Gambling involves putting something of value on an event with an uncertain outcome. The event can be anything from a sporting event to a lottery draw. In order for gambling to occur, three things are needed: consideration, risk, and a prize. People may gamble for many reasons, including social and financial gain. However, for some individuals, gambling can become problematic and lead to addiction. It is important to recognize the warning signs of a gambling problem, so that treatment can be initiated as early as possible.
It is estimated that 2.5 million Americans (1%) have a severe gambling problem, and an additional 5-8 million (2-3%) have mild or moderate problems. People from all walks of life can develop a gambling problem, regardless of economic status or cultural background. The development of a gambling problem can also be influenced by age, genetics and medical history. People with a family history of gambling are at greater risk for developing a problem, and individuals who begin gambling as children or teenagers are more likely to develop a problem than those who start as adults.
While most individuals participate in gambling for social or entertainment purposes, a small group of individuals become excessively involved in terms of time and money invested. These individuals often experience adverse consequences that are substantial and persistent, and these impacts can have serious psychiatric, social, and family implications. Historically, these individuals were considered to have gambling disorders, and this has been reflected in the various editions of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (DSM).
Recent changes in the DSM nomenclature have highlighted the parallel between pathological gambling and substance abuse; however, evidence is still lacking regarding whether pathological gambling is an addiction or a mental health condition. Furthermore, there is debate regarding the relative importance of evaluating patients’ gambling behaviors in a general medical setting.
Those with a comorbid mood disorder, such as depression or anxiety, are at an increased risk of developing a gambling problem. Additionally, these conditions can trigger or make worse gambling problems, and they can also interfere with the effectiveness of treatment.
There are a number of ways to treat gambling problems, including therapy and self-help programs. Therapists can help by teaching coping skills and providing family education. Self-help programs include Gamblers Anonymous, a program based on Alcoholics Anonymous that encourages participants to find a sponsor and work the 12 steps of recovery. Other self-help methods include finding alternative activities to gambling, such as socializing with friends in other venues, enrolling in an educational class or volunteering for a cause. Those with a comorbid illness can seek treatment for both their mood disorders and gambling issues, and they can work with their doctors to establish an appropriate plan of care. These measures will allow them to reduce their risk of gambling addiction and improve their overall quality of life.