Understanding Gambling Addiction: Signs, Symptoms, and Solutions

Gambling has been a popular human activity for centuries. However, excessive and irresponsible gambling can lead to various emotional, physical, and financial problems. Problem gambling refers to a type of impulse control disorder, where individuals diagnosed with this condition tend to have less control over their gambling than those who gamble recreationally. Problem gambling can also be referred to as gambling addiction, compulsive gambling, pathological gambling or gambling disorder.

Together, let’s unravel the layers of this impulse control disorder, exploring its manifestations, impacts, and the crucial importance of seeking help

Understanding the Hidden Dangers of Problem Gambling

‘Problem/pathological gambling falls under impulse control disorders (ICDs). Impulse control disorders are recognised by a repetitive or compulsive engagement in a behaviour despite negative consequences, limited control over the problematic behaviour, an urge or craving is experienced before engagement in the problematic behaviour, pleasure-seeking during the performance of the problematic behaviour’ (Grant, Donahoue, Odlaug, 2011).

Problem/Pathological gambling may manifest early in life or later, and symptoms can become apparent within a few months to two years, depending on the progression of the addiction. According to the Diagnostic Statistical Manual of Mental Disorder (DSM-IV), problem gambling behavior can be characterised by 9 criteria:

1. A need to gamble with increasing amounts of money to achieve the desired excitement.
2.  Restlessness or irritability when attempting to stop gambling.
3.  Repeated unsuccessful efforts to control, cut back, or stop gambling.
4. Using gambling to escape from problems or relieve a dysphoric mood.
5. After losing money gambling, often returns to recoup losses (chase).
6. Lying to family members to conceal the extent of the involvement with gambling.
7. Commission of illegal acts to finance gambling.
8. Jeopardizing or losing personal and vocational relationships because of gambling.
9. A reliance on others for money to pay off debts.

If an individual has 1 or 2 of the above-mentioned characteristics might develop a gambling problem/gambling disorder. If you have 3 to 5 signs mentioned above it is advisable for you to seek professional help before it gets worse. If you have 6 or more of these signs, you might be a pathological gambler which means you have severe gambling problem.

Definition of Gambling Addiction

Gambling addiction is defined as the continued involvement with gambling activities despite negative consequences. This is likely to lead to damage to the individual’s life and the lives of their families and significant others. According to the American Psychiatric Association (2010), pathological gambling is now classified as an impulse-control disorder that is similar to others in that it entails a long-term disabling and hard-to-control pattern of behaviour.

According to Kaplan & Sadock (2011) problem gambling is defined as “persistent and recurrent maladaptive gambling that causes economic problems and significant disturbances in personal, social, or occupational functioning.”

The prevalence of gambling addiction is a growing global public health concern, with an increasing number of individuals identified as problem or pathological gamblers. The availability and accessibility of different forms of gambling platforms have contributed to the problem. Lotteries are the most common form of gambling, followed by card games, sports betting, and online gambling.

According to DSM V TR (2013)“the prevalence of pathological gambling is influenced by both availability of gambling and the duration of availability of legalized gambling, there is an increase in prevalence of gambling disorder.” Studies have shown that people from lower socioeconomic groups who are diagnosed with specific mental health problems are more likely to develop pathological gambling.

Gambling addiction can have a significant impact on individuals and society. A study by Hodgins and El-Guebaly (2004) found that almost a quarter of participants who are gamblers had experienced at least three forms of harm from gambling, such as bailiff seizures, utility disconnections, eviction, and the use of welfare. Harm was higher among male participants with greater years of gambling and higher debts. The spouses of those who had been harmed were also affected, with 21% reporting at least three problems related to the impact on the family.

Individuals with gambling addiction often end up with high debts, which can cause significant problems for their families. A study by Lorenz, Yaffee, and Hoffmann (1989) found that among the spouses they interviewed, family problems included severe financial difficulties such as bankruptcy and loss of all savings (92%), legal problems often due to financial difficulties, and emotional or psychological problems (82%). The effects of gambling problems were often detrimental to the family, including the loss of money and resources, neglect of spouse and children, and the need to borrow or access savings accounts or life insurance policies.

