Is Gambling Addiction a Mental Illness?

Yes, Gambling addiction, also known as gambling disorder, is recognized as a mental illness. It’s classified by the American Psychiatric Association‘s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an addictive disorder. This classification places gambling addiction alongside other behavioral addictions, acknowledging the compulsive nature of the disorder and its significant impact on an individual’s life. The recognition of gambling addiction as a mental illness underscores the seriousness of the condition and the need for appropriate treatment and support to address its complex challenges.

What Is Gambling Disorder?

Gambling disorder is a mental health condition characterized by a compulsive urge to gamble despite negative consequences. This condition affects an individual’s ability to control their gambling behavior, leading to significant personal, financial, and social challenges.

What Qualifies as a Mental Illness?

A mental illness is a condition that affects a person’s thinking, behavior, emotions, or mood in a way that significantly impairs their ability to function in daily life. Mental illnesses are typically diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include the presence of persistent and distressing symptoms that interfere with work, social interactions, or other important areas of life. Mental illnesses can vary in severity and may require different types of treatment, including therapy, medication, or other interventions to manage symptoms and improve quality of life.

How Is Gambling Disorder Diagnosed?

Gambling disorder is diagnosed based on criteria outlined in the DSM-5. To be diagnosed with gambling disorder, an individual must exhibit four or more of the following symptoms within a 12-month period:

Preoccupation with gambling: Persistent thoughts about past gambling experiences, planning future gambling activities, or seeking ways to obtain money for gambling.
Increasing need to gamble: Needing to gamble with larger amounts of money to achieve the desired level of excitement.
Restlessness or irritability: Feeling restless or irritable when attempting to reduce or stop gambling.
Unsuccessful attempts to control gambling: Repeatedly trying and failing to control, cut back, or stop gambling.
Gambling when distressed: Using gambling as a way to cope with distressing emotions, such as feelings of helplessness, guilt, anxiety, or depression.
Chasing losses: Returning to gamble again and again after losing money in an attempt to recover losses.
Lying about gambling: Concealing the extent of gambling involvement from family and friends.
Jeopardizing relationships and opportunities: Risking important relationships, jobs, or educational opportunities due to compulsive gambling.
Relying on others for financial relief: Depending on others to provide money to relieve financial crises caused by compulsive gambling.

The evaluation also involves a thorough assessment, including a detailed medical and psychiatric history, to rule out other conditions that might contribute to or mimic gambling behaviors.

How Severe Is Your Gambling Disorder?

The severity of gambling disorder is determined by the number of diagnostic criteria met within a 12-month period. The disorder is classified into three levels of severity:

Mild: If you meet 4 to 5 of the diagnostic criteria, your gambling disorder is considered mild. This indicates that while the behavior is problematic, it may not have yet led to significant disruptions in your life.
Moderate: Meeting 6 to 7 criteria indicates a moderate level of severity. At this stage, gambling behavior is more ingrained and likely to cause substantial harm to personal, financial, and social aspects of your life.
Severe: If you meet 8 to 9 criteria, your gambling disorder is classified as severe. This level reflects a deep and pervasive addiction that significantly impacts your daily functioning, relationships, and overall well-being.

Understanding the severity of your gambling disorder is essential for determining the most appropriate treatment approach and for recognizing the urgency of seeking help.

Risk Factors for Gambling Disorder

Several factors can increase the likelihood of developing a gambling disorder. These risk factors include:

Genetics: A family history of gambling disorder or other addictions may increase the risk of developing similar behaviors due to genetic predispositions.
Mental Health Conditions: Individuals with mental health conditions such as depression, anxiety, or substance use disorders are at a higher risk of developing gambling disorder as a way to cope with emotional distress.
Age: Young people and seniors are particularly vulnerable to developing gambling disorders. Among youth, gambling rates are alarmingly high, with estimates indicating that between 60% and 80% of high school students have gambled for money in the past year.
Gender: Men are generally more likely to develop gambling disorders than women, though the gap narrows with age.
Personality Traits: Certain personality traits, such as impulsivity, competitiveness, or a tendency toward risk-taking, can make an individual more susceptible to gambling addiction.
Social Environment: Exposure to gambling through family, friends, or a social network that normalizes or encourages gambling can increase the risk of developing a gambling disorder.
Early Exposure: Being introduced to gambling at a young age, especially during adolescence, can increase the likelihood of developing a gambling problem later in life.

