Defining gambling addiction
3- Defining Gambling Addiction
Pathological gambling is currently the only behavioural addiction included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and is classified as an impulse control disorder. This kind of behaviour addiction is the uncontrollable urge to gamble despite repeated dire consequences. Behind this compulsion to gamble is a phenomenon similar to that at play with those addicted to substances. Gambling can stimulate the brain’s reward system much as drugs and alcohol do. Those in the grip of gambling addiction have lost the ability to think rationally, with the result that they do harm to themselves and those around them.
- What is gambling addiction
- Similarities between gambling and substance addictions
- Criteria of gambling addiction
- Types of gambling addiction
What is gambling addiction
- Gambling addiction is a mental health problem that falls in the category of behavior addictions. The types of gambling that people with this disorder might engage in are as variable as the games available. Betting on sports, buying lottery tickets, playing poker, slot machines, or roulette are only a few of the activities in which compulsive gamblers engage. Where they choose to gamble varies as well. While many prefer gambling in a casino, the rate of online/Internet gambling addiction continues to increase, with more people turning to this convenient mode of indulging their gambling habit. Alternatively, some compulsive gamblers may also engage in risky stock market investments, often through day trading. The goal for the gambler is the rush of excitement they experience when betting. Gambling addiction is also called compulsive gambling or pathological gambling.
- Money is central to the experience of gambling. Gambling addicts, as with people in general, attach various positive attributes to money, such as power, comfort, security and freedom. Unlike other people, though, compulsive gamblers fail to recognize – even after much painful experience — that gambling puts them at risk of losing all these good things in life. Problem gamblers also fail to comprehend that gambling is a random process in which the odds are against them. Any gambling operation – a casino, an online betting site, a racetrack, the local bookmaker – is there to make money for its owner. The odds always favor the “house”. The longer a gambler stays at the blackjack table or at a slot machine or bets the horses, the greater the chance they will lose – and the more they will lose. Through a process of delusional thinking, the gambler convinces himself that he is more likely to win than to lose. If he loses, he rationalizes it as an aberration, something sure not to be repeated if only he wagers more carefully. This belief persists in the face of overwhelming evidence to the contrary. At work here is the phenomenon of denial, which is a powerful and integral force in all addictions and which enables the addict to continue blindly down the path to destruction. Finally, when they do win, people with gambling addictions tend to gamble away their winnings quickly.
- Gambling addiction is sometimes referred to as a “hidden illness” because there are no obvious physical signs or symptoms such as are evident in drug or alcohol addiction. Yet there nevertheless are devastating psychological, social, and financial and relationship consequences to pathological gambling. Given the absence of some of the outward manifestations of the addiction, these gambling addicts may find it easier than a drug addict, for instance, to deny or minimize the problem. In any case, the gambling addict will go to great lengths to hide their betting. Between bouts of gambling binges, the gambling addict is going to feel a lot of guilt and shame. Even the addict in the deepest denial will have moments where they recognize that what they are doing is crazy. Problem gamblers will often withdraw from their loved ones, sneak around, and lie about where they’ve been and what they’ve been up to in order to cover up the extent of their problem.
- Compulsive gamblers are unable to resist the compulsion to gamble, even when they know their gambling is hurting themselves or their loved ones. Gambling is all they can think about and all they want to do, no matter the consequences. The gambler is like the untreated alcoholic who cannot resist that first drink, even though they see the damage drinking is doing. Compulsive gamblers keep gambling whether they’re up or down, broke or flush, happy or depressed. Even when they know the odds are against them, even when they can’t afford to lose, people with a gambling addiction can’t “stay off the bet.”
- Although more men than women are thought to suffer from pathological gambling, women are developing this disorder at higher rates, now making up as much as 25% of individuals engaging in pathological gambling in the Western world. Men tend to develop this disorder during their early teenage years while women tend to develop it later. However, the disorder in women then tends to get worse at a much faster rate than in men. Other apparently gender-based differences in gambling addiction include the tendencies for men to become addicted to more interpersonal forms of gaming, like blackjack, craps, or poker, whereas women tend to engage in less interpersonally based betting, like slot machines or bingo.
Similarities between gambling and substance addiction
- In the past, the psychiatric community generally regarded compulsive gambling as more of a behavior issue than an addiction—a behaviour primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association officially classified pathological gambling as an impulse-control disorder and in 2013 in what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual’s latest edition. The decision reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling. Essentially, experts agree that gambling addiction is a sickness, a disease – and that it can affect anyone. Therefore, it’s not something anyone need feel ashamed of. It’s not a failure of character or the result of weakness. Above all, it can be treated.
- The psychiatric community based its decision on numerous recent studies in psychology, neuroscience and genetics demonstrating that gambling and drug addiction are far more similar than previously realized. Research in the past two decades has dramatically improved neuroscientists’ working model of how the brain changes as an addiction develops. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure and motivation. When we engage in an activity that keeps us alive or helps us pass on our genes – such as a good meal or engaging in sex — neurons in the reward system squirt out a chemical messenger called dopamine, giving us a little wave of satisfaction. When stimulated by amphetamine, cocaine or other addictive drugs, the reward system disperses up to 10 times more dopamine than usual.
- Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal—they feel physically ill, cannot sleep and shake uncontrollably—if their brain is deprived of a dopamine-stimulating substance for too long. The more an addict uses a drug, the harder it becomes to stop.
- Pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. This is why they say that alcoholism or drug addiction runs in families. It has been shown that a person with an alcoholic parent or grandparent is more likely to become an alcoholic himself. Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive—which may partially explain why they seek big thrills in the first place.
- Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways. These insights come from studies of blood flow and electrical activity in people’s brains as they complete various tasks on computers that either mimic casino games or test their impulse control. A study using such a card game suggests problem gamblers—like drug addicts—have lost sensitivity to their high: when winning, subjects had lower-than-typical electrical activity in a key region of the brain’s reward system.
- Clinical studies measuring impulsivity among people show that pathological gamblers have unusually low levels of electrical activity in prefrontal brain regions that help people assess risks and suppress instincts. In other words, the gamblers in these studies were not good at recognizing when they were danger. Drug addicts also often have a listless prefrontal cortex, making them less capable of assessing risks. For example a person with healthy levels of brain electronic activity recognizes some people as dangerous — and so keeps away from them. And the gambling world is known for attracting elements that operate outside the law – in other words, criminal types. These are the kind of people that most of us steer clear of. We would have no reason to associate with those who might be a threat. But someone with low prefrontal activities despite is actually drawn to hazardous situations for the excitement. These are the kinds of people more prone to developing addiction, be it to substances or behaviours.
- Further evidence that gambling and drugs change the brain in similar ways surfaced in an unexpected group of people: those with the neurodegenerative disorder Parkinson’s disease. Characterized by muscle stiffness and tremors, Parkinson’s is caused by the death of dopamine-producing neurons in a section of the midbrain. Over the decades researchers noticed that a remarkably high number of Parkinson’s patients, between 2 and 7 % are compulsive gamblers. This finding suggests that addicts tend to have low dopamine producing neurons, the natural feel good factors. The result is the addict feels listless and morose in the everyday world. Simply put, a healthy person – a person with normally functioning brain neurons – will take pleasure in going to the movies, taking a walk in the park, playing football, or having a quiet evening at home with the family. But for addicts, such activities fail to excite, fail to satisfy. The untreated addict needs extremes of stimulation to rouse them out of their feelings of emptiness. Some clinicians believe that addicts might respond to the same treatment used to ease symptoms of Parkinson’s, such as levodopa and other drugs that increase dopamine levels. If the dopamine level can be corrected, according to this thinking, the addict will be less inclined to engage in the risk-taking behaviour associated with their addiction.
Criteria of gambling addiction
The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the primary system used to classify and diagnose mental health disorders in United States. According to DSM, a person may have a problem with gambling if he or she exhibits four (or more) of the following in a 12-month period:
1- Euphoria: Needs to gamble with increasing amounts of money in order to achieve the desired excitement or “high”.
2- Withdrawal symptoms: Is restless or irritable when attempting to cut down or stop gambling.
3- Powerless: Has made repeated unsuccessful efforts to control, cut back, or stop gambling to no avail.
4- Obsession: Is obsessive and preoccupied with gambling (e.g. having persistent thoughts of reliving past gambling experiences, planning the next gambling venture, thinking of ways to get money with which to gamble)
5- Escapism: Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
6- Insanity: Does not stop after having lost money but continues with the belief that next time it will be different.
7- Consequences: Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
8- Dependence on others: A person addicted to gambling relies on others to provide money to relieve desperate financial situations caused by gambling.
Types of gambling addictions
- There are three common types of gambler: the professional gambler, the social gambler, and the problem or chronic gambler. Social gamblers consider gambling to be a valid form of recreational activity, and maintain full control over the time, money and energy they expend on gambling. They consider the cost of gambling to be payment for entertainment. Chronic gambling involves the continued involvement in gambling activities despite consequences, even the most severe kinds of problems. All gambling addicts are problem gamblers, although not all problem gamblers have a gambling addiction. In one manifestation of denial, the problem gambler will often believe themselves to be, or pretend to be, a social or professional gambler.
- There are also many different gambling behaviours. One may gamble in a crowded casino or sitting at home alone in front of the computer placing bets online. What tends to distinguish the type of gambling addiction is also the environment and availabilities. Depending on what part of the world you live in, your betting may be confined to local card games or internet gambling as opposed to visiting a casino. People rich and poor and from every country and walk of life are prey to gambling addiction. The commonality is the chronic gambler’s inability to say no to wagering money he cannot afford to lose, in an endless downward cycle.
Some examples of types of gambling activities people become addicted to are:
- Card games
- Skill games
- Slot machines