Causes of Gambling Addiction

Psychosocial factors have been at the centre of the causes of gambling addiction compared to biological factors. Humans experience gambling problems influenced by their surrounding environments, if the environment does not have a gambling platform, individuals are not going to participate in gambling. Lack of knowledge about the risks of gambling and responsible gambling also contribute to causes of gambling addiction.

‘Psychosocial factors may predispose persons to develop problem gambling: loss of parents by death (Grief/Bereavement), separation, divorce, or desertion before a child is 15 years of age; inappropriate parent discipline (absence, inconsistency, or harshness); exposure to, and availability of, gambling activities for adolescents; family emphasis on materials and financial symbols; and lack of family emphasis on saving, planning, and budgeting’(Kaplan & Sadock, 2011).

Development of Gambling Addiction

Gambling develops in the early stage in males and later stage in females. The severity of this disorder can cripple a person’s various areas of life. Every addiction has its developmental stages and below are developmental stages of gambling addiction.

According to Kaplan & Sadock (2011) ‘gambling addiction has 4 developmental stages:

1. The winning phase, ending with a big win, is equal to about a year’s salary, which hooks a gambler. Women usually use gambling as an escape from problems.
2. The progressive-loss phase, in which gamblers structure their lives around gambling and then move from being responsible gamblers to irresponsible gamblers who take considerable risks, cash in securities, borrow money, miss work, and lose jobs.
3. The desperate phase, gamblers start to gamble with large amounts of money, not pay debts, become involved with loan shacks, and possibly embezzling.
4. The hopeless stage of accepting that loss can never be made up, but the gambling continues because of the associated arousal or excitement. The disorder may take up to 15 years to reach the last phase, but then, within a year or two, gamblers have deteriorated totally.

Warning Signs of Gambling Addiction

According to Grant (2011), Gambling problem or pathological gambling affects your life and ability to function in other aspects of your life. Identifying warning signs in yourself or someone you care about is an important step towards seeking help before problems become too severe. Just as importantly, being able to identify and support individuals displaying just one of these warning signs may be sufficient to deter them from further gambling and prevent the onset of any problems. The earlier problems are detected, the better the chance a person must get them under control.

In this way, identifying warning signs early may prevent full-blown gambling problems from occurring. Some of these signs may include.

Preoccupation with gambling

Individuals who are developing or already developed gambling problems are preoccupied with reliving past gambling experiences, handicapping or planning the next venture, and thinking of ways to get money with which to gamble (Kaplan & Sadock, 2011).

The yale-Brown Obsessive scale is designed to measure gambling thoughts or urges, problem gamblers who have responded to this scale reported that they experience gambling-related thoughts/urges every day, these thoughts/urges interfere with their social and work functioning, stress caused by these thoughts/urges, fail to resist these thoughts/urges, and have little or no control over these thoughts/urges.  They further reported that they spend most of their free time engaging in activities related to gambling, these activities are also interfering with work/social roles, and they are failing to stop these activities.

Financial difficulties

According to the Diagnostic and Statistical Manual of Mental Disorders (2014) ‘Problem gamblers need to gamble with increasing amounts of money to achieve the desired excitement’. During therapy sessions, problem gamblers reported that they have been given money from a family member or close friend to relieve a desperate financial situation caused by gambling and cannot afford the lifestyle that they used to afford.

They further stated that they have been downgraded in the food they used to buy, and places they used to stay, had difficulty paying their debts and were unable to financially support their families because all their money was taken by their irresponsible gambling behaviour. Individuals who practice responsible gambling behaviour hardly experience financial problems caused by gambling problems.

Denial of the amount of time and money devoted to gambling

According to DSM IV TR (2014) ‘distortions in thinking (e.g. denial, lies, superstitions, overconfidence, or a sense of power and control) may be present in individuals with pathological gambling.’ Denial is one of the early stages of every form of addiction. Lying to yourself, family members, therapists or others to conceal the extent of involvement with gambling (Synopsis of Psychiatry). In therapy, they reported that they are embarrassed about disclosing the true nature of their irresponsible gambling behavior.

