Problem Gambling and Pathological Gambling: When Do You Cross the Line?
June 5, 2012
David Prescott, Ph.D. – EMMC Behavioral Medicine Program
Problem Gambling and Pathological Gambling:
It is estimated that about four out of five people gamble at some time in their life. Sometimes, what begins as a recreational pursuit becomes a significant life problem. About two percent of people who gamble have at least one gambling related behavior that causes noticeable problems in their lives. Less than one percent of people who gamble will eventually meet criteria for being diagnosed as a pathological gambler. The average annual financial losses from problem gambling, while varying enormously, average around $5,000 per person per year.
What Are Some Signs of Pathological Gambling?
People who are labeled as pathological gamblers cannot resist the impulse to gamble. They usually start gambling at a younger age than others, often around the age 16 or 17. Pathological gambling is diagnosed when gambling occurs persistently over time, and the behavior interferes with other areas of life functioning such as family or work. Criteria for pathological gambling include:
- Jeopardize or lose important relationships or career opportunities because of gambling
- Spending increasing amount of money on gambling to maintain excitement or thrill
- Becoming restless or irritable if person stops gambling
- After losing money, returns to gambling to get even (“chasing losses")
- Repeated unsuccessful efforts to stop gambling.
Pathological Gambling and Other Mental Health Problems:
For those few people who develop pathological gambling, co-existing mental health problems are often a part of the picture. People with pathological gambling are more likely to also be diagnosed with bipolar disorder, panic disorder, or substance abuse disorder than the general population. It is not entirely clear what the causal relationship between pathological gambling and these others disorders might be.
Types of Gambling Most Often Associated with Gambling Problems:
Problem gambling is not strictly associated with people gambling at casinos, although casinos are one venue for problem gambling. The most frequent type of gambling that becomes a problem is lottery type, with bingo games and internet gambling also among the top areas where gambling problems occur.
How Can I determine if a Gambling Problem Exists?
At either end of the spectrum, ranging from occasional recreational gambling to extreme pathological gambling, it is usually easy to determine whether or not a problem exists. As with many psychiatric disorders, determining the exact line where a problem exists differs from person to person.
One place to help you if you, or someone you know, may have a problem is a 20 question survey published by “Gambler’s Anonymous.” The survey can be found at the Gambler’s Anonymous and includes questions such as:
- Did you ever lose time from work or school because of gambling?
- Were you reluctant to use ‘gambling money’ for normal expenditures?
- Have you ever felt remorse about gambling?
- After losing, have you ever felt that you must return to gambling as soon as possible to win back your losses?
Treatment for Problem and Pathological Gambling:
As with most mental health and psychiatric problems, the sooner a person begins to get help, the better the prognosis. Treatment options for problem and pathological gambling include:
- Counseling using cognitive behavioral therapy (CBT): Cognitive behavioral therapy examines the thinking and behavior patterns that contribute to problem gambling, and helps a person change these problematic patterns. For example, people with problem gambling often distort their thinking to minimize the chance that they will gamble again, or the fact that the gambling is causing problems.
- Self-help support groups, such as Gamblers Anonymous: Gamblers Anonymous is a 12-step program similar to Alcoholics Anonymous. Practices used to treat other types of addiction, such as substance abuse and alcohol dependence, can also be helpful in treating pathological gambling.
- Medications: A few studies have been done on medications for treating pathological gambling. Early results suggest that antidepressants and opioid antagonists (naltrexone) may help treat the symptoms of pathological gambling. However, it is not yet clear which people will respond to medications.
For More Information:
Gambler’s Anonymous: http://www.gamblersanonymous.org
National Institute of Health PubMed: http://www.ncbi.nlm.nih.gov/pubmedhealth