What Is Gambling Disorder?

Gambling disorder is a condition characterized by a continued engagement in gambling behaviors that significantly affect a person's mental health, relationships, finances, and more. It is also sometimes referred to as compulsive gambling or gambling addiction.

Read on to learn more about gambling disorder, symptoms, causes, diagnosis, treatment, and how to cope.

Gambling Disorder

Some individuals can engage in gambling recreationally without developing any compulsion or addiction. However, others may develop maladaptive (negative) gambling behaviors.

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association's handbook for diagnosing mental health conditions, gambling disorder is grouped with substance-related disorders and addictions. This is because gambling behavior is associated with the brain's reward center, similar to addiction. It was previously listed as an impulse control disorder.

When a person becomes preoccupied with gambling or their gambling behaviors become uncontrollable, it can lead to negative consequences. People who gamble may experience intense emotions, depression, anxiety, or isolation due to their behavior. The impact on themselves and their relationship with others, including family and friends, may suffer.

Additionally, a constant desire to gamble—particularly if it leads to losing money—can cause financial distress or problems with work.

Symptoms

To receive a diagnosis of gambling disorder, the DSM-5 outlines that there must be an episodic or persistent pattern of behavior occurring over a 12-month period.

In addition, four or more of the following criteria must be met:

• Gambling with increasing amounts of money to achieve the desired outcome
• Difficulty reducing or controlling behavior, including irritability
• Unsuccessful attempts to change or control behavior 
• Fixation with gambling behaviors, such as constantly thinking about previous experiences, creating plans to gamble, or devising ways to get money to gamble
• Gambling while experiencing emotional discomfort, such as anxiety, depression, guilt, shame, or helplessness
• Lying to hide behavior or the extent of gambling behavior
• Risking or losing essential relationships
• Affecting educational or employment endeavors
• Seeking relief from tense financial situations brought on by gambling

The hallmark of gambling disorder is continuing to gamble regardless of the consequences. This often stems from difficulty with managing gambling behavior.

Research indicates people with gambling disorder may gamble more frequently and with more money over time. This can lead to considerably more frequent losses and cause a person to chase their losses or attempt to gamble to recover what they've lost.

Causes

Research continues to examine compulsive gambling behaviors and potential causes. Though the reasons are not entirely understood, dopamine and the brain's reward center are associated with gambling disorder.

Low serotonin is also thought to be associated with gambling disorder, as evidenced by association with impulse control disorder and its response to treatment with selective serotonin reuptake inhibitors (SSRIs).

Research suggests that some individuals with the following conditions may have a higher risk of developing problematic gambling behaviors:

• Mood disorders
• Anxiety disorders
• Substance use disorders
• Personality disorders
• Impulse control disorders

Other risk factors related to the onset of gambling disorder include:

• Being in adolescence, young adulthood, or middle age, as gambling disorder is more common among younger and middle-aged people 
• Being male, as gambling is more prevalent among men than women
• Having a first-degree relative (parent, sibling, or child) who has problems with gambling 
• Personality traits such as impulsiveness
• Having difficulty coping (compulsive gambling may surface as a means of coping with difficult emotions, relationships, or other stressors)
  

Diagnosis

To diagnose gambling disorder, a mental health professional will explore a patient's symptoms and evaluate them according to the criteria in the DSM-5.

A mental health assessment can help determine if there are other mental health conditions influencing gambling issues as well.

For instance, gambling can sometimes occur with conditions like bipolar disorder, a brain disorder causing extreme mood swings consisting of depression and mania or hypomania (a less extreme form of mania). A provider will want to rule out a manic episode as a factor.

A mental health evaluation will also uncover the extent to which problems are creating dysfunction. Patients may be asked to report on:

• Past and current gambling behaviors
• Consequences resulting from gambling and their impact
• Attempts to manage or control behavior 
• Thoughts and emotions related to gambling compulsions and behavior 
• History of mental health conditions, substance use, or addictions 
• Family history of gambling
  

Treatment

It is possible to manage and recover from gambling disorder, or even gambling behaviors that are causing problems but don't necessarily meet the full criteria for a diagnosis. Treatment options include therapy, medication, and support groups.

Working with a mental health professional can help patients move toward reducing and controlling behavior. Research demonstrates some efficacy with a couple of therapeutic methods, including the following:

• Cognitive behavioral therapy (CBT) can help gamblers explore thoughts and feelings about gambling, their ability to control their behavior, and work to change their perspective. Therapists use techniques to help patients learn coping skills to overcome strong emotions, triggers, and relapse prevention. This type of therapy is the most effective for gambling disorder.
• Motivational interviewing is designed to help people strengthen their own motivation to change their gambling behaviors. Therapists may use interventions within this approach along with CBT or on their own to reduce gambling behavior.
  
• Group therapy conducted in a therapy setting or a peer-based format, like Gamblers Anonymous, can help gamblers find support and a sense of community.

A healthcare provider may also recommend medication to treat mental health or substance use disorders occurring with gambling behavior. These can include:

• Antidepressants can treat conditions like anxiety and depression. They also influence serotonin, which is associated with decision-making, emotions, and impulse control.
• Naltrexone is a medication used in the treatment of alcohol use and opioid dependence. It can reduce urges in gamblers.
• Mood stabilizers may treat the manic episodes that can lead to gambling behaviors. 
  

Coping

Coping with compulsive gambling can be challenging, because it touches so many aspects of a person's life.

In addition to seeking treatment, identifying tools and strategies to manage emotions and consequences related to gambling in daily life can make a difference. These include, but aren't limited to:

• Commit to treatment and follow the treatment plan established by your provider
• Seek services such as couples or family therapy to help with relationships
• Join a support group
• Separate self from actions
• Set boundaries surrounding finances
• Be honest and clear about problems 
• Engage in stress reduction and mindfulness
• Take care of yourself by eating well, exercising, and getting enough sleep
  

Summary

Gambling disorder is a mental health condition characterized by a compulsion to participate in gambling activities. When gambling behavior continues despite negative or financial consequences, it can be diagnosed as gambling disorder. There are many treatment options available to help recover from gambling.

A Word From Verywell

Gambling can have devastating effects on a person's psychological, interpersonal, and financial well-being. If you have gambling disorder, you may experience guilt, shame, depression, or anxiety resulting from your behavior. Remember that you are not alone. Treatment and support are available. Seeking professional and peer support can help facilitate recovery.