They would rather hide it than disclose it to family members or professionals who are willing to help them. This denial contributes to making their irresponsible gambling behavior become more severe because it is protected by the lies. If you are a gambler and you notice this habit in your behavior, it is advisable not to allow yourself to lie to individuals who are willing to help you fight your problematic gambling behavior. Gamblers who gamble responsibly do not hide or deny the true nature of their gambling behavior.

Unrealistic expectations

Problem gamblers who attended the National Responsible Gambling Treatment Program reported that they are always carrying memories or thoughts of winning big money in gambling. This thought gives them unrealistic expectations for their irresponsible gambling behaviour.

Furthermore, problem gamblers reported that they use gambling as a way of escaping problems, relieving uncomfortable or bad feelings or moods, and making money and eventually, it will solve all their financial problems. They do not see gambling as a way of entertainment. Responsible gamblers see gambling as a way of entertainment, not a way of making money, and they do not rely on gambling to solve their financial and mental health problems.

Believing that the money is not real: Gambling addiction is different from other addictions because it revolves around money. This activity is based on risking, winning, and losing money. Problem gamblers who attend therapy sessions have reported that they always regret how they have recklessly gambled all their hard-earned money in a short period. They further stated that irresponsible gambling behaviour made them lose the usual value and meaning of money.

Chasing Your Losses

According to DSM V TR (2014), gambling addiction symptoms include ‘after losing money gambling, often returns same day or tomorrow trying to win what you’ve lost’. Problem gamblers in therapy sessions report that they gamble continuously because they are trying to win back the money they have lost. They further state that if they win a lot of money, they will be able to stop gambling.

Chasing losses fall under impulsive gambling. A gambler has an illusion that they are in control of the behaviour while they have already lost control. Chasing losses always puts gamblers in financial problems because their focus is on chasing the losses and not paying attention to what they are losing. Gamblers make a series of irresponsible decisions while chasing their losses. Social and professional gamblers normally walk away instead of chasing their losses.

Physical Symptoms of Gambling Addiction

You may also suffer from physical symptoms. These symptoms include personal hygiene neglect, sleep disturbances, weight loss or gain, and stress-related symptoms.

Neglect of personal hygiene: According to Oregon Health Authority (2024), problem gamblers have poor hygiene and overall self-care. Numerous studies have shown a direct connection between an addict’s hygiene and the severity of their addiction.

One of the studies, done by Slutske, Natural, and Sher, (2019), confirms that ‘gamblers’ hygiene level is directly related to the severity of their gambling addiction. The worse the disorder, the worse it tends to make one look dirty and smell’.

Individuals who have presented with gambling addiction signs in therapy sessions appeared to have poor hygiene. The drastic decrease in personal hygiene is most noted by an individual’s lack of showering and/or bathing. The lack of showering frequently causes the body to become dirty, smelly, and uncomfortable. While gambling, the individual is always looking to maximize the time spent playing and minimizing the time needed to prepare to play.

Weight loss or gain

People who have a gambling addiction may also neglect to take care of their diet. The most noticeable of these signs are weight changes. This could be due to an increase in stress from worrying about gambling. Weight loss or gain may also be partly due to medication, as people with a gambling addiction are more likely to be on medication for depression, which can cause a loss of appetite, or anxiety, which can cause an increase in appetite.

Lam, D. & Mok, M. (2017) stated that “Compared to the general population, rates of obesity and being overweight are higher among individuals who engage in problem gambling behaviors’.

Sleep disturbances

Sleep disturbances can manifest in many forms for those with a gambling problem. Some of these include difficulty falling asleep, staying asleep, or restless sleep. Frequent nightmares that are related to the stress of trying to win money or the games themselves are common. This person may also have the opposite of restless sleep and feel sleepy during the day. This can be due to their late nights spending time at the casino, internet gambling, or poker playing. Oftentimes, the person has no idea of these sleep disturbances and may need to be informed by their bed partner. All of these can have very serious effects on a person’s health, and they must be addressed healthily.

