Pathologicalgambling is the inability to resist impulses to gamble, leading to severe personal or social consequences.
Gambling - compulsive; Compulsive gambling; Addictive gambling
Pathological gambling affects 1-2% of adults, andup to 4% of adults living within 50 miles of a casino. It typicallybegins in early adolescence in men and between ages 20 and 40in women.
Pathological gambling is a brain disease that seems to be similar todisorders such as alcoholism anddrug addiction. These disorders likely involveproblems with the part of the brain associated withbehaviors such as eating and sex. This part of the brain is sometimes called the "pleasure center" or dopamine reward pathway.
In people who develop pathological gambling, occasional gambling leads to habitual gambling. Stressful situations can make gambling problems more severe.
People with pathological gambling often feel ashamed and try to avoid letting others know of their problem. The American Psychiatric Association defines pathological gambling as consisting of five or more of the following symptoms:
- Preoccupation with gambling (spending much of the time thinking about gambling, such as past experiences, or ways to get more money to gamble with)
- Needing to gamble larger amounts of money in order to feel excitement
- Repeated unsuccessful attempts to cut back or quit gambling
- Restlessness or irritability when trying to cut back or quit gambling
- Gambling to escapeproblems or feelings of sadness or anxiety
- Chasing losses (gambling larger amounts of money to try to make back previous losses)
- Lying about the amount of time or money spent gambling
- Committing crimes to get money to gamble
- Loss of job, significant relationship, or educational or career opportunity due to gambling
- Need to borrow money for survival due to gambling losses
Exams and Tests
A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions may also be used to assist in diagnosis.
Treatment for people with pathologicalgambling begins with the recognition of the problem. Since pathological gambling is often associated with denial,people with theillness oftenrefuse to accept that they are ill orneedtreatment. Most people withpathological gambling enter treatment under pressure from others, rather thanvoluntarily accepting the need for treatment.
Treatment options include individual and group psychotherapy, medications, and self-help support groups such as Gamblers Anonymous.Gamblers Anonymousis a 12-step program similar to Alcoholics Anonymous. Abstinence principles that apply to other types of addiction, such as substance abuse and alcohol dependence, can also be helpfulin the treatment of pathological gambling.
A few studies have been done on medications for the treatment of pathological gambling. Early results suggest that antidepressants, opioid antagonists, and mood stabilizers may help treat the symptoms of pathological gambling.
Like alcohol or drug addiction, pathological gambling is a chronic disorder that tends to get worse without treatment. Even with treatment, relapses are common. Nevertheless, people with pathological gambling can do very well with appropriate treatment.
People with pathological gambling oftenhave problems with substance abuse, depression, and anxiety. For example, up to half of people with pathological gambling also have alcohol and drug abuse problems. People with pathological gambling frequently consider suicide, and 15-20% of them attempt it.
People with pathological gambling tend to experience financial, social, and legal problems. These can include bankruptcy, divorce, job loss, and incarceration. The stress and excitement of gambling may lead to heart attacks in vulnerable people. Many of these complications can be prevented with appropriate treatment.
When to Contact a Medical Professional
Call your health care provider or mental health professional if you believe you have symptoms of pathologicalgambling.
Exposure to gambling may increase the risk of developing pathological gambling. Minimizing exposure may be helpful for vulnerablepeople. Public exposure to gambling, however, continues to increase in the form of lotteries, electronic and Internet gambling, and casinos. Intervention at the earliest signs of pathological gambling may prevent worsening of the disorder.