Gambling Pain
- “For women, gambling soothes them and numbs pain,” says Dr Henrietta Bowden-Jones, founder and director of the National Problem Gambling Clinic. “Sometimes they begin gambling as a result of.
- Gambling disorder involves repeated problematic gambling behavior that causes significant problems or distress. It is also called gambling addiction or compulsive gambling. For some people gambling becomes an addiction — the effects they get from gambling are similar to effects someone with alcoholism gets from alcohol.
There are many possible causes of pain in the hands or wrists, including injuries, repetitive strain, cysts, and arthritis. Some home remedies may help relieve the discomfort, but a person should. “Compulsive gambling leads to an addiction, which is a psychological symptom that is well-understood and treatable with psychotherapy oriented toward that understanding. It is not a biological, genetic or moral issue, and it is not fundamentally different from other compulsive behaviors or addictions.”.
Medically reviewed:06/22/2018
Last updated: 04/17/2020
Author: Addictions.com Medical Review
Reading Time: 7minutes
What is Gambling Addiction?
Gambling addiction or gambling disorder is defined as persistent and recurring problematic gambling behavior that causes distress and impairs your overall livelihood. Gambling addiction affects roughly 0.2% to 0.3% of the general U.S. population, and tends to affects males more than females, though this gender gap has narrowed in recent years. Gambling disorder is a behavioral addiction that can be effectively treated using a range of cognitive and behavioral therapies.
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The desire to buy scratch tickets, play slot machines, and visit casinos aren’t necessarily signs of gambling addiction. But when the desire to gamble becomes overwhelming to the point you can’t stop thinking about it until you gamble on something, may be a sign you need help. Those who suffer from gambling addiction will continue to gamble despite negative financial, legal, and social consequences.
Gambling disorder is a brain disease that can cause you to do things you wouldn’t normally do if you weren’t suffering from addiction. Behavioral addictions like gambling disorder are often difficult to manage and control without getting professional help. Addiction treatment centers can help you overcome gambling addiction and teach you important skills aimed at helping you repair problems in your life caused by your disorder.
What are the Signs and Symptoms of Gambling Addiction?
There are no physical health symptoms associated with gambling disorder. Familiarizing yourself with common gambling addiction behaviors can clue you into whether you or a loved one may need professional help.
Chasing after losses is the most common tell-tale sign of gambling disorder. This particular symptom is marked by the urgent need to continue gambling to earn back a loss or series of losses. Individuals diagnosed with gambling disorder may abandon their usual gambling strategies to win back all losses at once and may lie to family, friends, and therapists to hide the severity of their addiction.
The following behaviors are potential signs of gambling addiction:
- Needing to gamble using increasing amounts of money to achieve the desired rush and excitement.
- Feeling restless or irritable when trying to reduce or stop gambling.
- Inability to control, reduce, or quit gambling despite numerous repeated attempts.
- Preoccupation with gambling, such as devising ways to get more gambling money and reliving past gambling experiences.
- Gambling when experiencing feelings of distress, helplessness, guilt, anxiety, and depression.
- Chasing after your losses to get even after losing money gambling.
- Lying to conceal the severity of gambling behaviors, and the addiction.
- Loss of personal relationships, job, and educational pursuits due to gambling.
- Replying on others to provide money to resolve financial situations caused by gambling, such as a threat of eviction from the home.
Those with a mild gambling addiction may exhibit between four and five of these behaviors, while those with a moderately severe gambling addiction may exhibit six to seven of these behaviors. People who suffer from severe gambling addiction will usually exhibit all nine behaviors. Moderate to severe cases of gambling disorder tend to be more common than mild cases.
You might have a gambling problem if:
- You feel compelled to keep gambling until you’ve spent your last dollar. You may keep bidding until you’ve spent everything to win your money back, or you continue increasing bet amounts.
- You hide your gambling from friends or family members. You may sneak off to gamble without telling anyone, or lie about your gambling activities.
- You spend money you don’t have on gambling. You may use money intended for important bills like rent, mortgage, car payments, credit card bills, and other expenses for gambling.
- You steal from others or sell your possessions so you can gamble. You may steal money or belongings from others so you can gamble, or sell or pawn valuable possessions like musical instruments and vehicles to obtain more gambling money.
- You prioritize gambling over obligations related to work, school, family. You may stop going to work or school so you can gamble, or stop buying household necessities so you can use the money for gambling instead.
- You’re experiencing financial hardships due to gambling. You may have lost your home, car, job, and important personal possessions due to gambling.
