Gambling is any activity in which people risk something of value on an outcome that is determined at least partly by chance. The activity may involve money, goods, or services, and it can take place in a wide variety of settings. Some examples include placing a bet on a football game, buying a scratchcard, or playing a video game. Some forms of gambling are more risky than others. For example, betting on a horse race or a sports team might be considered gambling while playing poker is generally less risky. In addition, people can also gamble by investing in stocks and other financial instruments.
Problem gambling (PG) is an addiction that interferes with a person’s everyday functioning. Symptoms include: (1) the compulsive use of gambling that causes significant distress, (2) a lack of control over the behavior, and (3) failure to stop gambling even when it becomes disruptive or harmful to one’s life, work or relationships. In the past, the DSM-III criteria for substance dependence were used to diagnose PG, but these have been criticized for their unidimensionality and middle-class bias (Lesieur, 1984). It is unclear whether these criteria are useful in clinical practice because there may be unique features of PG that do not exist in SUDs. For example, loss chasing – the urge to continue gambling in order to try and get back lost money – is common in PG but is not necessarily found with other addictive behaviors.
The brain is wired to seek rewards, and gambling is a way to get those rewards. The act of gambling activates the reward center, and the body produces dopamine when a person wins. However, many people who struggle with a gambling disorder find that they experience the same positive feelings when they are losing. This makes it difficult to recognize that they have a problem.
A person’s family and community can play a critical role in helping them overcome gambling disorder. Often, problems in other areas of life – such as depression, anxiety, or substance abuse – can lead to or make worse gambling disorders. Family members should be aware of these factors and help their loved ones to seek treatment when necessary.
The US Food and Drug Administration has not approved any medications to treat gambling disorders, but psychotherapy can help. This involves talking with a mental health professional about unhealthy emotions, thoughts and behaviors related to gambling. The goal is to learn healthier ways to cope with stress and change negative patterns of behavior. For example, a therapist might teach a patient how to set boundaries with family and friends to prevent them from gambling together or how to manage their finances in a healthy manner. Psychotherapy can be done in group or individual sessions. Some types of psychotherapy, such as cognitive behavioral therapy and interpersonal therapy, are effective in treating gambling disorder. For more severe cases, inpatient or residential treatment programs may be needed. These programs provide round-the-clock care and support to help a person recover from their gambling disorder.