You don’t have to live near a casino to be surrounded by opportunities to gamble. At work or among friends, you might be asked to wager a few dollars on a big basketball tournament or football game. At grocery stores and gas stations, you can buy lottery tickets. Your local bar might have a video poker machine or host a bingo night. In recent years, a growing number of states, including North Carolina, have changed their laws to allow online sports betting.
Gambling is widespread: 85 percent of adults in the United States have participated at least once. For about 1 to 3 percent of them, however, it is a problem. According to the National Council on Problem Gambling, an estimated 2.5 million adults in the U.S. have a severe gambling disorder or gambling addiction, while an additional 5 million to 8 million have mild to moderate gambling problems.
Who is at risk of a gambling addiction, and what can be done about it? UNC psychologist Lorie Ritschel, PhD, provides insight.
Symptoms of a Gambling Addiction
The American Psychiatric Association defines a gambling disorder as an addictive disorder. To be diagnosed, you would exhibit at least four of these criteria in a year:
- Feels a need to increase the amounts of wagers to achieve a thrill
- Becomes irritable when trying to reduce or stop gambling
- Repeatedly tries to cut back on or stop gambling unsuccessfully
- Thinks frequently about gambling, whether that’s reliving past experiences, planning future experiences or considering ways to get money for gambling
- Gambles when feeling distressed
- Returns to gambling a day after losing money to try to win it back
- Lies to hide gambling activities
- Risks or loses relationships, jobs or other opportunities because of gambling
- Relies on others to provide money for financial problems caused by gambling
Experiencing just one or two of these criteria could indicate a major concern and result in financial troubles, impaired relationships and job loss. Gambling addiction has been linked with health problems including sleep issues, hypertension, cardiovascular disease, ulcers, depression, anxiety and suicidal thoughts.
The significance of someone’s gambling problem can’t be determined by the amount of money they lose, although accruing significant debt may be how loved ones discover the issue.
“Some people operate in privacy and can keep their gambling hidden,” Dr. Ritschel says. Others are more open about their activities and “enjoy the social element of casinos or a Friday night poker game.”
Possible Causes of Gambling Addiction
Anyone who gambles can become addicted to it. Gambling addiction is caused by a mix of genetic, psychological and environmental factors, though researchers are still determining why some people develop problems around this behavior.
The risk of gambling addiction may be slightly higher for adolescents, people with a family history of problem gambling and those who have another psychiatric or substance use disorder.
For some people, gambling provides a unique neurological reward. When you win a bet, your brain releases dopamine, which makes you feel good, and you’ll continue to play to try to achieve that.
“It’s a question of how much of a dopamine kick a person gets from winning or anticipating a win versus how much of a hit the loss or potential loss would be,” Dr. Ritschel says. “Some people find that risk of loss very anxiety-provoking, but others may be more focused on the satisfaction of a short-term gain rather than a long-term consequence.”
Treating a Gambling Addiction
Treatment for gambling addiction is similar to treatment for substance addiction, though options for inpatient and residential facilities specific to gambling are more limited.
When you seek treatment for substance addiction, you learn about controlling access to that substance. With gambling addiction, however, the issue is complicated, especially with the rise of online betting and gaming.
“Controlling access to gambling is harder when it’s available on your phone every day,” Dr. Ritschel says. “It is going to be more difficult now that there’s more access with technology.”
People with a gambling disorder may experience shame about their behaviors and their inability to stop, which can be a barrier to asking for help. “Addiction usually involves a belief that the person is broken or bad,” Dr. Ritschel says. “If we can address that, it can be a big motivator for change.”
As with other addictions, group meetings and peer support may aid in treatment. The National Council on Problem Gambling offers a hotline that connects people to local resources including therapists, counselors and support groups.
Through cognitive behavioral therapy, you can learn to modify your thinking or behavior patterns. A therapist can also help you clarify your values and see the ways in which gambling is inconsistent with them, so you can set goals to avoid problem behaviors.
“A values-based approach can help the person make a commitment to not engage in a problem behavior if it will compromise their family, their marriage or their future,” Dr. Ritschel says.
Another reason to try therapy is to understand some of the cognitive distortions associated with gambling, such as the idea that if you play long enough, you’ll win, or that skill can be advantageous in games of chance.
Helping Someone with a Gambling Addiction
If you are worried about a loved one’s gambling problem, Dr. Ritschel advises speaking with them calmly, which may be hard to do if you’ve discovered a huge financial loss. “It’s easier for someone to get defensive when they are approached with anger,” she says.
It can also be difficult for people to acknowledge that they have a gambling problem, and it may take multiple conversations for them to realize they need to change.
“With any problem behavior, try to approach the issue nonjudgmentally to the extent possible,” Dr. Ritschel says. “Try to be curious and make an attempt to understand why the behavior is happening and share concerns about how the behavior is hurting the marriage or the family.”
Concerned about addictive behaviors? Talk to your doctor. If you need a doctor, find one near you.