Gambling disorder is a behavioral addiction characterized by persistent and recurrent problematic gambling behavior that causes significant distress or impairment. It is recognized as a mental health condition in the DSM-5 and affects millions of people worldwide, with devastating impacts on finances, relationships, and overall well-being.
Table of Contents
- What is Gambling Disorder?
- Types of Gambling
- Signs and Symptoms
- Causes and Risk Factors
- Diagnosis
- Effects of Gambling Disorder
- Treatment Options
- Recovery and Relapse Prevention
- Helping Someone with Gambling Disorder
- Resources and Support
What is Gambling Disorder?
Definition
Gambling disorder is defined by:
- Persistent, problematic gambling despite negative consequences
- Loss of control over gambling behavior
- Increasing priority given to gambling over other activities
- Continuation despite harm to self or others
Key Statistics
| Statistic |
Data |
| US adults with gambling disorder |
1-2% |
| Problem gamblers (less severe) |
2-3% |
| Global prevalence |
0.4-2% |
| Online gambling growth |
Rapid increase since 2020 |
| Suicide risk |
Higher than general population |
| Financial impact |
Often substantial debt (US surveys report averages in the tens of thousands of dollars) |
Gambling Disorder in DSM-5
In 2013, gambling disorder was reclassified from "Impulse Control Disorder" to "Substance-Related and Addictive Disorders" - recognizing it as an addiction similar to substance use disorders.
Types of Gambling
Common Forms
| Type |
Description |
Risk Level |
| Casino gambling |
Slots, table games, poker |
High |
| Sports betting |
Online and in-person |
High (growing rapidly) |
| Lottery/scratch cards |
State lotteries, scratch-offs |
Moderate |
| Online gambling |
Virtual casinos, poker, betting |
Very High |
| Horse/dog racing |
Track betting |
Moderate-High |
| Bingo |
Traditional and online |
Lower |
| Stock market/day trading |
High-risk trading |
High |
| Fantasy sports |
Daily fantasy leagues |
Moderate-High |
| Cryptocurrency trading |
Speculative trading |
High |
High-Risk Characteristics
Gambling types with higher addiction potential:
- Fast pace (slots, online)
- Easy access (mobile apps)
- Variable rewards (unpredictable wins)
- Near misses (almost winning)
- Social elements (poker, fantasy sports)
Signs and Symptoms
Diagnostic Criteria (DSM-5)
4 or more of the following in 12 months:
| Criterion |
Description |
| 1. Tolerance |
Needing to gamble with more money for same excitement |
| 2. Withdrawal |
Restless or irritable when trying to stop |
| 3. Loss of control |
Unable to cut down or stop |
| 4. Preoccupation |
Constantly thinking about gambling |
| 5. Escape |
Gambling to avoid problems or relieve stress |
| 6. Chasing losses |
Trying to win back money lost |
| 7. Deception |
Lying about gambling extent |
| 8. Illegal acts |
Committing fraud, theft to fund gambling |
| 9. Risked relationships |
Jeopardizing relationships, job, education |
| 10. Bailouts |
Relying on others for financial rescue |
Behavioral Warning Signs
| Sign |
Description |
| Secretive behavior |
Hiding gambling activity |
| Financial problems |
Unexplained debts, borrowing money |
| Time disappearance |
Missing time, unexplained absences |
| Mood changes |
Irritability, anxiety, depression |
| Neglect |
Ignoring responsibilities, relationships |
| Chasing |
Trying to win back losses |
| Increasing bets |
Gambling larger amounts |
| Failed attempts to stop |
Multiple unsuccessful efforts |
Emotional Signs
- Excitement when gambling
- Anxiety when not gambling
- Guilt and shame after gambling
- Depression about losses
- Hopelessness about situation
- Defensiveness when confronted
Causes and Risk Factors
Biological Factors
| Factor |
Description |
| Genetics |
Higher risk if family member has addiction |
| Brain chemistry |
Dopamine dysregulation |
| Reward system |
Altered response to rewards |
| Age |
Younger age of first gambling increases risk |
Psychological Factors
| Factor |
Description |
| Impulsivity |
Difficulty controlling urges |
| Depression |
Gambling as escape |
