Gambling Addiction and Problem Gambling

Understanding gambling addiction and problem gambling

Gambling addiction, also known as compulsive gambling, is a type of impulse-control disorder. Compulsive gamblers can’t control the impulse to gamble, even when they know their gambling is hurting themselves or their loved ones. Gambling is all they can think about and all they want to do, no matter the consequences. Compulsive gamblers keep gambling whether they’re up or down, broke or flush, happy or depressed. Even when they know the odds are against them, even when they can’t afford to lose, people with a gambling addiction can’t “stay off the bet.”

Gamblers can have a problem, however, without being totally out of control. Long before an addiction has fully developed, gambling can have a negative impact. Problem gambling is any gambling behavior that disrupts your life. If you’re preoccupied with gambling, spending more and more time and money on it, chasing losses, or gambling despite serious consequences, you have a gambling problem.

There are two types of compulsive or problem gamblers. While their behaviors are similar, they gamble for very different reasons:

• Action gamblers are addicted to the thrill of risk-taking. Gambling itself is their “drug.” They usually gamble with others, since part of the rush is beating the house or other gamblers. Action gamblers usually prefer games of skill, such as card games, craps, and sports betting. They may also play the stock market.
• Escape gamblers gamble to escape emotional pain, worries, and loneliness. Rather than gambling to feel a rush, they gamble to feel numb. Escape gamblers prefer more isolated activities such as slot machines, bingo, and online poker. They also prefer games that don’t require much thought, so they can “zone out.”

Signs and symptoms of problem gambling

Gambling addiction is sometimes referred to as the "hidden illness" because there are no obvious physical signs or symptoms like there are in drug or alcohol addiction. Problem gamblers typically deny or minimize the problem. They also go to great lengths to hide their gambling. For example, problem gamblers often withdraw from their loved ones, sneak around, and lie about where they’ve been and what they’ve been up to.

While the warning signs of problem gambling can be subtle­, there are some red flags that should put you on alert:

• Secrecy over money and finances
• New desire to control household finances
• Overdue or unpaid bills
• Unexplained loans or cash advances
• Lack of money, despite the same income and expenses
• Unusual increase in credit card activity
• Asking friends and family for money
• Missing jewelry, cash, or valuables
• Dwindling savings or assets
• Missing bank or credit card statements
• Calls or letters from bill collectors
• Unexplained cash, especially when there are unpaid bills

The “four phases” of problem gambling and gambling addiction

People with gambling problems typically go through four phases, progressing from recreational gambling to problem gambling and finally to gambling addiction. Each phase can last from months to years.

• Winning phase – The winning phase often starts with a big win, leading to excitement and a positive view of gambling. Problem gamblers believe they have a special talent for gambling and that the winning will continue. They begin spending greater amounts of time and money on gambling.
• Losing phase – Problem gamblers become more and more preoccupied with gambling. They start to gamble alone, borrow money, skip work, lie to family and friends, and default on debts. They also begin to "chase" their losses: gambling in order to win back money that was lost.
• Desperation phase – Problem gamblers lose all control over their gambling. They feel ashamed and guilty after gambling, but they can’t stop. They may cheat or steal to finance their addiction. The consequences of compulsive gambling catch up with them: they may lose their jobs, get divorced, or get arrested.
• Hopeless phase – In the hopeless phase, problem gamblers hit “rock bottom.” They don’t believe that anyone cares or that help is possible. They don’t even care if they live or die. They may abuse drugs and alcohol to numb the pain. Many problem gamblers also consider or attempt suicide.

Treatment for problem gambling

In order to overcome a gambling addiction, you must first admit that you have a problem. For many problem gamblers, this is the hardest part. But recovery won’t happen if you’re minimizing the addiction, making excuses, or blaming others.

Once you’re ready to own up to your gambling problem, the work of recovery can begin. Start by seeking professional help from an addiction specialist. This is also the time to come clean to your loved ones and ask for their support. Overcoming a gambling addiction or problem is never easy. But recovery is possible if you stick with treatment and seek support.

For advice or a treatment referral, call the National Council on Problem Gambling’s confidential hotline at 1-800-522-4700

Treatment options for gambling addiction and problem gambling

• Cognitive-behavioral therapy for problem gambling focuses on changing unhealthy gambling behaviors and thoughts, including rationalizations and false beliefs. It also teaches problem gamblers how to fight gambling urges, deal with uncomfortable emotions rather than escape through gambling, and solve financial, work, and relationship problems caused by the addiction.
• Gamblers Anonymous is a twelve-step recovery program patterned after Alcoholics Anonymous. It is widely viewed as the most effective treatment for compulsive gambling. Gamblers Anonymous provides a supportive, non-judgmental atmosphere where you can share what you’re going through and get feedback and advice from fellow gamblers who understand your problem. To find a Gamblers Anonymous meeting in your area, click here.
• Medication won’t cure a gambling problem, but it may be helpful if depression, bipolar disorder, ADHD, or another mental health problem is fueling the compulsive gambling. Medications used in the treatment of problem gambling include antidepressants and mood stabilizers. Naltrexone, a medication that reduces drug and alcohol cravings, may also reduce gambling cravings in action gamblers. Naltrexone must be carefully monitored because of serious potential side effects.

