When gambling becomes a problem

Gambling is usually considered a recreational activity, but for some people it can become a significant problem. People with a gambling disorder have an uncontrollable urge to spend money on games of chance despite serious personal consequences. It can take many forms, from going to casinos to betting on sports to online gaming.

When harmless fun becomes a problem
Gambling becomes a problem when it disrupts one’s life. It can continue despite profound negative consequences to the individual and their loved ones, and can severely impact a person’s interpersonal relationships, finances, and physical and mental health. This can be similar to people with an alcohol or other drug problem, who continue to drink or use despite the consequences.

“People with a gambling disorder experience many of the same neurological and physiological reactions as those with substance abuse,” explains Dr. William Brock, a psychologist with Sharp Grossmont Hospital for Behavioral Health.

“Over time, they become increasingly unable to control their urge. When compulsive gamblers try to stop, they often experience symptoms similar to withdrawal from drugs such as restlessness, irritability, insomnia, anxiety and depression,” says Dr. Brock. For many compulsive gamblers, the main strategy to cope with these problems is to return to gambling.

Behaviors that could indicate a problem
There are certain behaviors that are considered when diagnosing a gambling addiction. They include:

• Spending increasing amounts of money

• Frequent thoughts about gambling

• Gambling when feeling distressed

• Lying to conceal gaming and financial activity

• Repeated unsuccessful efforts to cut back or stop 

• Becoming irritable when trying to cut back or stop

• Struggling to get even with losses

• Relying on others to help with money problems

Most people who have a problem managing their habit will experience periods when it doesn’t seem to be a problem, followed by episodes of severe compulsive behavior. Ultimately, the question is whether or not the gambling is having a serious, unhelpful effect on an individual’s life. If so, then it is time to seek help.

Compulsion linked to other mental health symptoms
Compulsive gambling is often associated with other mental health issues, including anxiety and depression, substance use disorders, more emergency room admissions and a higher risk for suicide. The reverse is also true; often, people with mental health issues sometimes turn to gambling as a way to cope with or avoid the problems in their lives.

“While compulsive gambling may seem like a simple choice to someone who isn’t drawn to the activity, the truth is more complex,” says Dr. Brock. “Gambling disorder should be viewed as a serious mental health issue. It can help to understand that we all have habits, and many of them can be very unhelpful in our lives. When a behavior becomes ingrained, the parts of our brain that guide our judgment and values are suppressed.”

Treatment for a gambling disorder
Treatment usually involves multiple approaches. Frequently, a combination of therapy and medication with support services can help.

• Cognitive behavior therapy (CBT) involves identifying the unhelpful beliefs and thoughts related to gambling and replacing them with more helpful, positive thoughts. CBT will often use systematic exposure and mindfulness skills to reduce urges to gamble.

• Medication may be used in conjunction with therapy to help problems such as depression or anxiety that often accompany a gambling disorder.

• Family therapy can help heal damaged relationships, and help family members cope with the stresses of helping a loved one with a serious gambling problem.

• Self-help groups provide support and an opportunity to talk with others who are experiencing the same situation. Group members share strategies for overcoming urges to gamble and provide safe, supportive relationships.

One goal of treatment is to recognize when a relapse has occurred or is becoming likely, and determine ways to reduce the potential harm to the person with the gambling disorder as well as their loved ones.

Helping a loved one with gambling addiction
With knowledge, help and support, people can make positive changes in their life. Scolding, nagging or giving unwanted advice is seldom a successful strategy to help a loved one with a problem. It is better to keep in mind the goal of helping that person get the appropriate help.
Here are some positive strategies for helping a loved one who has a gambling disorder:

• Recognize your loved one’s struggle; they may have many bad feelings about their behavior and are often trying to figure out ways to cope.

• Encourage your loved one to get help by talking to their primary care provider or a mental health counselor with training in behavioral addictions, or attending a self-help meeting.

• Understand the severity of the problem and that it will take your loved one significant time and effort to start making changes in their life.

• Discuss the warning signs of gambling addiction and educate all family members about what to do if signs of a problem emerge.

• Seek support and help from others; self-help group for family members can be very helpful.

Where to seek help for gambling addiction
The first step in making a change in life is to research. The following resources can help:

• California Council on Problem Gambling: 1-800-GAMBLER

• National Problem Gambling Helpline Network: 1-800-522-4700

• SMART Recovery: SMARTRecoverySD.org

• San Diego Gamblers Anonymous: 1-888-233-8547 or SanDiegoGA.org

• San Diego Region Access and Crisis Line: 1-888-724-7240 or Up2SD.org

• National Suicide Prevention Lifeline: 1-800-273-8255

Sharp Grossmont Hospital Behavioral Health Services offers an intensive outpatient program for individuals with addictive behavior and a related mental health problem such as anxiety or depression. For more information about these services, please call 619-740-5811.

For the news media: To talk with Dr. Brock about gambling addiction for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.