The study which was conducted by Parhami, Siani,  Rosenthal & Lin (2012)  to examine the relationship between gambling severity and sleep disturbances stated that  “Decreased sleep quality is seen in any form of gambling disorder (problem or pathological), but only pathological gamblers experience significantly increased daytime sleepiness relative to recreation gambling controls. Although a few studies have made note of sleep disturbances experienced during crisis or withdrawal, these findings demonstrate that problematic sleep occurs for current non-treatment seeking gamblers as well”.

Stress Related Diagnoses

According to Montana Council on Gambling Problems (2024), Problem gamblers report higher levels of stress-related physical problems than average. Conditions may include migraine headaches, tension headaches, irritable bowel syndrome, peptic ulcer and insomnia.

When your finances, relationship with family members, work and mental health are negatively affected by gambling problems, you don’t have a choice but to become stressed.

Emotional Symptoms of Gambling Addiction

You may also suffer from emotional symptoms. These symptoms include emotional instability, depression and hopelessness, anxiety, and irritability.

Emotional Instability

Systematic review from 2018 stated that it is very common for gambling problem to co-occur with bipolar disorder. 68% of people with a behavioral addiction also had bipolar disorder.

Emotional instability usually refers to a rapid and uncontrollable shift in emotional states. This can take the form of mood swings, irritability, and increased aggression. For the majority of problem gamblers, mood instability is the most commonly observed symptom. Problem gamblers manifest a mood-change state of uncharacteristic irritability, anger, and frustration.

Such mood shifts are taxing on those closest to the gambler; people with whom the gambler interacts can usually see the shift, and this can also take a heavy emotional toll on those people too. Due to the loss of large amounts of money in what is often a short space of time, gamblers can experience a continued state of high stress. This can contribute to a downward spiral in the mood of the gambler, which only serves to worsen the gambling in an attempt to recapture a high.

Depression and Hopelessness

Common symptoms of depression are poor decision making. This takes the form of negative or hopeless thoughts about oneself and life in general. Pessimism, poor self-esteem, and the belief that one is helpless to change one’s life situations are all common in people who are depressed. This can lead to the thought that gambling is a solution to change one’s life for the better. This is particularly relevant to people who are overly impulsive, and who are often looking for quick and easy ways to make money without considering the long-term consequences. As they try to escape the reality of their situation by gambling, the cognitive state of depression only deepens.

Another common thought of depressed people is the desire to “punish themselves”. Gamblers often report that they want to hurt themselves because they do not feel they are worthy of having good things in life. This can be linked to self-sabotage, where the gambler tries to create more problems in their life in order to deal with or run away from the guilt of problems they already have. One of the criteria for pathological gambling is that it is used as a way to escape from feelings of helplessness, and it is not uncommon for people to gamble until there is nothing left as an “ultimate escape” from life.

According to Gate away foundation (2023) experiencing ‘depression symptoms can cause a person to seek out activities to escape from their reality, even if they’re reckless. One of these activities can include gambling. Gambling and depression statistics show that people with more severe depression symptoms are more likely to engage in irresponsible gambling behaviors as an escape or attempt to experience the highs of gambling.

Anxiety

Studies had shown that individuals who struggle with gambling addiction also struggle with signs of anxiety disorder. One large epidemiological study found a lifetime prevalence of anxiety disorders of 41.3% among disordered gamblers (Petry et al., 2005). Individuals who are already experiencing signs of anxiety have high rate of developing gambling addiction compared to individuals who do not have signs of anxiety. Players who have been diagnosed with anxiety disorder must be aware of their condition as it puts them at high risk.  In another analysis, Desai and Potenza (2008) also found a high prevalence of panic disorder, generalized anxiety, and social phobia in gambling disorder.

