- The Mood Disorders Society of Canada proposes the development of a strategic research agenda to increase our understanding of the prevalence, risk factors, negative impact, and pathways to gambling for people with mood and anxiety disorders.
- Pathological gambling, as the part of obsessive-compulsive disorder, requires the higher doses of antidepressants as it usually required for depressive disorders. In cases where participants do not have or have minimal symptoms of anxiety or depression, antidepressants still have those effect.
- There is a significant amount of clinical evidence to suggest that there is at least a link between problem gambling and mood disorders. One study suggests that 1/3 of problem gamblers have at least one parent with a mood disorder. 20% of recovering gambling addicts still exhibit depressive behavior even after stopping gambling for a.
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.
Gambling while on vacation or buying the occasional lottery ticket poses little to no threat to a person's overall quality of life. When done on a recreational basis, gambling can be a fun activity. Compulsive gambling, however, takes gambling activities to a whole other level.
According to the Pennsylvania Department of Health, three percent of Americans will experience job loss, broken families, debt and legal problems as result of compulsive gambling behaviors. In effect, the word 'compulsive' best depicts the disorder aspect of compulsive gambling.
More oftentimes than not, compulsive behaviors result from some form of obsession that overwhelms a person's ability to control or manage the behavior. These characteristics most resemble addiction-type behaviors without the drug or alcohol component. Not unlike drug/alcohol addictions, compulsive gambling behaviors trigger physiological changes and behavioral changes, both of which have a noticeable impact on a person's everyday quality of life.
Process-Based Addictions
Addiction describes a disorder characterized by a loss of control, so compulsive behavior becomes a key component within any form of addiction. Process-based addictions involve activities where a person loses control over his or her ability to walk away from further engagement. Compulsive gambling behaviors fall within the process-based addiction category.
Much like addictions to alcohol and drugs, a person may start out gambling on an infrequent basis as a form of recreation. For people with addiction tendencies, the fun or thrill of engaging in the activity becomes a force all its own, similar to how a drug 'high' drives addicts to keep using.
Ultimately, someone with a compulsive gambling (addiction) disorder will exhibit the following characteristics –
- Spending increasing amounts of time gambling
- Disregard for negative consequences brought on by gambling behavior
- An inability to limit or stop gambling behavior
- Thinking about and anticipating the next time he or she gambles
- An emotional tie with the activity
Gambling Effects in the Brain
Someone who cannot control their gambling may be said to have a gambling disorder.
For people addicted to gambling, the act of gambling has become an obsession. Obsessions, in general, trigger certain emotional responses, which play a central role in perpetuating this condition.
Likewise, compulsive gamblers experience a 'rush' or 'high' that produces chemical changes in the brain, much like a drug or alcohol 'high.' According to Scientific American, these chemical changes affect the same neurotransmitter chemicals that regulate emotions, learning, cognitive functions and motivation.
Over time, these chemical changes start to 'rewire' how the brain works and eventually alter a person's motivations, thoughts and behaviors. In effect, the more a person engages in gambling the more out of balance brain chemical processes become.
Symptoms of Compulsive Gambling
Like drug and alcohol abuse disorders, a gambling disorder can wreak havoc in most every area of a person's life. Symptoms of compulsive gambling disorder include –
Mood Disorder Compulsive Gambling Behavior
- Decline in personal appearance and/or hygiene
- Frequent mood swings
- Sleep problems
- Risk-taking
- Financial difficulties
- Changes in appetite
- Legal problems
- Relationship conflicts
- Problems at work
Not surprisingly, these same symptoms can result from drug/alcohol addictions. As with any form of addiction, a person's gambling behaviors will only get worse unless he or she gets needed treatment help.
Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships.
Mood Disorder Compulsive Gambling Disorders
Compulsive gambling most often begins in early adolescence in men, and between ages 20 and 40 in women.
People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or drugs. Although it shares features of obsessive compulsive disorder, compulsive gambling is likely a different condition.
In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.