| Anxiety |
Gambling to relieve tension |
| ADHD |
Higher rates of gambling disorder |
| Personality |
Higher risk-taking, sensation-seeking |
| Cognitive distortions |
Illusion of control, gambler's fallacy |
Social/Environmental Factors
| Factor |
Description |
| Accessibility |
Easy access to gambling |
| Advertising |
Exposure to gambling marketing |
| Social norms |
Gambling accepted in social circle |
| Early exposure |
Childhood exposure to gambling |
| Trauma |
History of adverse experiences |
| Stress |
Major life stressors |
The Addiction Cycle
┌─────────────────────────────────────────────────────────────────┐
│ GAMBLING ADDICTION CYCLE │
├─────────────────────────────────────────────────────────────────┤
│ │
│ ┌──────────────────────────────────────────┐ │
│ │ │ │
│ │ ANTICIPATION │ │
│ │ "I'm going to win big tonight" │ │
│ │ │ │
│ └────────────────┬─────────────────────────┘ │
│ │ │
│ ▼ │
│ ┌──────────────────────────────────────────┐ │
│ │ │ │
│ │ ACTION │ │
│ │ Gambling behavior occurs │ │
│ │ │ │
│ └────────────────┬─────────────────────────┘ │
│ │ │
│ ▼ │
│ ┌──────────────────────────────────────────┐ │
│ │ │ │
│ │ CONSEQUENCES │ │
│ │ Financial loss, guilt, shame │ │
│ │ │ │
│ └────────────────┬─────────────────────────┘ │
│ │ │
│ ▼ │
│ ┌──────────────────────────────────────────┐ │
│ │ │ │
│ │ CHASING/ESCAPE │ │
│ │ "I need to win it back" or escape │ │
│ │ │ │
│ └────────────────┬─────────────────────────┘ │
│ │ │
│ └──────────────► Back to top │
│ │
└─────────────────────────────────────────────────────────────────┘
Diagnosis
Screening Tools
| Tool |
Description |
| NODS (NORC DSM Screen) |
17-item screening tool |
| SOGS (South Oaks Gambling Screen) |
20-item questionnaire |
| PGSI (Problem Gambling Severity Index) |
9-item assessment |
| Lie/Bet Questionnaire |
Brief 2-item screen |
Severity Specifiers
| Severity |
Criteria |
| Mild |
4-5 criteria met |
| Moderate |
6-7 criteria met |
| Severe |
8-9 criteria met |
Common Comorbidities
| Condition |
Prevalence in Gambling Disorder |
| Depression |
30-50% |
| Anxiety disorders |
20-40% |
| Substance use disorders |
30-50% |
| ADHD |
15-25% |
| Personality disorders |
20-30% |
Effects of Gambling Disorder
Financial Impact
| Consequence |
Description |
| Debt |
Frequently substantial; averages in the tens of thousands of dollars in US surveys |
| Bankruptcy |
Higher rates than general population |
| Asset loss |
Homes, cars, savings |
| Theft/fraud |
Legal consequences |
| Credit damage |
Long-term financial impact |
Relationship Impact
- Trust breakdown
- Financial strain on family
- Neglect of partner and children
- Conflict and arguments
- Separation and divorce
- Domestic violence (increased risk)
Mental Health Impact
| Effect |
Description |
| Depression |
Very common |
| Anxiety |
High rates |
| Suicidal thoughts |
~1 in 5 problem gamblers report a suicide attempt (clinical studies estimate 12-24%; National Council on Problem Gambling) |
| Shame and guilt |
Persistent negative emotions |
| Isolation |
Withdrawal from support |
Physical Health Impact
- Sleep disturbances
- Stress-related illness
- Substance use
- Neglect of health
- Higher mortality rates
Treatment Options
Psychotherapy
Cognitive Behavioral Therapy (CBT)
Most effective treatment:
| Component |
Description |
| Cognitive restructuring |
Challenge gambling beliefs |
| Trigger identification |
Recognize high-risk situations |
| Coping skills |
Alternative responses to urges |
| Relapse prevention |
Strategies to maintain recovery |
| Financial management |
Budgeting, limiting access |
Other Therapies
| Therapy |
Description |
| Motivational Interviewing |
Enhance motivation to change |
| Gamblers Anonymous |
12-step peer support |
| Family therapy |
Address relationship impact |
| Impulse control training |
Manage urges |
Medications
| Medication |
Evidence |
| Naltrexone |
Some evidence for reducing urges |
| Antidepressants |
For comorbid depression |
| Mood stabilizers |
Limited evidence |
| N-acetylcysteine |
Emerging evidence |
Note: No FDA-approved medication specifically for gambling disorder.