The Four Steps program: A gambling treatment that can “rewire” your brain

Jeffrey Schwartz has created a variation of a cognitive-behavioral therapy called The Four Steps Program. It has been successful in treating a wide range of conditions, including compulsive gambling. The Four Steps program takes advantage of neuroplasticity, the remarkable ability of our brains to change throughout our lives. The goal of treatment is to “rewire” the addicted brain by thinking about gambling in a new way. You can literally change your brain — developing new neural pathways and restoring brain chemical balance—by practicing the following four steps:

• Step 1: Relabel. Recognize that the urge to gamble is nothing more than a symptom of your gambling addiction, which is a treatable medical condition. It is not a valid feeling that deserves your attention.
• Step 2: Reattribute. Stop blaming yourself and try to understand that the urge to gamble has a physical cause in your brain. You are separate from the disease of addiction, but not a passive bystander. With practice, you can learn to control your unwanted thoughts about gambling.
• Step 3: Refocus. When the urge to gamble strikes, don’t wait for it to go away. Instead, shift your attention to something more positive or constructive. Do something else, even if the compulsion to gamble is still bothering you.
• Step 4: Revalue. Over time, as you practice the first three steps, you’ll gradually learn to revalue your flawed thoughts about gambling. Instead of taking them at face value, you’ll realize that they have no inherent value or power. They’re just “toxic waste” from your brain.

Self-help for problem gambling and gambling addiction

Tackling a gambling problem is possible if you avoid tempting environments, give up control of your finances (at least at first), find exciting or enjoyable activities to replace gambling, and surround yourself with people to whom you’re accountable. It’s also important to keep stress in check, since stress can trigger compulsive gambling or make it worse.

Dealing with gambling cravings

When you’re feeling the urge to gamble, the following strategies can help:

• Do something else. Distract yourself with another activity, such as cleaning your house, going to the gym, or watching TV.
• Postpone gambling. Tell yourself that you’ll wait five minutes, fifteen minutes, or an hour — however long you think you can hold out. As you wait, the urge to gamble may pass or become weak enough to resist.
• Give yourself a reality check. Visualize what will happen if you give in to the urge to gamble. Think about how you’ll feel after all your money is gone and you’ve disappointed yourself and your family again.
• Reach out for support. Call a trusted family member, meet a friend for coffee, or go to a Gamblers Anonymous meeting.

If you aren’t able to resist the gambling craving, don’t be too hard on yourself or use it as an excuse to give up. Overcoming a gambling addiction is a tough process. You may slip from time to time; the important thing is to learn from your mistakes and continue working towards recovery.

Helping a family member with a gambling problem

If your family member has a gambling problem, you can help by encouraging him or her to get treatment and by offering your support. This doesn’t mean bailing the gambler out of trouble or covering up the problem. It’s important to hold problem gamblers responsible for their actions—including the consequences. It’s also important to take care of yourself. You have a right to protect yourself emotionally and financially. Don’t blame yourself for the gambler’s problems. You don’t control your family member’s behavior; the choice to stop gambling is theirs alone.

Tips for family members of problem gamblers:

• Take over the family finances
• Review bank and credit card statements
• Request credit reports from the three main credit bureaus
• Monitor Internet use to see if the person is gambling online
• Be honest about how the gambler’s behavior makes you feel
• Get counseling or join a support group such as Gam-Anon
• Encourage the person to go to Gambler’s Anonymous

Related links for problem gambling and gambling addiction

Help and support for problem gambling and gambling addiction

The National Council on Problem Gambling – Offers a confidential, 24-hour helpline for problem gamblers or their family members. Call 1-800-522-4700.

Gamblers Anonymous – Twelve-step Gamblers Anonymous program, a nationwide support network of meetings to assist people who have a gambling problem. (Gamblers Anonymous)

Signs and symptoms of problem gambling and gambling addiction

About Problem Gambling – Guide to problem gambling, compulsive gambling and gambling addiction. Includes an FAQ and the signs and symptoms. (The National Council on Problem Gambling)

Do I Need Help? : Helpful Questions for Self-evaluation – Includes questions for self-evaluation, as well as questions for family members who suspect a gambling problem. (Connecticut Department of Mental Health and Addiction Services)

The Self Survey "Twenty Questions" – Online questionnaire to help gamblers determine if they have a problem or a gambling addiction. (California Department of Drug and Alcohol Programs)

Treatment for problem gambling and gambling addiction

Finding Help: Treatment and Self-help Programs – Covers the treatment options for compulsive gambling and gambling addiction. (Connecticut Department of Mental Health and Addiction Services)

Problem Gamblers and their Finances (PDF) – In-depth guide for treatment professionals on how to help a problem gambler cope with financial problems and pressures. (Substance Abuse and Mental Health Services Administration)

Self-help for problem gambling and gambling addiction

Your First Step to Change: Gambling – Self-change toolkit helps problem gamblers learn how to overcome their addiction. (The Division on Addictions, Cambridge Health Alliance and Harvard Medical School)

Freedom from Problem Gambling (PDF) - Self-help workbook for compulsive gamblers, with tips on how to avoid relapse and fight gambling urges. (California Department of Drug and Alcohol Programs)

Helping a family member with a gambling problem

Problem Gambling and the Family – Learn how gambling addiction affects the family and what family members can do to address the problem. (Connecticut Department of Mental Health and Addiction Services)

Help for Families – Suggestions on how to handle a family member’s compulsive or problem gambling. (Chris Lobsinger’s Problem Gambling)

Gam-Anon - Twelve-step program for the problem gambler’s spouse, family members, or close friends. (Gam-Anon International Service Office, Inc)

Jeanne Segal, Ph.D., Deborah Cutter, Psy.D., and Melinda Smith, M.A., contributed to this article. Last modified: March 08.