When people think of addiction, it is often with regards to substance use, but there are addictions which do not involve substances that can take over people’s lives. Gambling addiction, while it may not be as physically obvious at a first glance, is a legitimate addiction that can cause significant hardship for people. From a diagnostic standpoint, it is defined as “persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:
Needs to gamble with increasing amounts of money in order to achieve the desired excitement
Is restless or irritable when attempting to cut down or stop gambling
Has made repeated unsuccessful efforts to control, cut back, or stop gambling
Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble)
Often gambles when feeling distressed
After losing money gambling, often returns another day to get even (“chasing one’s losses”)
Lies to conceal the extent of involvement with gambling
Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling
Relies on others to provide money to relieve desperate financial situations caused by gambling” (Diagnostic and Statistical Manual of Mental Disorders, 2013, p. 585).
People with this diagnosis may have distortions of thinking such as denial or a belief that they have control over the outcome of a chance event. Money is viewed as being the way out of the mess as well as the cause of the mess. The disorder is not defined by a specific money wagering amount, meaning that someone with a lot of extra money can gamble away thousands of dollars a month and not have it significantly impair them, but someone else may be losing much less money and be facing more hardship as a result. In terms of causal factors, both genetics and environment seem to play a role.
Some of the functional consequences of this disorder are loss of important relationships, employment issues, and negative impact on educational endeavors. An interesting fact is that people with gambling disorder tend to be in poorer health and tend to use medical services at higher rates than the average population rate (Diagnostic and Statistical Manual of Mental Disorders, 2013, pp. 587-589). For a long time, gambling disorder was classified by the DSM as an impulse control disorder, but in 2013 it was changed to a substance-related and addictive disorder ("Science of Addiction," 2019, p. 24).
Gambling is linked to the function of the reward system in the brain. When one gambles, the brain’s reward system is activated, and dopamine, a chemical messenger in the brain that is associated with pleasure, is released. With continued gambling, the brain can build up a tolerance to the dopamine that gets released during gambling, making it necessary for people to take bigger risks in order to get that same level of dopamine in the brain. The brain can become dependent on it in the same way that one gets addicted to a substance. People can even experience withdrawal symptoms when they stop gambling if they have become addicted to it. Studies have found that there are two main areas in the brain that are linked to gambling habits. These are the prefrontal cortex, which is associated with planning and problem solving, and the ventral striatum, which handles rewards and emotions such as happiness. People with addictions such as gambling disorder or substance use disorder have a strengthened connection to the reward system, ventral striatum, and decreased activity in the planning and problem solving part of the brain, the prefrontal cortex. This explains why people can become increasingly dependent on a high-reward behavior that they have trouble controlling or stopping. These brain systems tend to be under-active in people that have gambling disorders, which makes sense from the standpoint that since these systems, such as the reward system, are under-active, gamblers engage in more extreme behavior to try to make up for that deficiency. While it may seem like gamblers are focused on money, the driving factor is the reward response and related systems in the brain ("How gambling affects your brain," n.d.).
References
Diagnostic and Statistical Manual of Mental Disorders (5th ed.). (2013). American Psychiatric Association.
How gambling affects your brain. (n.d.). Gateway Foundation. https://www.gatewayfoundation.org/addiction-blog/how-gambling-affects-brain/
The Science of Addiction. (2019). Time Magazine.
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