- You’re facing a range of negative emotions triggered by gambling. Gambling may be a serious problem in your life if it’s triggering depression, anxiety, frustration, agitation, and remorse.
- You want to stop gambling but can’t. You have tried to stop gambling but can’t seem to stop despite your desire to do better and to stop gambling.
Negative Effects of Gambling Addiction
Gambling addiction can produce many more negative effects than just financial hardship. Gambling disorder can affect your physical health, mental health, and social functioning, and lead to the loss of important relationships with friends and loved ones. You may also suffer a decline in work or school performance, and feel more restless and bored with all other areas of life that don’t involve gambling.
Those who suffer from gambling addiction tend to suffer from higher rates of poor general health than those who don’t gamble. Tachycardia and angina are common health problems among those diagnosed with gambling addiction. Many who suffer from gambling disorder also tend to experience distortions in thinking surrounding their addiction, such as superstitions, overconfidence, and a sense of power over the outcome of chance events. Nearly 50% of those receiving treatment for gambling disorder experience suicidal ideation, while an estimated 17% have tried to commit suicide.
The negative effects of problem gambling include:
- Financial problems including high debt, poverty, or bankruptcy
- Domestic violence and child abuse in families
- Suicidal thoughts, attempts, or the act of suicide
- Legal troubles, including arrests for theft or prostitution
- Behavior problems in children of problem gamblers
- Depression, anxiety, and other mental health disorders
- Loss of relationships with friends and family
- A decline in performance at work or school
- Suicide and death
- A risk for drug or alcohol abuse
How Does Gambling Addiction Interact with Addiction?
Alcohol and cocaine are the two most common substances associated with gambling and binge gambling, respectively. Alcohol is legally available in most gambling settings such as bars and casinos and is often rewarded to gamblers for free at many of these establishments. Roughly 44% of people with gambling disorder in the U.S. also suffer from an alcohol use disorder.
Binge gambling is defined as intermittent episodes of uncontrolled gambling after long periods of abstinence. For instance, a person who practices binge gambling may only visit the casino five times per year but gamble non-stop for long periods during their stay. Cocaine use tends to be common among these gamblers since it produces stimulating effects of increased energy, alertness, focus, concentration, and confidence.
Individuals with gambling disorders tend to suffer higher rates of co-occurring alcohol and drug use disorders compared to their peers. Gambling often takes place in environments that enable and encourage alcohol and drug use. Gambling can also trigger mental health conditions like anxiety and depression, which many may self-treat using alcohol and drugs like marijuana, painkillers, and other addictive substances.
How Are Gambling Addiction and Substance Use Treated?
Gambling Paint
Gambling addiction is commonly treated using cognitive and behavioral therapies that treat the root psychological causes of your addiction. These therapies also help you identify and change negative, unhealthy thoughts and behaviors that may have led to your gambling addiction. Treatments for gambling addiction can be tailored especially for you or your loved one based on the factors surrounding your disorder.
Gambling addiction can also be treated using community reinforcement, group therapy, and 12-step support groups like Gamblers Anonymous. These treatments help you identify your triggers that can lead to gambling and teach you ways to overcome and manage those triggers. For instance, if a stressful day at work usually makes you feel like gambling, you may learn yoga, deep breathing, or other healthy methods that relieve stress without putting your health and well-being at risk.
Gambling Addiction Help
If you or someone you love needs treatment for gambling addiction, it’s important that you use a treatment approach that best suits your recovery needs. Gambling addiction treatment is available in many different settings, including inpatient and outpatient treatment settings.
Inpatient gambling addiction treatment can greatly benefit those who suffer from severe gambling disorder, and who have suffered severe financial, legal, or social problems. Inpatient treatment includes around-the-clock supervision in a hospital-like setting where you can live for the duration of your treatment program. The intense level of therapy, counseling, and supervision provided by inpatient treatment centers can help significantly reduce the risk of relapse while in recovery.
Compulsive gamblers often need support from friends, family members, and peers to help them stop gambling. Gamblers Anonymous groups can provide peer and social support for those in recovery or for those who wish they can stop gambling. These groups can provide a solid, healthy foundation for a successful and long-term recovery from gambling addiction.
Here’s how to help a family member or loved one suffering from a gambling addiction:
- Understand the addiction. The first thing you can do to help a loved one who is addicted to gambling is to learn all you can about the addiction. Find a support group that can help you cope with the stress that comes from having a loved one who is addicted to gambling.