People with compulsive gambling often feel ashamed and try to avoid letting other people know about their problem. The American Psychiatric Association defines pathological gambling as having 5 or more of the following symptoms:
- Committing crimes to get money to gamble.
- Feeling restless or irritable when trying to cut back or quit gambling.
- Gambling to escape problems or feelings of sadness or anxiety.
- Gambling larger amounts of money to try to make back past losses.
- Losing a job, relationship, education, or career opportunity due to gambling.
- Lying about the amount of time or money spent gambling.
- Making many unsuccessful attempts to cut back or quit gambling.
- Needing to borrow money due to gambling losses.
- Needing to gamble larger amounts of money in order to feel excitement.
- Spending a lot of time thinking about gambling, such as remembering past experiences or ways to get more money with which to gamble.
A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions www.gamblersanonymous.org/ga/content/20-questions can help with the diagnosis.
Treatment for people with compulsive gambling begins with recognizing the problem. Compulsive gamblers often deny they have a problem or need treatment.
Most people with pathological gambling only get treated when other people pressure them.
Treatment options include:
- Cognitive behavioral therapy (CBT).
- Self-help support groups, such as Gamblers Anonymous. Gamblers Anonymous www.gamblersanonymous.org/ is a 12-step program similar to Alcoholics Anonymous. Practices used to treat other types of addiction, such as substance use and alcohol use, can also be helpful in treating pathological gambling.
- A few studies have been done on medicines for treating compulsive 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 medicines.
Like alcohol or drug addiction, pathological gambling is a long-term disorder that tends to get worse without treatment. Even with treatment, it's common to start gambling again (relapse). However, people with pathological gambling can do very well with the right treatment.
Complications may include:
- Alcohol and drug use problems
- Anxiety
- Depression
- Financial, social, and legal problems (including bankruptcy, divorce, job loss, time in prison)
- Heart attacks (from the stress and excitement of gambling)
- Suicide attempts
Mood Disorder Compulsive Gambling Symptoms
Getting the right treatment can help prevent many of these problems.
Call your health care provider or mental health professional if you believe you have symptoms of pathological gambling.
Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse.
Gambling - compulsive; Pathological gambling; Addictive gambling
American Psychiatric Association website. Non-substance-related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:585-589.
Balodis IM, Potenza MN. The biology and treatment of gambling disorder. In: Johnson BA, ed. Addiction Medicine: Science and Practice. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 33.
Weissman AR, Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 23.
According to the Pennsylvania Department of Health, three percent of Americans will experience job loss, broken families, debt and legal problems as result of compulsive gambling behaviors. In effect, the word 'compulsive' best depicts the disorder aspect of compulsive gambling.
More oftentimes than not, compulsive behaviors result from some form of obsession that overwhelms a person's ability to control or manage the behavior. These characteristics most resemble addiction-type behaviors without the drug or alcohol component. Not unlike drug/alcohol addictions, compulsive gambling behaviors trigger physiological changes and behavioral changes, both of which have a noticeable impact on a person's everyday quality of life.
Process-Based Addictions
Addiction describes a disorder characterized by a loss of control, so compulsive behavior becomes a key component within any form of addiction. Process-based addictions involve activities where a person loses control over his or her ability to walk away from further engagement. Compulsive gambling behaviors fall within the process-based addiction category.
Much like addictions to alcohol and drugs, a person may start out gambling on an infrequent basis as a form of recreation. For people with addiction tendencies, the fun or thrill of engaging in the activity becomes a force all its own, similar to how a drug 'high' drives addicts to keep using.
Ultimately, someone with a compulsive gambling (addiction) disorder will exhibit the following characteristics –
- Spending increasing amounts of time gambling
- Disregard for negative consequences brought on by gambling behavior
- An inability to limit or stop gambling behavior
- Thinking about and anticipating the next time he or she gambles
- An emotional tie with the activity
Gambling Effects in the Brain
Someone who cannot control their gambling may be said to have a gambling disorder.
