Gambling is considered by most to be a socially acceptable activity, but some people are unable to control gambling behavior. Gambling is considered an addiction when it interferes with your relationships, negatively affects work and finances, or causes you to engage in illegal or unethical behaviors in order to continue gambling.
Diagnostic criteria for pathological gambling are similar to those of substance addiction, and many of the same genetic vulnerabilities and responses to pharmacological treatments are found in pathological gamblers as are found in substance addicts.
An estimated 2 million people in America meet criteria for pathological gambling. Up to 6 million are considered “problem gamblers,” and up to 15 million are considered to be “at risk” for pathological gambling behavior.
Characteristics of People Who Gamble Compulsively
Gambling is more likely to be a pathological condition among people who demonstrate the following behaviors:
- Ongoing preoccupation with thoughts of gambling
- Borrowing money from family, friends, or even co-workers to gamble
- Lying about the amount of money or time spent gambling
- Compulsion to bet continually larger amounts in an attempt to overcome losses
- Hiding gambling activity by shifting money from account to account
- Selling valuables to finance gambling
- Irritability when attempting to halt gambling behavior
- Multiple, unsuccessful attempts to stop gambling
- Taking out loans or neglecting bills to gamble
- Turning to crime to fund gambling
How Pathological Gambling Affects the Brain
Pathological gambling affects the brain in many of the same ways substance addiction does. Indeed, many pathological gamblers must seek addiction treatment to address their problem, with some entering rehabilitation centers to focus on overcoming the addiction. Psychiatric researchers have conducted brain imaging studies and found that a specific area of the brain called the mesolimbic-prefrontal cortex is affected by pathological gambling.
In particular, response of this part of the brain is blunted in response to nonspecific rewards, but it is activated when exposed to gambling-related stimuli. Four main cognitive consequences result:
- Reward-punishment processing is altered in relation to behavioral conditioning.
- Gambling “cues” come to create strong urges to gamble.
- Impulsivity increases.
- Decision-making in the face of negative consequences is impaired.
Treatment Options for Gambling Addiction
Checking into a rehabilitation center to address gambling addiction may sound extreme, but if you are a pathological gambler, it may be necessary in order to focus on the problem and overcome it. Addiction treatment for gambling is similar to that for other addictions and includes 12-step programs, one-to-one therapy, lifestyle changes, and medications. Quitting gambling altogether is essential for recovery, because even occasional gambling can cause a relapse.
Though some pathological gamblers must enter a rehabilitation center to receive treatment, you may also receive addiction treatment on an outpatient basis. Outpatient treatment involves regular attendance at classes and counseling sessions at a facility while you continue to live at home and go to work or school or continue your normal daily activities. Twelve-step programs like Gamblers Anonymous are often available if you cannot afford more intensive addiction treatment; these programs help you build a support network of other recovered gambling addicts.
CBT as a Treatment Option for Gambling Addiction
Cognitive behavioral therapy, or CBT, is a type of psychological therapy that focuses on identifying harmful attitudes and learning to substitute them with more constructive and positive attitudes. In addition to working one-on-one with a therapist, you also complete individual assignments to practice and strengthen new attitudes and responses. Identifying triggers for gambling behavior, developing rewards for non-gambling behavior, and understanding the feelings that develop during gambling are necessary for success of CBT in treating gambling addiction.
The best treatment for pathological gambling depends on the individual and a decision should be made with the help of trained addiction specialists. If you are concerned about your own or someone else’s compulsive gambling, we encourage you to contact us at any time to learn more about treatment options.
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