Recognizing these risk factors can help in identifying those who may be more vulnerable to developing a gambling disorder, allowing for earlier intervention and prevention efforts.

The Most Addictive Forms of Gambling

Certain types of gambling are considered more addictive due to their structure, speed, and accessibility. These forms of gambling can quickly lead to compulsive behavior:

Slot Machines: Slot machines are considered one of the most addictive forms of gambling due to their fast-paced gameplay, frequent rewards, and easy accessibility. The combination of continuous play and immediate feedback creates a highly engaging experience, often leading to extended gambling sessions. Research indicates that slot machines generate over $1 billion in wagers each day, highlighting their widespread appeal and potential for addiction.
Online Gambling: Online gambling, which includes virtual casinos, sports betting, and poker, is particularly addictive due to its 24/7 availability and the convenience of gambling from any location. The anonymity and ease of access provided by online platforms make it more difficult for individuals to recognize and manage their gambling behavior. Research indicates that the online gambling market in the U.S. is projected to grow at a rate of approximately 9.77% from 2024 to 2029, reflecting its increasing prevalence and potential for addiction.
Sports Betting: Sports betting can be highly addictive, particularly with the rise of in-play betting, which enables continuous wagering throughout a game. The excitement of live events and the potential for quick wins often drive repeated bets and a strong compulsion to chase losses. In 2023, Americans wagered approximately $119.84 billion on sports, a 27.5% increase from the previous year, highlighting the growing popularity of sports betting as a mainstream activity.
Keno and Bingo: Keno and bingo hold significant cultural importance in the United States, deeply embedded in their histories and the social contexts in which they are played. These games are widely accessible, both in casinos and on online platforms, making it easy for players to participate. The quick results and social aspects of these games enhance their appeal, as players often enjoy the communal experience. This combination of social interaction and rapid gameplay can lead to increased gambling frequency, contributing to their potential for addiction.
Lottery and Scratch Cards: Lottery tickets and scratch cards are often perceived as low-risk forms of gambling, but they can be addictive, especially for individuals who are drawn to the thrill of winning. Their low cost and quick outcomes make these games easily accessible and potentially habit-forming. According to the North American Association of State and Provincial Lotteries (NASPL), Americans spent over $113 billion on lottery tickets in 2023. This figure is projected to grow to around $194 billion by 2025, driven by the expansion of lottery offerings and the rise in online sales.

These forms of gambling are designed to be highly engaging and can quickly lead to compulsive behavior, making it important to approach them with caution, especially for those vulnerable to addiction.

Mental Health Impact of Gambling Disorder

Gambling disorder significantly affects mental health, often leading to or worsening various emotional and psychological challenges. Research shows that around 96% of individuals with gambling disorders also have one or more co-occurring psychiatric disorders, such as substance use disorders, anxiety disorders, or mood disorders like depression.

Mood Disturbances: Gambling disorder is commonly associated with mood disorders, with studies indicating that up to 75% of individuals with gambling problems also experience unipolar depression, and around 30% have bipolar disorder. The stress and guilt from compulsive gambling can intensify these mood disturbances, contributing to feelings of hopelessness and despair.
Anxiety Disorder: Anxiety disorders are highly prevalent among individuals with gambling disorders. Research shows that about 37% of people with gambling problems have a history of anxiety disorders, with lifetime prevalence rates reaching up to 60% in some studies. Specific anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, and social phobia, are particularly common among problem gamblers. These anxiety conditions often exacerbate the challenges of managing gambling behavior, making comprehensive treatment essential.
Substance Use Disorders: There is a significant overlap between gambling disorders and substance use disorders. Research indicates that nearly one-third to half of individuals receiving treatment for substance use disorders also struggle with gambling problems. This high rate of co-occurrence underscores the need for integrated treatment approaches that address both conditions simultaneously, as managing one disorder can be complicated by the presence of the other.
Suicidal Ideation: There is a strong correlation between gambling disorder and suicidal thoughts. Studies suggest that 17% to 24% of individuals with pathological gambling may attempt suicide at some point in their lives, often driven by severe financial losses and the overwhelming consequences of their gambling behavior.

These mental health impacts highlight the urgent need for comprehensive treatment that addresses both the gambling disorder and any co-occurring psychiatric conditions.

Physical Health Impact of Gambling Addiction

Gambling addiction is also associated with several physical health conditions, largely due to the chronic stress it induces, lifestyle changes from prolonged gambling behavior, and the physiological effects of impulsive and compulsive behaviors.

