Pathological Gambling (Gambling Disorder)

Overview

Pathological gambling, now usually called gambling disorder, is a mental health condition in which a person is unable to control the urge to gamble even when it causes serious problems in their life. It is recognized as a behavioral addiction because it shares many features with substance addictions, including loss of control, cravings, and continued behavior despite harm.

Gambling disorder is more than simply enjoying betting or having a run of bad luck. People with the condition keep gambling to chase losses, gamble with money they cannot afford to lose, and find it very hard to stop even when they want to. The behavior can devastate finances, damage relationships and careers, and cause significant emotional distress, including depression and thoughts of suicide. It is a treatable condition, and many people recover with the right help and support.

Symptoms

Gambling disorder is recognized by a pattern of problematic gambling behavior. Common signs include:

• Needing to gamble with increasing amounts of money to feel the same excitement
• Feeling restless or irritable when trying to cut down or stop
• Repeated unsuccessful efforts to control, cut back, or stop gambling
• Being preoccupied with gambling, such as constantly planning the next bet or reliving past ones
• Gambling when feeling distressed, anxious, or low
• Chasing losses by returning to win back money
• Lying to hide the extent of gambling
• Risking or losing relationships, jobs, or opportunities because of gambling
• Relying on others for money to cope with gambling debts

Gambling disorder is strongly linked to depression, anxiety, and an increased risk of suicidal thoughts. If you or someone you know is having thoughts of self-harm or suicide, seek help immediately by contacting a crisis line or emergency services.

Causes

Gambling disorder develops from a combination of biological, psychological, and social factors. Contributors include:

• Brain reward system: Gambling activates the brain's reward pathways in ways similar to addictive substances, reinforcing the behavior.
• Genetics and family history: A family history of gambling or other addictions increases risk.
• Mental health conditions: Depression, anxiety, substance use, and other disorders often occur alongside gambling problems.
• Personality and circumstances: Impulsivity, stress, and easy access to gambling can all play a part.

The growth of online and app-based gambling, available at any time, has made it easier for problems to develop and harder to step away.

Risk Factors

• A family history of gambling problems or other addictions
• Other mental health conditions, such as depression, anxiety, or substance use
• Starting to gamble at a younger age
• Impulsive or competitive personality traits
• High levels of stress or financial pressure
• Easy access to gambling, including online and mobile betting

Diagnosis

A mental health professional diagnoses gambling disorder through evaluation, since there is no laboratory test. The process may include:

• Clinical interview: Exploring gambling habits, attempts to stop, and the impact on finances, relationships, and mood
• Review of criteria: Assessing how many features of gambling disorder are present and over what time
• Screening questionnaires: Brief self-report tools that help identify problem gambling
• Screening for related conditions: Checking for depression, anxiety, substance use, and thoughts of self-harm

Treatment

Gambling disorder is treatable, and many people recover with a combination of approaches tailored to their needs.

• Psychotherapy: Cognitive behavioral therapy helps people recognize triggers and harmful thinking, develop coping skills, and resist urges. It is a cornerstone of treatment.
• Support groups: Peer support programs such as Gamblers Anonymous offer encouragement and accountability.
• Medication: No medicine is specifically approved for gambling disorder, but medicines may help treat accompanying depression, anxiety, or other conditions.
• Practical measures: Self-exclusion schemes, limiting access to money, and financial counseling to manage debt.
• Treating co-occurring conditions: Addressing depression, anxiety, and substance use that often accompany gambling problems.

Recovery can take time and may include setbacks, but with ongoing support many people regain control of their gambling and rebuild their lives.

Prevention

• Set strict limits on time and money spent gambling, and stick to them
• Never gamble to escape stress, low mood, or to win back losses
• Avoid gambling with money needed for essentials
• Use tools such as deposit limits and self-exclusion on gambling apps and sites
• Seek help early if gambling starts to feel out of control or is causing harm

When to See a Doctor

Reach out to a doctor or mental health professional if you cannot control your gambling, are chasing losses, hiding the extent of it, or if it is harming your finances, relationships, or wellbeing. Help is available and effective. Gambling disorder carries an increased risk of depression and suicidal thoughts. If you or someone you know is thinking about self-harm or suicide, seek help right away by contacting a suicide or crisis helpline or emergency services. National gambling helplines and support services can also provide confidential support.

Related Topics

Frequently Asked Questions

References

1. National Council on Problem Gambling. About Problem Gambling.
2. Mayo Clinic. Compulsive gambling — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Impulse control disorders.
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).