For people addicted to gambling, the act of gambling has become an obsession. Obsessions, in general, trigger certain emotional responses, which play a central role in perpetuating this condition.
Likewise, compulsive gamblers experience a 'rush' or 'high' that produces chemical changes in the brain, much like a drug or alcohol 'high.' According to Scientific American, these chemical changes affect the same neurotransmitter chemicals that regulate emotions, learning, cognitive functions and motivation.
Over time, these chemical changes start to 'rewire' how the brain works and eventually alter a person's motivations, thoughts and behaviors. In effect, the more a person engages in gambling the more out of balance brain chemical processes become.
Symptoms of Compulsive Gambling
Like drug and alcohol abuse disorders, a gambling disorder can wreak havoc in most every area of a person's life. Symptoms of compulsive gambling disorder include –
Mood Disorder Compulsive Gambling Behavior
- Decline in personal appearance and/or hygiene
- Frequent mood swings
- Sleep problems
- Risk-taking
- Financial difficulties
- Changes in appetite
- Legal problems
- Relationship conflicts
- Problems at work
Not surprisingly, these same symptoms can result from drug/alcohol addictions. As with any form of addiction, a person's gambling behaviors will only get worse unless he or she gets needed treatment help.
Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships.
Mood Disorder Compulsive Gambling Disorders
Compulsive gambling most often begins in early adolescence in men, and between ages 20 and 40 in women.
People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or drugs. Although it shares features of obsessive compulsive disorder, compulsive gambling is likely a different condition.
In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.
People with compulsive gambling often feel ashamed and try to avoid letting other people know about their problem. The American Psychiatric Association defines pathological gambling as having 5 or more of the following symptoms:
- Committing crimes to get money to gamble.
- Feeling restless or irritable when trying to cut back or quit gambling.
- Gambling to escape problems or feelings of sadness or anxiety.
- Gambling larger amounts of money to try to make back past losses.
- Losing a job, relationship, education, or career opportunity due to gambling.
- Lying about the amount of time or money spent gambling.
- Making many unsuccessful attempts to cut back or quit gambling.
- Needing to borrow money due to gambling losses.
- Needing to gamble larger amounts of money in order to feel excitement.
- Spending a lot of time thinking about gambling, such as remembering past experiences or ways to get more money with which to gamble.
A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions www.gamblersanonymous.org/ga/content/20-questions can help with the diagnosis.
Treatment for people with compulsive gambling begins with recognizing the problem. Compulsive gamblers often deny they have a problem or need treatment.
Most people with pathological gambling only get treated when other people pressure them.
Treatment options include:
- Cognitive behavioral therapy (CBT).
- Self-help support groups, such as Gamblers Anonymous. Gamblers Anonymous www.gamblersanonymous.org/ is a 12-step program similar to Alcoholics Anonymous. Practices used to treat other types of addiction, such as substance use and alcohol use, can also be helpful in treating pathological gambling.
- A few studies have been done on medicines for treating compulsive 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 medicines.
Like alcohol or drug addiction, pathological gambling is a long-term disorder that tends to get worse without treatment. Even with treatment, it's common to start gambling again (relapse). However, people with pathological gambling can do very well with the right treatment.
Complications may include:
- Alcohol and drug use problems
- Anxiety
- Depression
- Financial, social, and legal problems (including bankruptcy, divorce, job loss, time in prison)
- Heart attacks (from the stress and excitement of gambling)
- Suicide attempts
Mood Disorder Compulsive Gambling Symptoms
Getting the right treatment can help prevent many of these problems.
Call your health care provider or mental health professional if you believe you have symptoms of pathological gambling.
Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse.
Gambling - compulsive; Pathological gambling; Addictive gambling
American Psychiatric Association website. Non-substance-related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:585-589.
Balodis IM, Potenza MN. The biology and treatment of gambling disorder. In: Johnson BA, ed. Addiction Medicine: Science and Practice. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 33.
Weissman AR, Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
