Gambling is an activity whereby something of value (money, merchandise, services) is risked on the outcome of an event that has a random probability of occurring. It can take the form of lottery, casino games (e.g. blackjack and slots), sports betting, and more. People who gamble can develop problems if they place bets with money that they cannot afford to lose, or with an amount that will affect their financial situation negatively. Problem gambling can have a number of negative effects on the individual’s life, including poor relationships, health, work performance, and legal issues.
While some people can enjoy gambling as a recreational activity, for others it is addictive and a source of great distress and problems. It can cause debt and bankruptcy, destroy family relationships, harm a person’s career prospects, and even lead to suicide. Problem gambling is a major public health issue, and many people struggle to recognise the symptoms.
There is a range of treatments available for problem gamblers, such as cognitive-behavioral therapy and psychotherapy. CBT teaches people to challenge irrational beliefs and behaviours, such as the belief that a sequence of losses or near misses (such as two out of three cherries on a slot machine) will eventually change into a win. Psychotherapy can help people recognise and deal with the underlying problems that are causing them to gamble, such as anxiety or depression.
Psychiatrists are trained to assess the level of problem gambling and can offer help and support. Those who are particularly serious about their addiction may be offered treatment in a residential facility, which can also help them to overcome irrational beliefs and behaviours that are contributing to their gambling addiction.
Many studies have been conducted into the impacts of gambling, both positive and negative. These impacts can be categorized into personal, interpersonal, and community/society levels (see diagram below). Personal and interpersonal level impacts are mostly non-monetary in nature and include invisible costs to the gambler themselves, such as their reduced quality of life.
Unlike some other addictions, such as substance abuse, pathological gambling is not recognised by the World Health Organisation as a mental illness, and is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, a growing body of research shows that it is an addictive behavior, and should be treated as such. This includes a move to reclassify it as a behavioural addiction in the DSM-5, and recognition that it can affect all ages and genders. This change in classification is based on the scientific evidence that the neurobiology of gambling is similar to that of other addictions, including drug abuse. In addition, the social and psychological consequences of the addiction are similar to other social and emotional disorders such as depression and anxiety. The DSM-5 changes will be implemented in 2021. It is expected to improve the way psychiatrists recognize and treat problem gambling. It will also make it easier for researchers to collaborate internationally.