- Find support. Support for yourself and for your loved one who is addicted can be very beneficial in helping with a gambling addiction. Many support groups are available throughout communities and in treatment centers. Therapists and counselors can also provide support for gambling addiction.
- Manage money tightly. If your loved one is addicted to gambling and is actively pursuing help, take over managing all financial responsibilities for your loved one. This can help reduce any gambling impulses your loved one may be experiencing throughout their recovery.
By Colin Hodgen, Ph.D.
Gambling Disorder is recognized in the U.S. as an addictive disorder. Indeed, it is currently the only Addictive Disorder listed in the Diagnostic and Statistical Manual, 5th edition (DSM-5, 2013) published by the American Psychiatric Association (APA).
But, what is gambling disorder exactly? What drives a gambling behavior in problem gamblers? Expert Colin Hodgen explores more here in this article. Then, we invite your questions at the end. In fact, we try to respond to all questions personally and promptly.
What is a gambling disorder?
Previously classified as an Impulse Control Disorder, “Gambling Disorders” are now seen as a behavioral or process addiction with 4 core features. As explained by Dr. Jon Grant of the University of Chicago, these core features are:
Gambling Man Paint Horse
- repetitive or compulsive engagement in a behavior despite adverse consequences;
- diminished control over the problematic behavior;
- an appetitive urge or craving state prior to engagement in the problematic behavior; and
- hedonic [pleasurable] quality during the performance of the problematic behavior.
The long term effects of gambling disorder are often observed as:
- Tolerance
- Withdrawal
- Repeated unsuccessful attempts to cut back or stop
- Impairment in major areas of life functioning
In other words, gambling is something we continue to do, over and over, even if it causes problems in our lives. We are no longer able to consistently decide when we will or will not gamble, and if we do gamble, we can’t consistently decide when we will or will not stop. Further, we experience sometimes overpowering urges or cravings to repeat the behavior, and that behavior provides a sense of pleasure, relief, or release in the moment, thereby reinforcing the behavior. This behavior must be repeated and completed to reduce chronic anxiety. Over time, we experience clinically significant impairment or distress in our daily lives at home, school, or work.
Why do people gamble?
Gambling behavior is often separated into two categories: action and escape.
a) Action – Some people seem to gamble for the excitement.
b) Escape – Others tend to gamble to “get away from it all.”
The American Society of Addiction Medicine (ASAM) terms these behavior syndromes as “reward” and “relief.” If we focus on the “escape” or “relief” conditions, it becomes apparent that many gamblers are seeking some sort of pain relief, some reduction in the stress, pain, or anxiety in their lives, whether past or present.
- Numbing pain – Gambling activity becomes a way of “numbing” the acute/chronic pain and can lead into addiction. This numbed condition makes it very difficult for the individual or the treatment provider to connect with and/or resolve the underlying trauma and consequent pain.
- Relieving anxiety – In general, many gamblers engage in the behavior to reduce or relieve a cumulative condition of anxiety. This anxiety state can arise from or lead to chronic psychic pain and cognitive dissonance. Chronic anxiety can be a result of earlier life trauma or persistent excitation of the “fight-or-flight” response within the limbic system of the brain. A brain in chronic pain will often go to desperate measures to reduce or avoid continued pain.
- Coping with trauma – The brain pain is both acute and chronic. The acute state arises from the immediate circumstances of the gambler; the chronic state often is a residue of long-term, perhaps early childhood, trauma.
Over time, the gambler exhausts the repertoire of available coping responses, and is left with a dysfunctional, ineffective, and increasingly harmful set of behaviors and emotional responses. This history of trauma can lead to long-term effects on the brain and its function, through a process of adaptive learning or neuroplasticity.
The brain of gambling addicts
We need to understand brain function to address a gambler’s behavior and plan for recovery. Let’s take a brief look at what goes on in the brain, from the inside out, before taking a brief look at treatments that can be helpful in dealing with the immediate and long-term remediation of the effects of gambling disorder.
The brain is basically an electrochemical generator of the central nervous system and it regulates our thoughts, feelings, and actions. To do so, our brain generates and regulates various neurotransmitting chemicals. Here are five (5) primary neurotransmitters and their associated activities:
When the primary neurotransmitters Dopamine, Serotonin, and Norepinephrine are in balance, we see well-ordered mood and behavior:
Deficits in one or more of these chemicals (shown in italics) cause imbalances, and we see disordered mood and behavior:
Most of these mood states will be familiar to those with addictive behaviors.
