For most gamblers, betting on the outcome of a sporting event, lottery drawing, casino table game, or any event with an outcome determined by chance represents an entertaining recreational activity. However, for some, gambling can become an addiction.
Excessive gambling recognized as an addiction
Gambling disorder is now a part of the American Psychiatric Association’s latest version of its diagnostic manual (DSM-5). It is the first “behavioral” addiction included in the substance-related and addictive disorders section of the manual. For the first time, the APA recognizes that substance-related addiction and difficult-to-control behavioral addiction are similar enough to be grouped as comparable expressions of addiction.
Now, clinicians, scientists, policy makers, gambling purveyors, and the public alike recognize that addiction can emerge from patterns of excessive behavior that derive from either using a substance, such as tobacco or alcohol, or engaging in activities like betting, video game playing, or sex. This might come as a surprise, but it’s true. You can become addicted to gambling just like you can become addicted to alcohol or other drugs.
History and causes of gambling problems
Historically, opinions about gambling have tended to mirror the social and moral climate of the day. Gambling problems aren’t anything new; there were scientific papers written about excessive gambling as far back as 1798 and, reaching even further back into history, there are cave drawings depicting gambling-related behaviors. However, the concept that problem gambling is not a moral defect but instead a disorder is relatively new. Most experts and clinicians now consider it a legitimate biological, cognitive, and behavioral disorder. Further, although mental disorders can lead to problem gambling, gambling to excess also can lead to other problems.
Gambling problems have many potential causes: genetics, erroneous thought patterns, impulse control disorders, poverty, and personal experiences, for example. An estimated 2 percent to 3 percent of the US population has experienced some kind of gambling-related problem during the past 12 months. That means about 5.5 million people currently have a gambling disorder, or gambling-related problems that don’t quite rise to the level of a disorder.
Do you have a gambling problem?
To see if you might be struggling with a gambling disorder, try this quick three item screen:
–During the past 12 months, have you become restless, irritable, or anxious when trying to stop and/or cut down on gambling?
–During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?
–During the past 12 months, did you have such financial trouble as a result of gambling that you had to get help with living expenses from family, friends, or welfare?
If you answered yes to any of these questions, you should evaluate your gambling and how it fits into your life. There are many resources to help, and my colleagues and I have published an easily accessible book — “Change Your Gambling, Change Your Life” (Jossey-Bass, 2012) — that can help you to evaluate your gambling and decide whether you might be a candidate for treatment. Some people need treatment to recover from addiction, while others recover on their own with no help from anyone.
To figure out whether you might benefit from a change, you need to take stock. A variety of mental health issues often accompany excessive gambling. You might have some of these symptoms even if they don’t reflect a full-blown disorder. It’s worth it to figure out whether gambling and associated activities are adversely influencing your life. Understanding how gambling works for you is a worthwhile exercise, even if you choose to continue doing it.
(Howard J. Shaffer, Ph.D., C.A.S., is a contributor to Harvard Health Publications.)
