Overview

Compulsive gambling, also called gambling disorder, is the uncontrollable urge to keep gambling despite the toll it takes on your life. Gambling means that you're willing to risk something you value in the hope of getting something of even greater value.

Gambling can stimulate the brain's reward system much like drugs or alcohol can, leading to addiction. If you have a problem with compulsive gambling, you may continually chase bets that lead to losses, hide your behavior, deplete savings, accumulate debt, or even resort to theft or fraud to support your addiction.

Compulsive gambling is a serious condition that can destroy lives. Although treating compulsive gambling can be challenging, many people who struggle with compulsive gambling have found help through professional treatment.

Symptoms

Signs and symptoms of compulsive gambling (gambling disorder) include:

• Being preoccupied with gambling, such as constantly planning how to get more gambling money
• Needing to gamble with increasing amounts of money to get the same thrill
• Trying to control, cut back or stop gambling, without success
• Feeling restless or irritable when you try to cut down on gambling
• Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or depression
• Trying to get back lost money by gambling more (chasing losses)
• Lying to family members or others to hide the extent of your gambling
• Jeopardizing or losing important relationships, a job, or school or work opportunities because of gambling
• Resorting to theft or fraud to get gambling money
• Asking others to bail you out of financial trouble because you gambled money away

Unlike most casual gamblers who stop when losing or set a loss limit, people with a compulsive gambling problem are compelled to keep playing to recover their money — a pattern that becomes increasingly destructive over time.

Some people with a compulsive gambling problem may have remission where they gamble less or not at all for a period of time. However, without treatment, the remission usually isn't permanent.

When to see a doctor or mental health professional

Have family members, friends or co-workers expressed concern about your gambling? If so, listen to their worries. Because denial is almost always a feature of compulsive or addictive behavior, it may be difficult for you to realize that you have a problem.

If you recognize your own behavior from the list of signs and symptoms for compulsive gambling, seek professional help.

Causes

Exactly what causes someone to gamble compulsively isn't well-understood. Like many problems, compulsive gambling may result from a combination of biological, genetic and environmental factors.

Risk factors

Although most people who play cards or wager never develop a gambling problem, certain factors are more often associated with compulsive gambling:

• Mental health disorders. People who gamble compulsively often have substance abuse problems, personality disorders, depression or anxiety. Compulsive gambling may also be associated with bipolar disorder, obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD).
• Age. Compulsive gambling is more common in younger and middle-aged people. Gambling during childhood or the teenage years increases the risk of developing compulsive gambling. However, compulsive gambling in the older adult population can also be a problem.
• Sex. Compulsive gambling is more common in men than women. Women who gamble typically start later in life and may become addicted more quickly. But gambling patterns among men and women have become increasingly similar.
• Family or friend influence. If your family members or friends have a gambling problem, the chances are greater that you will, too.
• Medications used to treat Parkinson's disease and restless legs syndrome. Drugs called dopamine agonists have a rare side effect that may result in compulsive behaviors, including gambling, in some people.
• Certain personality characteristics. Being highly competitive, a workaholic, impulsive, restless or easily bored may increase your risk of compulsive gambling.

Complications

Compulsive gambling can have profound and long-lasting consequences for your life, such as:

• Relationship problems
• Financial problems, including bankruptcy
• Legal problems or imprisonment
• Poor work performance or job loss
• Poor general health
• Suicide, suicide attempts or suicidal thoughts

Prevention

Although there's no proven way to prevent a gambling problem, educational programs that target individuals and groups at increased risk may be helpful.

If you have risk factors for compulsive gambling, consider avoiding gambling in any form, people who gamble and places where gambling occurs. Get treatment at the earliest sign of a problem to help prevent gambling from becoming worse.

Diagnosis

If you recognize that you may have a problem with your gambling, talk with your primary care doctor about an evaluation or seek help from a mental health professional.

