Pathological Gambling

What is pathological gambling?

Pathological gambling, most commonly referred to as compulsive gambling or gambling addiction, is a type of non-substance related disorder and is considered addictive behavior.

Like any other addiction-related behavior, those who suffer from pathological gambling will gamble under any circumstances, and cannot resist the impulse to gamble. The brain reacts to the impulse to gamble the same way it would in a drug or alcohol addict. Pathological gambling typically leads to job loss, criminal activity, financial difficulties, and risk to relationships.

It is thought that pathological gambling affects approximately 2 to 4 percent of the population, men more often than women. Males who are compulsive gamblers typically begin in early adolescence; women who are compulsive gamblers typically begin a little later in life, between the ages of 20 and 40.

The four categories of gambling are social, professional, problematic, and pathological. Social and professional gambling is not considered a problem among these types of gamblers. Social gambling is simply gambling on occasion, with limited risk, in a social setting with friends or family. Professional gambling also demonstrates limited risk and is exercised in a controlled environment.

Problem gambling starts gamblers down a path of frequent gambling and taking more risk by gambling more money; problem gamblers may try to cut down on their habit but typically don’t. This can lead to pathological gambling which is characterized by denial, overconfidence, and a belief that money is the solution to all of their problems.

There are many causes of pathological gambling – most share characteristics with any other addictive behavior.

Symptoms of pathological gambling

Pathological gambling shares characteristics of obsessive compulsive disorder, however, it is considered an addictive behavior with symptoms corresponding to those of drug addicts.

Pathological gamblers are typically predisposed to five or more of the following symptoms:

  • The gambler lies to those close to them or the people with whom they work about the extent of their gambling problem
  • The gambler needs to gamble more often and with increasingly more money to achieve the excitement of winning
  • The gambler cannot control themselves after repeated attempts to stop gambling
  • The gambler is preoccupied with gambling and is always inventing ways to get more and more money for gambling
  • The gambler has problems such as anxiety or depression and gambles to “get away”
  • After losing money, the gambler will go back the next day to win back their losses, also called “chasing”
  • The gambler has committed illegal acts such as fraud or theft to finance their gambling habit
  • The gambler has risked relationships or employment because of their gambling habit
  • The gambler relies on those around them to provide them with funds when they get into financial trouble due to gambling
  • The gambler is irritable when trying to cut back on or quit gambling
  • The gambler spends a lot of time thinking about gambling

Pathological gamblers tend to have the following personality characteristics:

  • Unrealistic thinking such as denying they have a problem
  • Are usually overconfident
  • Are superstitious
  • Believe they are in control
  • Tend to be competitive and restless
  • Are easily bored
  • Are overly generous
  • Are typically workaholics or binge workers

Gamblers can easily cross over from gambling to problem or pathological gambling very easily. Often, the signs for problem gambling are not even known to the gambler, or they simply deny they have a problem. Only when the gambler starts having financial problems or problems with relationships and/or work can this realization come to light.

It’s important for compulsive gamblers to seek treatment for their problem. It’s possible that family, friends, or those in the medical community will need to intervene and help the person realize they have a gambling problem and need help. There are several treatment options available for pathological gamblers.

Causes of pathological gambling

Pathological gambling typically stems from occasional or social gambling. Stressful situations can lead to more severe gambling problems in someone who may have been a social gambler. However, the fact that gambling is an addiction also demonstrates that those with addictive behavior patterns are at a higher risk to become pathological gamblers.

Scientific research has shown that drug addicts and pathological gamblers share many of the same genetic characteristics for reward seeking. Compulsive gamblers tend to go after more risk just as drug addicts require stronger drugs to get high. Studies by neuroscientists have illustrated that gambling and drugs impact a lot of the same brain circuitry in similar ways.

Casinos and sports betting houses used to be limited to a few states, however, with the growth of Native American casinos, riverboat casinos, offshore sports betting, and state and national lotteries, people have increased access to gambling outlets. Gambling on the internet has intensified the problem tenfold as it has given those who don’t live near casinos access to gambling venues, although in recent years, internet gambling has been restricted in many states.

Age is currently a risk factor for pathological gambling problems. Older adults (those over age 65) are more at risk than other age groups because of unique factors to their specific population. A study conducted in 1989 shows that almost 11% of residents in a Pennsylvania elder care facility were problem gamblers. A 2006 study of New Jersey residents over 55 years of age was conducted and found that 23% were “disordered” gamblers, while 17% were at risk of becoming disordered gamblers, 4% were identified as problem gamblers, and 2% were pathological gamblers. Disordered gamblers among the elderly were characterized as having spent six times more than non-problem gamblers on lotteries and 3.5 times more in casino environments.

