Pathological gambling
Pathological gambling, also known as gambling disorder, is a recognized psychological condition characterized by the persistent and recurrent problematic gambling behavior that leads to clinically significant impairment or distress. It was previously categorized as an impulse control disorder but is now classified under “Substance-Related and Addictive Disorders” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Meaning and Symptoms
- Preoccupation with Gambling: Individuals with pathological gambling are often preoccupied with gambling (e.g., reliving past gambling experiences, planning the next venture, or thinking of ways to get money with which to gamble).
- Loss of Control: They typically exhibit a loss of control, evidenced by their inability to stop gambling despite the desire and repeated efforts to do so.
- Escalation: Gamblers may need to bet more money more frequently to experience the same level of excitement. This is known as “chasing” one’s losses, which refers to the act of gambling more to attempt to recover money previously lost.
- Withdrawal: Symptoms like restlessness or irritability may occur when trying to cut down or stop gambling.
- Deception: Individuals may lie to family members, therapists, or others to hide the extent of their gambling.
- Financial and Relationship Impact: There are often significant personal consequences, such as loss of significant relationships, job, educational, or career opportunities due to gambling, and relying on others for money to relieve desperate financial situations caused by gambling.
Forms of Pathological Gambling
Pathological gambling can encompass various types of gambling activities, including but not limited to:
- Casino gambling (e.g., slots, table games)
- Sports betting
- Online gambling
- Lotteries
- Poker and other card games
- Betting in informal settings
The form the gambling takes can vary widely depending on access, cultural acceptance of gambling, and the gambler’s personal preferences and tendencies.
Treatment of Pathological Gambling
- Cognitive Behavioral Therapy (CBT): This is the most common and effective form of therapy for gambling disorders. CBT for gambling addiction focuses on changing unhealthy gambling behaviors and thoughts, such as rationalizations and false beliefs. It also teaches problem-solving skills and relapse prevention.
- Medication: There’s no specific medication approved for the treatment of pathological gambling, but certain medications, like antidepressants and mood stabilizers, have shown efficacy in reducing gambling behaviors in some individuals.
- Self-help and Peer Support Groups: Programs like Gamblers Anonymous (GA) provide support and a recovery program based on the 12-step model similar to Alcoholics Anonymous. These groups can offer emotional support and practical advice to individuals struggling with gambling addiction.
- Family Therapy: Gambling addiction can significantly impact families, and family therapy can help address these issues, providing family members with the tools to support recovery.
- Financial Counseling: Since gambling can lead to severe financial stress, professional financial counseling and planning can be crucial in recovery to manage debts and develop financial discipline.
- Lifestyle and Coping Strategy Adjustments: Lifestyle changes, including exercise, meditation, and engaging in new hobbies, can help reduce the stress that might trigger gambling behaviors. Effective coping strategies are also taught to manage urges and maintain gambling abstinence.
Combining these treatments can provide a comprehensive approach to help individuals recover from pathological gambling, addressing both the psychological elements of the addiction and the practical consequences in their lives.
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