To evaluate your problem with gambling, your doctor or mental health professional will likely:

• Ask questions related to your gambling habits. He or she may also ask for permission to speak with family members or friends. However, confidentiality laws prevent your doctor from giving out any information about you without your consent.
• Review your medical information. Some drugs can have a rare side effect that results in compulsive behaviors, including gambling, in some people. A physical exam may identify problems with your health that are sometimes associated with compulsive gambling.
• Do a psychiatric assessment. This assessment includes questions about your symptoms, thoughts, feelings and behavior patterns related to your gambling. Depending on your signs and symptoms, you may be evaluated for mental health disorders that are sometimes related to excessive gambling.
• Use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5, published by the American Psychiatric Association, lists criteria for the diagnosis of gambling disorder.

Treatment

Treating compulsive gambling can be challenging. That's partly because most people have a hard time admitting they have a problem. Yet a major component of treatment is working on acknowledging that you're a compulsive gambler.

If your family or your employer pressured you into therapy, you may find yourself resisting treatment. But treating a gambling problem can help you regain a sense of control — and perhaps help heal damaged relationships or finances.

Treatment for compulsive gambling may include these approaches:

• Therapy. Behavior therapy or cognitive behavioral therapy may be beneficial. Behavior therapy uses systematic exposure to the behavior you want to unlearn and teaches you skills to reduce your urge to gamble. Cognitive behavioral therapy focuses on identifying unhealthy, irrational and negative beliefs and replacing them with healthy, positive ones. Family therapy also may be helpful.
• Medications. Antidepressants and mood stabilizers may help problems that often go along with compulsive gambling — such as depression, OCD or ADHD. Some antidepressants may be effective in reducing gambling behavior. Medications called narcotic antagonists, useful in treating substance abuse, may help treat compulsive gambling.
• Self-help groups. Some people find that talking with others who have a gambling problem may be a helpful part of treatment. Ask your health care professional for advice on self-help groups, such as Gamblers Anonymous and other resources.

Treatment for compulsive gambling may involve an outpatient program, inpatient program or a residential treatment program, depending on your needs and resources. Treatment for substance abuse, depression, anxiety or any other mental health disorder may be part of your treatment plan for compulsive gambling.

Relapse prevention

Even with treatment, you may return to gambling, especially if you spend time with people who gamble or you're in gambling environments. If you feel that you'll start gambling again, contact your mental health professional or sponsor right away to head off a relapse.

Coping and support

These recovery skills may help you concentrate on resisting the urges of compulsive gambling:

• Stay focused on your No. 1 goal: not to gamble.
• Tell yourself it's too risky to gamble at all. One bet typically leads to another and another.
• Give yourself permission to ask for help, as sheer willpower isn't enough to overcome compulsive gambling. Ask a family member or friend to encourage you to follow your treatment plan.
• Recognize and then avoid situations that trigger your urge to bet.

Family members of people with a compulsive gambling problem may benefit from counseling, even if the gambler is unwilling to participate in therapy.

Preparing for an appointment

If you've decided to seek help for compulsive gambling, you've taken an important first step.

What you can do

Before your appointment make a list of:

• All the feelings you're experiencing, even if they seem unrelated to your problem. Note what triggers your gambling, whether you've tried to resist the urge to gamble and the effect that gambling has had on your life.
• Key personal information, including any major stresses or recent life changes.
• All medications, vitamins, herbs or other supplements that you're taking, including the doses.
• Other physical or mental health disorders that you have and the treatments.
• Questions to ask your doctor to make the most of your appointment time.

Questions to ask your doctor may include:

• What's the best approach to my gambling problem?
• What are the alternatives to the primary approach that you're suggesting?
• Should I see a psychiatrist, psychologist, addiction counselor or other mental health professional?
• Will my insurance cover seeing these professionals?
• Can I get help as an outpatient or would I need inpatient treatment?
• Are there any brochures or other printed material that I can have?
• What websites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask:

• When did your gambling first start?
• How often do you gamble?
• How has gambling affected your life?
• Are your friends or family members worried about your gambling?
• When you gamble, how much do you typically put on the line?
• Have you tried to quit on your own? What happened when you did?
• Have you ever been treated for a gambling problem?
• Are you ready to get the treatment needed for your gambling problem?