Gambling Painting
A particular combination of neurotransmitter deficits contributes to the distress of the gambler, specifically combined deficits in Dopamine and Serotonin which contribute to the hybrid state of Depression and Craving experienced by most individuals with Gambling Disorder.
Impulsivity in the problem gambler
What may seem to be impulsivity in the compulsive gambling is often also a characteristic of both anxiety and a need for anxiety reduction. Problem gamblers will often present with symptoms of co-occurring Anxiety and/or Depression and will have concurrent difficulty with Impulse Control.
Glutamate and dopamine in the brain
Much of what we know about addictive behaviors relates to dopamine dysregulation, and is often associated with the effects of GABA and Glutamate on dopamine. Glutamate is an excitatory chemical and motivates behavior; GABA is an inhibitory chemical and deters or defers behavior.
Below we see two examples of the interaction of Glutamate and Dopamine, first where Glutamate from the PreFrontal Cortex motivates a pleasurable behavior associated with Dopamine. In the second example, Glutamate triggers GABA to inhibit disordered pleasurable behavior associated with Dopamine:
Psychotropics may not be the best gambling disorder treatment
Oftentimes, individuals, and the primary care physicians and mental health professionals who deal with them, attempt to diagnose and treat the mood/behavioral symptoms (anxiety, depression, sleep disturbance, etc.) without examining the underlying addictive conditions which produce these symptoms. Sadly, from a medication-based perspective, the use of psychotropics may cause more problems than they relieve.
Recently, in fact, the onset of troublesome compulsive behaviors such as compulsive gambling, compulsive shopping, and hypersexual behaviors have been associated with medications such as Mirapex and Abilify, side effects which were not anticipated or sometimes even associated with the medication. This is not to say that appropriate psychopharmacology cannot help reduce the distress of a problem gambler.
Chronic Pain Gambling Problem
However, great care should be used when attempting to address addictive behaviors solely through use of psychotropic medications.
Well, then, what can we do?
Treatments for gambling problems
Cognitive Behavioral Therapy (CBT) – This type of therapy is associated with good outcomes in treatment of addictive disorders and is also associated with better outcomes in long-term recovery. Generally, CBT targets improving the gambler’s “executive functioning,” that is, planning, cognitive flexibility, and inhibition responses. It involves a Functional Analysis of an individual’s Antecedents or triggers, the subsequent Behaviors, and the resultant Consequences. Over time, the gambler is better able to choose more appropriate and effective behaviors and begins to experience more positive Consequences.
Gambling Pain
Neurolinguistic Programming (NLP) – Another useful and effective approach involves Neurolinguistic Programming (see Dr. Janice Walton’s April 26,2016 article, “NLP Strategies Counselors Can Use When Treating Addictive Behavior” on Addiction Blog. This therapeutic approach also addresses thinking, behavior, and executive functioning. In the absence of co-occurring mental health disorders, this approach can be quite effective with behavioral/process disorders as well as substance-related disorders.
Alternative gambling treatments – For additional information on treatment alternatives, please see an earlier Addiction Blog entry, Jaime Costello’s article, “How to quit gambling: Alternatives for recovery” .
For additional insights into Gambling Disorder, please see any of the other Bybee Initiative posts on Addiction Blog under the Compulsive Gambling category. For more extensive examination of the neurobiology of addictive disorders, see Neurobiology of Addiction (Koob & Le Moal, 2005).
The nature of gambling disorder
Gambling Disorder, and similar process/behavioral disorders, can often resemble substance-related disorders. Many of the components of traditional substance-related disorders can be customized for use in treatment. After all, we’re dealing with the effects of chemicals on brain function. In the case of Gambling Disorder, these are Endogenous (internal source) chemicals (Dopamine, Serotonin, etc.) rather than Exogenous (external source) chemicals such as alcohol, opioids, or stimulants.
Whatever the source, and whatever the etiology of the disorder, individuals, families, and communities suffer the effects and consequences of Gambling Disorder. This disorder is uniquely insidious, a “hidden addiction,” since there are no immediate biochemical tests for the disorder. Oftentimes the disorder and the damage only become evident after some catastrophic event. Our challenge is to stay vigilant for early indicators and early intervention. Our task is Awareness, Education, and Advocacy.
Got any questions about the brain and gambling?
Do you have any additional questions and would like to ask questions regarding the diagnosis, nature, and treatment of gambling disorder? We welcome you to post them in the comments section below. We try to answer all legitimate inquiries personally and promptly, or refer you to someone who can help.