Stress-Related Conditions: Individuals with gambling disorders are at higher risk for developing stress-related conditions such as hypertension, cardiovascular disease, and peptic ulcers. The chronic stress from financial strain and the pressure of chasing losses can significantly impact overall health.
Sleep Disorders: Compulsive gambling often leads to sleep deprivation, as individuals may engage in prolonged gambling sessions that last for hours or even days without adequate rest. This lack of sleep can weaken the immune system and increase the risk of chronic conditions.
Weight Issues: Gambling can contribute to unhealthy weight gain or loss. Some individuals may overeat due to stress or boredom during gambling, especially in environments with easy access to food. Others may neglect nutrition during extended gambling sessions, leading to weight loss and associated health problems.
Chronic Pain: There is a correlation between problem gambling and chronic pain conditions. The severity of gambling problems often aligns with increased physical health issues and reduced physical functioning, which can be worsened by a sedentary lifestyle common among those who gamble for long periods.
Cardiovascular Events: Studies have indicated that cardiac events are among the leading causes of death in casinos, particularly due to the high-stress environment, prolonged periods of inactivity, and the potential for substance use, such as alcohol and stimulants.
Hormonal Imbalances: Problem gamblers frequently experience elevated levels of stress hormones like cortisol, which can lead to various negative health effects, including increased blood pressure and other stress-related ailments.

Recognizing these connections is essential for understanding the full impact of gambling addiction on an individual’s physical health and the importance of addressing these issues in treatment.

Common Misconceptions About Gambling Addiction

There are several misconceptions about gambling addiction that can hinder understanding and effective treatment. Some of the most common include:

“Gambling addiction is just a lack of willpower.” Many people mistakenly believe that gambling addiction is simply a matter of poor self-control. In reality, it’s a recognized mental health disorder with complex psychological, neurological, and social factors influencing gambling behavior.
“You have to gamble every day to be addicted.” Gambling addiction does not necessarily involve daily gambling. An individual can have a gambling disorder even if they gamble infrequently, as long as the behavior is compulsive and leads to adverse consequences.
“Problem gambling is primarily about money.” Gambling addiction is not solely about financial loss; it is fundamentally an emotional and psychological issue. Many individuals with gambling problems may not experience significant financial losses but still suffer from emotional distress and relationship issues due to their gambling habits.
“You can’t be addicted to gambling because it’s not a substance.” Although gambling does not involve ingesting a substance, it can be just as addictive as drugs or alcohol. The behavior stimulates the brain’s reward system in similar ways, leading to compulsive behavior.
“Gambling addiction is just a phase that will pass on its own.” Gambling addiction is a serious condition that typically requires professional intervention for recovery. Without appropriate treatment, the problem often worsens over time, leading to more severe consequences for the individual and their loved ones.

Understanding these misconceptions is important for recognizing the true nature of gambling addiction and ensuring that those affected receive the appropriate support and treatment.

Public Health Concerns of Gambling Disorder

Gambling disorder is increasingly recognized as a significant public health concern due to its widespread impact on individuals, families, and communities. This condition affects not only the mental and physical health of those directly involved but also has broader societal implications.

A primary concern is the financial strain gambling disorder places on individuals and their families, often leading to debt, bankruptcy, and poverty. This financial instability frequently results in increased reliance on social services and welfare programs, adding to the burden on public resources. According to the National Council on Problem Gambling (NCPG), the social costs of problem gambling in the U.S. are estimated at approximately $7 billion annually, encompassing healthcare expenses, criminal justice involvement, and lost productivity.

Gambling disorder is also associated with severe mental health concerns, including depression, anxiety, and suicidal ideation. The risk of suicide is notably higher among individuals with gambling problems, with studies showing that around 16% of those affected attempt suicide, compared to 0.7% of the general population. The co-occurrence of gambling disorder with other addictive behaviors, such as substance abuse, further complicates treatment and escalates healthcare costs.

The disorder’s ripple effects extend to communities, contributing to increased crime rates, including theft and fraud, as individuals may resort to illegal activities to support their gambling habits. Additionally, the disorder’s impact on families, including domestic violence and child neglect, highlights the need for comprehensive public health strategies.

Addressing gambling disorder as a public health concern requires coordinated efforts across healthcare, social services, and regulatory frameworks. If you or a loved one is struggling with gambling addiction, Encore Outpatient Services in Arlington, VA, offers specialized treatment programs designed to provide the support and care needed for recovery. Contact Encore Outpatient Services today to learn more about how we can help.