According to Help Guide.org (2024), Many people gamble as a way of managing anxiety. As they gamble, people often report being separated from their anxious feelings or projecting their feelings of anxiety onto the excitement they feel when they partake in their gambling activity of choice. As a result, gambling can work its way into the fabric of their everyday life, and the impulse to gamble can overwhelm the rest of their lives.

Irritability

Irritability is the feeling that a problem gambler feels when they try to reduce or stop their gambling. This feeling of irritability always affects how a problem gambler communicate with family members, colleagues, friends and significant others. To avoid this feeling problem gamblers continue to gamble without paying much attention to the financial consequences. According to DSM-V-TR (2014) problem gamblers feel irritable when they can’t access gambling. Problem gamblers experience this feeling and fail to recognize that it is a sign of gambling problem. Individuals who gamble responsibly do not experience irritability when they can’t access gambling.

Gambling Addiction and Suicide

Severe problem gambling had caused gamblers to consider suicide as a way out of the gambling problems (unable to pay debt, legal consequences, disowned by family, homelessness, loss of job, divorce, depression). When the symptoms of pathological gambling become unbearable suicidal ideations are common. Some try to commit suicide while others keep on having suicidal ideations without acting on them. There are pathological gamblers who had been in therapy and end up committing suicide.

Based on study Gambling-related suicides and suicidality: A systematic review of qualitative evidence (2022), gambling can be identified as an important contributor to suicide. The qualitative research evidence summarized in this study indicates that the two main processes that connect pathological gambling to suicide or suicidality are indebtedness and shame. These two processes have also been identified in previous research literature, and gambling is a significant contributing factor to unmanageable indebtedness as well as to crippling shame’.

Gambling Addiction Treatment

There are different types of treatment designed to treat gambling addiction. Counselling or psychotherapy are the most common way of treating gambling addiction. Counsellors often use cognitive behavioral therapy to treat gambling disorder.

According to Grant (2011) “Cognitive-behavioral therapy (CBT) is based on the knowledge that our thoughts cause our feelings and behaviors, not external things like people, situations, and events. CBT is structured and goal oriented, with the therapeutic goal of helping you unlearn your unwanted reactions and learn a new way of reacting. A critical component of the program is to question the thoughts related to your impulsive behaviors. You need to look at your thoughts as being hypotheses or theories that can be questioned, tested, and corrected if they are inaccurate. For example, if you suffer from PG, you may have thoughts such as, “I am bound to win eventually. I just need to keep playing.” CBT helps you question these inaccurate thoughts by having you realize that although you may win on occasion, you seldom walk away with your winnings.’

Gamblers anonymous is an international group where individual suffering from gambling addiction gather in their towns to help each other on how to defeat gambling addiction. According to Kaplan & Sadock (2011) ‘Gamblers anonymous is a method of inspirational group therapy that involves public confession, peer pressure and presence of reformed gamblers (as sponsors) available to help problem gamblers to resist the impulse to gamble irresponsibly.’

With today’s technology, online apps have been developed to help individuals struggling with gambling problems. These apps had been noticed to be effective treating individuals who struggle with other behavioral addictions and have been adopted in the field of treating pathological gambling too. These apps are easily accessible anytime a problem gambler would want to use them, unlike professional therapists who might not be always available for a client.

According to Smartphone Apps for Problem Gambling: A Review of Content and Quality, a study conducted by McCurdy, Loya, Hart-Derrick, Young, (2023), ‘Recent Findings To date, there are no published studies that have evaluated the quality of publicly available smartphone apps for problem gambling’. The purpose of this study was to evaluate publicly available mobile apps aimed at improving problematic gambling behaviour.

Little is known about the effect of medicine treating gambling addiciton.

Conclusion

As we come to the end of our article on signs of gambling addiction and the definition of gambling addiction. We highlighted the dangers of gambling addiction and how they cripple an individual’s life including the life of family members and friends. We’ve navigated through the role environment play in causing gambling addiction and how gambling addiction develop.

This article has presented warning signs, physical and emotional symptoms of gambling addiction, how gambling problems can cause suicide. In doing so, we hope to empower readers and familiarize our players with the true nature of gambling addiction to promote responsible gambling.