Reasons given for gambling problems among the elderly include:

  • Social interaction, loneliness
  • Avoiding isolation
  • Relaxation
  • Passing time
  • Being able to get out for a day
  • Independence
  • Financial reasons.

Many elderly adults may not understand how addiction works and the fact that they may have a gambling problem and therefore are less likely to seek or feel they need treatment.

Those who have close relatives that have had a pathological gambling problem could also be at risk for developing this problem themselves so they need to take care when getting involved in any activities that include gambling.

While pathological gambling is caused by the same behaviors as drug addiction, recognizing the symptoms is the first line of defense in getting any help for their problem.

Treatment of pathological gambling

A psychological evaluation can be used to diagnose pathological gambling. Gamblers Anonymous has a 20-question screening process to help with diagnosis as well.

At one time, the psychiatric community regarded pathological gambling as a compulsion (behavior that is characterized by the need to relieve anxiety) rather than an addiction. However, a recent decision recategorized pathological gambling as an addiction, a decision that was based on recent studies on genetics, psychology and neuroscience that demonstrated gambling and drug addiction characteristics are very similar. A big part of the study found that pathological gamblers tend to respond better to medication and therapy methods that are used for treating addiction rather than therapies used to treat compulsions.

With any addictions, treatment will only be effective if the gambler admits they have a gambling problem and need treatment. A majority of the people who suffer from pathological gambling often get help because of family pressure. Younger people may have more trouble because they are unaware of treatment avenues, and older people are less likely to admit they have a problem.

There are some effective treatment options to get help for pathological gamblers, including:

  • Self-help options with support groups such as Gamblers Anonymous
  • Individual psychotherapy
  • Groups that help general addiction behaviors
  • Cognitive Behavioral Therapy (CBT)
  • Abstinence
  • Based on studies for medications to treat compulsive gambling, it is suggested that opioid antagonists, mood stabilizers, and antidepressants could help treat symptoms. However, this is still being tested.

Complications associated with pathological gambling can include depression, anxiety, substance abuse, and possible suicide attempts. For those in poor health, the stress and excitement of gambling can lead to heart attacks.

Just like any type of addiction, pathological gambling is a condition that will grow worse in time without the proper treatment avenues. And as with any addictive behavior, gamblers do run the risk of relapse even after successful treatment.

Research has shown that 75% of those who got help and stopped eventually returned to gambling. More than 80% of pathological gamblers never seek treatment, which makes prevention essential where possible.

There are many ways to prevent pathological gambling before it becomes a problem.

Prevention of pathological gambling

Pathological gambling can be prevented by limiting exposure to begin with, particularly with persons who have addictive personalities. There are educational programs for those who are at greater risk to develop pathological gambling problems that can be useful in prevention.

Intervening when someone shows early signs of pathological or problem gambling can help the person before their addiction gets worse.

Preventing gambling in youth can help to curb problems later. Risk reduction strategies include family and school involvement and helping younger people strengthen their ability to cope with stress. Youth organizations, such as the YMCA Youth Gambling Project, educate youth about gambling and the problems it can cause.

Researchers agree that since no one strategy works for prevention in drug and alcohol abuse issues among younger people, the same holds true for gambling addiction.

Focusing social media campaigns on anti-gambling messages can also help to prevent gambling in youths, including:

  • Using statistics to inform youths of the actual chances of winning at gambling
  • Using young actors to deliver anti-gambling messaging
  • Present young people with alternatives to gambling
  • Target individuals on age-based messaging

At the other end of the spectrum are elderly gamblers. There is a growing problem among the elderly, and pathological gambling problems are becoming higher within the 65+ community. Getting help for older pathological gamblers can be tricky because they tend to deny they have a problem more often and are less likely to seek treatment.

One of the issues that propagates gambling among seniors are the casinos themselves. Many gambling establishments target seniors by offering them discounts, free transportation and advertising targeted toward an older age range. Senior centers can prevent gambling among the elderly by providing them with alternatives to socializing and entertainment.

For those who are recovering pathological gamblers, there are ways to prevent relapse:

  • Use self-encouragement and remind yourself of the risks of pathological gambling
  • Stay focused on the goal of not gambling
  • Work with friends and family members with help in following treatment plans
  • Stay away from situations that encourage gambling or have any kind of gambling involved, even if they are just social or among friends.
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Last Reviewed:
September 17, 2017
Last Updated:
September 17, 2017
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