Self-Exclusion Programs
| Program |
Description |
| Casino self-exclusion |
Ban from physical casinos |
| Online self-exclusion |
Block from gambling sites |
| GamStop/Gamban |
Apps to block gambling |
| Bank restrictions |
Block gambling transactions |
Recovery and Relapse Prevention
Recovery Strategies
| Strategy |
Description |
| Avoid triggers |
Stay away from gambling venues, apps |
| Financial controls |
Give control of money to trusted person |
| Alternative activities |
Replace gambling with healthy activities |
| Support network |
Connect with others in recovery |
| Stress management |
Develop healthy coping skills |
| Routine |
Structure daily activities |
Warning Signs of Relapse
- Thinking about gambling more frequently
- Justifying "just one bet"
- Spending time with gambling friends
- Financial stress triggering urges
- Emotional distress without coping skills
- Isolation from support
Relapse Prevention Plan
┌─────────────────────────────────────────────────────────────────┐
│ RELAPSE PREVENTION PLAN │
├─────────────────────────────────────────────────────────────────┤
│ │
│ 1. IDENTIFY TRIGGERS │
│ • Stress, boredom, loneliness │
│ • Financial problems, advertisements │
│ │
│ 2. WARNING SIGNS │
│ • Thoughts about gambling │
│ • Justifying "small" bets │
│ • Emotional distress │
│ │
│ 3. COPING STRATEGIES │
│ • Call support person: ________________ │
│ • Go to meeting │
│ • Engage in alternative activity │
│ • Use self-exclusion tools │
│ │
│ 4. EMERGENCY CONTACTS │
│ • Therapist: ________________ │
│ • Sponsor: ________________ │
│ • Helpline: 1-800-522-4700 │
│ │
└─────────────────────────────────────────────────────────────────┘
Helping Someone with Gambling Disorder
Signs Someone May Have a Problem
- Borrowing money frequently
- Unexplained financial problems
- Secretive about finances
- Mood swings related to wins/losses
- Missing important events to gamble
- Lying about whereabouts
How to Help
| Do |
Don't |
| Express concern without judgment |
Lecture or criticize |
| Listen to their perspective |
Enable by paying debts |
| Encourage professional help |
Make excuses for them |
| Set boundaries around money |
Take over their responsibilities |
| Protect your own finances |
Expect immediate change |
| Learn about gambling disorder |
Blame yourself |
Setting Boundaries
- Don't lend money or pay gambling debts
- Don't lie for them or cover up
- Protect joint finances
- Set clear expectations
- Follow through on consequences
Resources and Support
Helplines
| Resource |
Contact |
| National Problem Gambling Helpline |
1-800-522-4700 (24/7) |
| National Council on Problem Gambling |
ncpgambling.org |
| Gamblers Anonymous |
gamblersanonymous.org |
| Gam-Anon (for family) |
gam-anon.org |
Online Resources
- GamStop - Self-exclusion program
- Gamban - Gambling blocking software
- BetBlocker - Free blocking tool
- NCPG - National Council on Problem Gambling
Related Resources
- Depression - Often co-occurs
- Anxiety - Common comorbidity
- Substance Use Disorders - Related addiction
Key Takeaways
- Gambling disorder is an addiction - Not a moral failing
- Recovery is possible - Effective treatments exist
- Financial protection is essential - Limit access to money
- Support matters - Professional help and peer support
- Comorbidities are common - Address underlying issues
- Relapse is part of recovery - Have a prevention plan
- Family support helps - But protect your own well-being
References
- American Psychiatric Association. (2022). DSM-5-TR.
- National Council on Problem Gambling. (2024).
- Petry, N. M., Blanco, C., Stinchfield, R., & Volberg, R. (2013). An empirical evaluation of the proposed DSM-5 gambling disorder criteria. Addiction, 108(3), 575-581.
- World Health Organization. (2024). Gaming and Gambling Disorders.
Last updated: 2026-03-24
Important Disclaimer
This page is for informational and educational purposes only. It is not medical advice, and it is not a substitute for professional diagnosis or treatment. If you are experiencing mental health difficulties, please consult a qualified healthcare professional. If you are in crisis, contact your local emergency services or a crisis helpline immediately.