Although gambling does not produce the cognitive or physical impairment associated with alcohol or drug abuse, an obsession with gambling can be just as devastating. Compulsive gambling can destroy social, personal and occupational or educational performance.
Compulsive gambling is considered a form of addiction. The term addiction is usually reserved to explain a compulsive attraction or pathological attachment to a substance, normally a drug. However, we now recognize that some behaviors can be addicting, such as eating, sex and gambling. All addiction is characterized by loss of control, preoccupation, compulsivity, narrowing of interests, dishonesty, guilt and chronic relapse.
Addictions to behavioral processes are called process addictions. The process of engaging in these behaviors leads to typical addiction symptoms (withdrawal, tolerance, heightened excitement or euphoria).
Process addictions are more common among children of alcoholics or addicts, recovering alcoholics or addicts, or current alcoholics or addicts. Like other addictions, in many cases there are no correlations with high-risk situations or historyit just happens.
When people describe their subjective experience related to gambling or other process addictions, their stories are qualitatively similar to users’ descriptions of their drug addictions. Compulsive gamblers indicate that they seek being in action, referring to the “high” or euphoric state associated with the act of gambling. Gamblers also describe the anticipated high or “rush” prior to being in action.
The description of these aroused states is remarkably similar to that described by cocaine addicts. A study involving 298 cocaine abusers found that a diagnosis of compulsive gambling could be made in 15 percent of the population19 percent of the males and 5 percent of the females. This is about five to seven times the rate expected in the general population.
Course of Gambling Addiction
The course of the gambling and process addictions is remarkably similar to that of drug addiction or alcoholism. Some divide pathological gambling into four phases: winning, losing, desperation and helplessness.
The early or winning phase is similar to the learning phase of a substance addict where the high is fun and the consequences minimal or nonexistent. As the disease progresses, there is a marked narrowing of interests as the gambler becomes preoccupied with gambling and obtaining money to gamble.
Home life and interpersonal relationships are affected as the gambler lies and covers up losses and is careless about the welfare of his family. Interests narrow to gambling and planning to gamble. There are often “bailouts,” where the family members lend the gambler money to pay off debts. This is akin to enabling behavior seen in families of alcoholics and addicts. Finally, as the gambler becomes alienated from family and friends, helplessness, demoralization, divorce, suicidal thoughts and other catastrophic consequences occur as the gambler hits bottom.
Phases of Compulsive Gambling
Compulsive gamblers go through the following four phases:
Phase 1: Winning phase
- more common in “action seekers” (usually men) than escape gamblers (usually women)
- initially occasional gambling followed by more frequent gambling
- big win
- increasing bet amount
- unreasonable optimismfeeling of omnipotence
- big shotbrags about winning while minimizing losses
- lasts months to years
Phase 2: Losing phase (“the chase”)
- often begins with unpredictable losing streak
- can’t stop gambling (“chasing”)
- borrows money (bailouts)
- covering-up, lying
- home and work life affected
- spouse, even if aware of gambling, usually unaware of extent of debt incurred
- personality changesirritable, restless and withdrawn
Phase 3: Desperation phase
- often begins with gambling away funds from a bailout that were supposed to pay debts
- options decrease
- illegal or immoral acts (e.g., fraud, embezzlement, writing bad checks)
- reputation affected
- alienation from family and friends
- most common time for seeking help “hitting bottom”
Phase 4: Helplessness
- suicide thoughts and attempts (15 to 25 percent prevalence rate of suicide)
- major depression
- co-morbid substance abuse
- emotional breakdown