared to wins, and the negative effects gambling has on their lives.

They lie to others and to themselves to reduce the feelings of guilt, shame, and responsibility. Because of this, it’s challenging for a person to assess their own symptoms of gambling accurately.

For some, gambling might seem like a positive coping skill because it’s exciting and enjoyable at times. In actuality, for some gambling is a negative coping skill that may bring about immediate relief before producing constant stress, sadness, and frustrations.

A person may breeze through the list of nine symptoms only to assure themselves there is no problem, the gambler just needs to “hit a hot streak.” This is dangerous and leads to more profound denial.

To counteract this phenomenon, an individual may consider reviewing the criteria with a trusted professional — someone who knows the true extent of their gambling. By combining their point-of-view with their perspective on the gambling behavior, an individual can arrive at a more objective assessment of their problem.

Who is at Risk?

Gambling disorder is not the most prevalent mental health condition affecting Americans, but it does pose a risk to millions.

Pathological Gambling Statistics

• Gambling addiction affects as many as one percent of Americans at some point in their life.
• Males are more likely than females to have gambling disorder, though this gap is getting smaller.
• Men are more likely to gamble on sports, card games, and horse racing.
• Women are more likely to wager on slot machines and bingo games.

Gambling disorder is a condition that affects people throughout their lifetime. Symptoms can first appear during early adolescence in some or during late adulthood for others. In either case, the behaviors are usually mild initially before developing into severe cases over time.

The Health Risks

Like any other addiction, gambling can dramatically impact a person’s physical health, mental health, and overall well-being. People with gambling disorder are at higher risk of cardiac issues and substance use disorders, and depression and anxiety. If left untreated, gambling addiction can quickly consume a person’s life.

Can a Gambler Ever Stop? 

Gambling disorder will not vanish or stop on its own. To make significant, lasting improvement, professional treatment is recommended. Gamblers Anonymous is the most utilized treatment approach. Cognitive Behavioral Therapy (CBT) is the most studied approach, and the approach with the most evidence for effectiveness.

If treatment is available and an option — knowing what to be aware of will ease the anxiety of reaching out and asking for help. Treatment is not the same as a self-help group. Addiction treatment will look different — depending on a person’s needs and level of treatment being offered. A mental health professional or addiction specialist can evaluate the symptoms, supports, and stressors and recommend appropriate services to treat gambling disorder.

Some problem gamblers seeking treatment will have difficulty working toward long-term lifestyle changes. They may have difficulty changing behavioral skills without help, due to their increased impulsivity and possible executive function problems. They will need strategies to help them direct their own behavior and keep long term goals in the forefront of their thinking.

Addiction treatment can be intense and involve living at a treatment center for an extended period or attending many hours of outpatient treatment weekly. Other treatments can be less intense and require only a few hours of therapy per month.

Like other conditions, it is important to engage in the level of care that best fits the needs. There are no medications prescribed for gambling disorder, but medications may be helpful in treating other mental health concerns. 

Many people gamble without serious risk, but for those with gambling disorder it’s a substantial hazard. If you or someone you know is at risk of a gambling addiction, seeking treatment early can reduce future harms.

If someone does becomes addicted, their entire life will eventually be impacted. They can face financial ruin, the loss of their home or business because of debts, the ending of a marriage or loss of child custody, or the downward spiral that can lead to additional addictions and psychological ailments.

A gambling problem may be held secret, leading the person struggling to feel increasing isolation and loneliness, not seeing a way out of their increasing problems from gambling.  For many who struggle, suicide might appear to be the only way out.

Problem Gambling, Mental Health, and Suicide

Problem gambling is typically accompanied by other difficulties. Very often, a person struggling with problem gambling is also struggling with mental health disorders and suicidal ideation. Of people struggling with gambling disorder:

• 40% also struggle with anxiety disorder,
• 50% also struggle with a mood disorder,
• 60% also struggle with a personality disorder.

In addition, of those 60% of people struggling with gambling disorder and a comorbid mental health disorder, 17% have attempted suicide, which accounts for nearly 1 in 5 people struggling. They are 2.5x more likely to attempt suicide then the general population. These people need help.

49% of people struggling with gambling disorder have thoughts of committing suicide.

(Moghaddam et al, 2015) www.ncbi.nlm.nih.gov/pubmed/25808267

 This is why it is so important to recognize a problem as early as possible and find help for treatment the gambling addiction. 1-800-NEXT STEP provides resources; Gamblers Anonymous provides meetings with support all over town, the Division of Problem Gambling provides resources for gambling therapists all over the State of Arizona. The first step would be to reach out.

The Family

Trying to deal with the stress and tension brought on as a result of the gambler’s behavior jeopardizes the bond among family members. When a spouse, children, siblings and other family members can no longer trust the gambler, feel no sense of security, have no confidence in the gambler or even fear for their future, the result is a breakdown in the family relationships. Endless lies, staying out late or not coming home at all — to threats, manipulation, violence or domestic abuse all contribute to the dissolution of family ties. Shame, avoidance of friends, secrecy and trying to hide the pain further magnify the isolation family members feel as a gambler’s behavior gets more and more out of control. Anxiety, guilt, shame, depression, insomnia, behavioral problems and emotional insecurity begin to afflict all the family members closest to or living in the same environment as the problem or compulsive gambler. With tensions escalating at a dangerous pace, the arguments and emotional outbursts may end in violence. With no trust in the gambler, no belief in their word, the spouse of the gambler often withdraws from the relationship in the form of sex.

Resources for Families

Gam-Anon is a free peer support organization for the families and loved ones of gambling addicts. Gam-Anon works as a support group by bringing together people affected by a gambling addict so they can share experiences and encouragement. For a list of meetings visit www.gam-anon.org/meeting-directory/arizona.

Support for Addicts

In informal support groups, people with addictions meet to talk about their problem, share success stories and support one another. Gamblers Anonymous is a 12-step program modeled after the one used by Alcoholics Anonymous. The organization’s website includes a page of 20 questions that help a person determine whether they have a gambling problem.

Resources:

Division of Problem Gambling- 1-800-NEXT STEP, https://problemgambling.az.gov/

Gamblers Anonymous — www.gaphoenix.org/

ACT Counseling & Education- 602-569-4328, www.actcounseling.com

AZ Council Compulsive Gambling

1-800-777-7207

Compass Recovery

1-800-216-1840

National Gambling Hotline

1-800-522-4700

Treatment Provider List:

problemgambling.az.gov/additional-links

It is often mistakenly assumed compulsive gambling is not a real addictive disorder, since the individual is not consuming a potentially lethal chemical substance. Gambling has ruined thousands of lives since staking wagers first came about. Recovery is possible. If you need help, reach out. In my practice I’ve witnessed success with the clients I work with.
Bobbe McGinley has been working in the field of Chemical Dependency since 1988, and she has worked with Problem and Compulsive gamblers since being Certified by the Arizona Council on Compulsive Gambling, Inc. in 1996 and Nationally Certified in 1999. Bobbe works in private practice, where she is now Clinical Director, Counselor and Consultant at her agency ACT – Counseling & Education. For information 602-569-4328 and www.actcounseling.com