Gambling is a type of risk-taking in which people place something of value, such as money, on a random event with the intention of winning a prize. There are many different kinds of gambling, including lottery tickets, scratch-off games, cards, casino games, slot machines, video poker, horse races, dice, sports events, and even some online games. While some gambling is harmless, for a subset of people, gambling becomes an addiction that leads to serious consequences like debt, family problems, and loss of employment. For those who are struggling with this problem, there is help available. There are several self-report and interview tools available for assessing gambling disorder (GD), which is defined in the DSM-5 as a persistent and recurrent problematic gambling behavior that results in significant impairment or distress. GD is distinct from other impulse control disorders such as kleptomania and pyromania, and it can be treated with psychosocial interventions and medications.
Despite its stigma, gambling has become an integral part of society. The majority of people engage in some form of gambling, and the psychiatric community has long recognised its role as an addictive behaviour. Nevertheless, in the past, the psychiatric profession viewed pathological gambling as more of a compulsion than an addiction, and it was only recently that the DSM-5 classified it as an impulse-control disorder alongside kleptomania and pyromania.
The majority of people who gamble do so for social reasons and are able to stop when they feel that their winnings have peaked. Those who are addicted to gambling have underlying psychological and emotional issues that may be contributing to their unhealthy behaviours. In addition to their desire for pleasure, these individuals often have trouble with emotions such as anxiety, guilt, depression, and low self-esteem, which can make them turn to gambling as a way of escaping or controlling negative feelings.
Another reason for the addictive nature of gambling is that it activates specific neural pathways in the brain that are associated with reward and motivation. When a person places a bet and wins, the brain releases dopamine – the same neurotransmitter that is released during enjoyable activities such as sex, eating, and drug abuse. In contrast, when a person loses, they experience negative emotions such as frustration, guilt, and anxiety. This can activate the brain’s reward pathway again, encouraging more risk-taking in order to experience the positive feeling of a win.
In addition to seeking treatment for their underlying mental health issues, those who struggle with gambling can also try to strengthen their support network, participate in hobbies such as art or sports, or take up a new hobby that will provide them with the same excitement and rewards as gambling. Some individuals also benefit from joining a peer support group such as Gamblers Anonymous, which is based on the 12-step model of Alcoholics Anonymous. Other interventions include marriage, career, and credit counseling, which can help rebalance one’s finances and relationships and lay the foundation for recovery from an unhealthy gambling lifestyle.